Background: Anemia during pregnancy is a leading nutritional disorder with serious short- and long-term consequences for both the mother and the fetus

The nutritional status of women before and during pregnancy can be determined by maternal knowledge, attitudes, and perceptions towards certain foods. The present study aimed to explore maternal dietary habits, food taboos, and cultural beliefs that can affect nutrition during pregnancy in rural Arsi, central Ethiopia. A qualitative, cross-sectional study, involving 38 key informant in-depth interviews and eight focus group discussions, was conducted among purposefully selected pregnant women and their husbands, elderly people, community leaders, health workers, and agriculture office experts. Participants were selected purposefully from all the major agro-ecologic areas of the study site. Data was analyzed manually using the thematic framework analyses method. The pregnant women reported that they did not change the amount and type of foods consumed to take into account their increased nutritional need during pregnancy. The consumption of meat, fish, fruits, and some vegetables during pregnancy remained as low as the pre-pregnancy state, irrespective of the women’s income and educational status. Although not practiced by all, a number of taboos related to the intake of certain food items and misconceptions that can adversely affect nutritional status during pregnancy were identified. The most common taboos were related to the consumption of green leafy vegetables, yogurt, cheese, sugar cane, and green pepper. However, the frequency and extent of the practice varied by maternal age, family composition, and literacy level. Older mothers, from rural villages, and those with no formal education were more likely to practice the taboos than younger and educated ones. Almost all of the participants disfavored weight gain during pregnancy in fear of obstetric complications associated with the delivery of a bigger infant. Misconceptions about weight gain during pregnancy and food taboos were widespread, particularly among older and illiterate rural communities. Thus, future nutrition programs should promote diversification of both the agricultural production and consumption.

Mothers’ nutrition is crucial for good pregnancy outcomes and in improving children’s nutritional status. The present study aimed to examine the level of knowledge and attitude towards maternal nutrition and dietary diversity practices among pregnant mothers in rural central Ethiopia. In-depth analysis of data from a prospective study involving a total of 389 eligible pregnant women, enrolled during their second antenatal care (ANC) visit was conducted between August 2014 and March 2015. Study participants were selected by employing systematic sampling techniques. Dietary diversity practices were assessed by asking each individual pregnant woman to provide a single 24-h dietary recall. Simple frequencies and graphs were used to present the analyzed data and interpretations. Vegetables were listed top as major sources of vitamin A (45.5%) and iron (23.8%). Nearly half (47%) of the mothers lacked awareness on balanced and diversified diets. Conversely, nearly three fourths (73.8%) and two thirds (66.8%) of them had favorable attitudes towards dietary diversity and early initiation of antenatal care follow up. With a median dietary diversity score of four, starchy staples (100%), legumes and nuts (89.2%) were major food groups consumed by almost all of the mothers included in the study. Though pregnant mothers had limited knowledge and poor dietary diversity practices, they exhibited a relatively favorable attitude towards major nutritional recommendations. Use of antenatal care and its follow up as a point of entry for educating pregnant women and increasing nutrition knowledge and attitude is recommended.

Background. Even if remarkable progress has been made in reducing preventable child deaths worldwide, neonatal mortality reduction has remained unsatisfactory. Low birth weight (LBW) is the major risk factor for child deaths during the neonatal period, yet only 5% of babies are weighed at birth in Ethiopia. The aim of the present study was to determine the magnitude and risk of dying among low birth weight neonates in rural Gedeo, Southern Ethiopia. Methods. Community-based mixed-method approach design was employed between September and October 2016 to identify and enroll study participants in rural Gedeo, Southern Ethiopia. Records of 17,503 live birth babies, of whom 2,065 (11.8%) had LBW, born in the last 12 months were screened to identify 885 (42.8%) biological mother–LBW neonate pairs from eight health centers. The study subjects were randomly selected using a multistage stratified cluster sampling technique. Cox proportional hazards regression model was used to predict maternal and neonatal risk factors associated with the risk of neonatal death. Results. The overall neonatal mortality rate (NMR) among LBW infants was 110 per 1000 live births (95% confidence interval: 75 –228). Close to half, 374 (42.3%), of the LBW neonates died during the first week of life. The estimated hazard ratios of mortality were higher among neonates whose mothers did not attend antenatal care (ANC) (HR=1.58, 95 % CI: 1.02-2.43), gave birth by assisted or cesarean delivery (HR=1.81 and 3.72; 95% CI: 1.10 - 3.02 and 2.11-6.55), and experienced some form of illness during pregnancy (HH=3.34, 95 % CI: 2.11-5.29), respectively. Similarly, neonates born with very low (<2000gm) birth weight and born prematurely (before 37 weeks of gestation) carried a higher (HR= 1.90 and 1.47; 95 % CI: 1.22 - 2.96 and 1.07-2.28) risk of death. On the other hand, maternal formal education was found to be the single protective factor (HR= 0.65,95 % CI: 0.43-0.99). Conclusion. Nearly one in every ten (11%) of neonates die before celebrating their firth month of life, mainly during the first week in rural Ethiopia. The risk of dying from LBW during the neonatal period is almost fourfold of the current estimated national NMR. Maternal obstetric characteristics and fetal maturity were predictors of mortality.

Background: Poor maternal nutrition during pregnancy is a leading modifiable risk factor associated with risks of adverse pregnancy outcomes (APO). Nevertheless, there is paucity of evidence if consumption of some food groups is associated with lower risk of APO, particularly in low-income settings. We aimed to determine whether consumption of some food groups is associated with lower risk of APOs such as: preterm birth (PTB), low-birth weight (LBW), and stillbirth in rural Central Ethiopia. Methods: A multi-center (8 health centers) prospective cohort study, enrolling 432 pregnant women during their initial antenatal care visit, was employed. All mothers were then followed monthly (for a total of four visits) from enrollment to delivery. Midwives in respective health centers assessed dietary diversity using the Women’s individual dietary diversity score and evaluated birth outcomes following standard procedures. Logistic regression models were run to predict association of food groups with the APO. Findings: Out of the 374 pregnant women who completed the study, one in five [74 (19.8%)] experienced at least one of the APO: 34 (9.1%) gave birth to LBW babies, 51(13.6%) had PTB and 17 (4.5%) experienced stillbirth. Poor or inconsistent consumption (<¾ assessments) of dark green leafy vegetables (adjusted odds ratio (AOR) = 2.01; 95% confidence interval (CI): 1.04–3.87), dairy products (AOR = 2.64; 95% CI: 1.11–6.30), and fruits and vegetables (AOR = 2.92; 95% CI: 1.49–5.67) were independently associated with higher APO risks. Whereas, being nonanemic at term (AOR = 0.24; 95% CI: 0.12–0.48) was independently associated with lower APO risks. Conclusions: Poor or inconsistent consumption of dairy, dark green leafy vegetables and fruits were associated with higher risk of APOs. While community-based trials and mechanistic studies are needed to substantiate these findings, efforts to promote dietary diversity through increased consumption of fruits, vegetables and dairy may be beneficial in this and similar settings.

Prevalence and Predictors of "Small Size" Babies in Ethiopia: In-depth Analysis of the Ethiopian Demographic and Health Survey, 2011