Determinants of Dietary Diversity Consumption and Nutritional Status of Pregnant Women Attending Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia

The nutritional status of a woman during pregnancy is important as a suboptimal diet impacts negatively on the health of the mother, the fetus and the newborn. There is limited knowledge in the area of malnutrition and factors’ affecting it among pregnant women despite evidence showing that maternal nutrition has important direct and/or indirect consequences for all other age. The objective of the study was to assess the determinants of dietary diversity and nutritional status of pregnant women attending antenatal clinic at Armed Forces Comprehensive Specialized Hospital. The study was cross-sectional and conducted by using both quantitative and qualitative methods. A multistage sampling procedure was employed to draw 320 samples, pregnant women. The women were selected in random through balloting among the first five pregnant women to arrive at the antenatal clinic and thereafter systematic sampling was used and every fourth woman that arrived were sampled until the sample size is met. The data were analyzed by using a software STATA version 14. Descriptive statistics to determine the dietary diversity and nutritional status were done and also to characterize the nutritional status. The statistical model namely, logistic and ordered logistic regression was used for factors affecting the dietary diversity and nutritional status. A P value of <0.1 was considered statistically significant. According to the logistic model interpretation, negative relation implies that the dependent and independent variables are inversely related; while the positive association is the outcome and independent variable have direct relations. The findings of the descriptive analysis indicated that low dietary diversity was experienced by 61.56 percent of the respondents and the rest of the study population was in a high dietary diversity. Based on Mid-upper arm circumference cut-offs 0.31 percent were severely malnourished, while 3.44 percent were moderately malnourished and 96.25 percent were well nourished. Findings from logistic regression revealed that income, meals that were eaten in the last 24 hours, and anemia have positively and significantly affects dietary diversity while not taking iron-fortified foods affects negatively. The results from the ordered logit model indicate that severe undernutrition is determined by not taking micronutrient daily positively where ever income and cleaning utensil properly impact negatively, although moderate undernutrition is associated with not taking micronutrient daily positively and negatively with cleaning utensil properly. Though being nourished is affected by not taking micronutrient daily negatively and positively by cleaning utensil properly. Whereas by World Health Organization hemoglobin cut-offs 2.50 percent, 11.56 percent, and 85.94 percent were in severe anemia, moderate anemia, and normal hemoglobin level respectively. The results from the multinomial regression model reveal that severe anemia is negatively associated with dietary diversity. At the same time, moderate anemia is affected positively by not taking micronutrient daily and negatively by age, dietary diversity score and morbidity status of the pregnant women. Similarly being in normal hemoglobin cut-off was affected positively by age, dietary diversity and morbidity, negatively affected by not taking micronutrient daily. Finally, the findings conclude that dietary diversity and nutritional status were very poor and socio-demographic, socio-economic, micronutrient supplementation, morbidity, environmental factors, and dietary diversity influence the nutritional status of pregnant women. It is recommended that promotion of dietary diversity and modification of diets be carried out through practical demonstrations in the community and health facilities and there should be income generation practices and entrepreneur encouragements should be practiced.