Dietary diversity, dietary iron intake and iron status among pregnant women in Embu county, Kenya
Mwaniki, Nicoleta Muthoni
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Iron deficiency is one of the most common micronutrient deficiencies in the world today. Maternal anemia is still a cause of considerable prenatal morbidity and mortality. The number of anemic women in the world is estimated to be 56 million, majority of them (75-80%) being diagnosed with iron deficiency anemia. In Kenya iron deficiency for women of reproductive age is at 48% while anemia in pregnancy is at 55%. One of the most important factors responsible for maternal iron deficiency is poor dietary practices. Dietary diversification is essential for nutrient adequacy as there is no single food that contains all the nutrients required to maintain good health and nutritional status. The purpose of this study was to establish dietary diversity, iron intake and iron status among pregnant women in Embu County. Cross- sectional analytical design was used and the sample size was 172 pregnant women. Sampling was done by systematic sampling technique. A structured researcher administered questionnaire was used to collect data on dietary diversity and iron intake and demographic and socio- economic characteristics of pregnant women.Mid upper arm circumference (MUAC) was used to assess nutritional status; iron status was assessed by measuring serum hemoglobin (HB) levels. The data was entered and analyzed using Statistical Package for Social Sciences (SPSS) Version 16 software. Data from 24 hour recall was analyzed using Nutri-survey. Pearson correlation and chi–square were used to determine the relationship and association between variables. The statistical significance was set at a value of p< 0.05. Data was presented as frequencies, percentages and means. The mean age of the study population was 27±5.3 years, 88.4% were married, and 68.3% had attained secondary education. About 28% of the participants were not meeting the minimum dietary diversity for women (MDD-W).About 45.7% were not meeting the recommended dietary allowances (RDA) for dietary iron and 20.1% were anemic. The MUAC mean was 26.9 ±3.7 with 86.6% having MUAC of 23 or more. A significant relationship was found between the level of income and dietary diversity score (DDS)(r=0.39, p=0.047),DDS and HB (r=0.48, p=0.041),iron intake and DDS (r=0.57,p=0.038 ) and between iron intake and HB (r=0.54,p=0.031).A significant relationship was found between MUAC and DDS (r=0.26, p=0.03).A significant association was found HB and morbidity (χ2) = 7.98, p= 0.034).It is recommended that dietary diversity and intake of adequate dietary iron be promoted through regular talks and demonstrations to the pregnant women attending the mother and child health (MCH) clinic at all health facilities. The information obtained from this study may be useful to the ministry of health in the county in designing appropriate interventions programs to promote adequate dietary iron intake and mitigate iron deficiency anemia among pregnant women in Embu County.