Efficacy of Psycho-Educational Nutrition Initiative on Energy and Micronutrient Intake, Physical Activity and Pregnancy Outcomes in Migori County, Kenya
Oyeho, Florence A.
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A large number of pregnant women in many parts of the world enter pregnancy at sub-optimal weight and height. A third of Kenyan population suffer from food insecurity that is further complicated by factors such as adverse weather conditions and increases in food prices. The result is malnutrition which primarily affects pregnant women and children under five years and significantly contributes to their morbidity and mortality. Maternal nutrition is critical for both mother and child as it lays fundamental foundation for the successful outcome of pregnancy. Kenya’s high rate of undernutrition among women of reproductive age are due to sub-optimal feeding practices, heavy workload, inadequate micronutrient intake and insufficient awareness and knowledge on nutritionally adequate diets among pregnant women leading to preterm births, low birth weight, high mortality and morbidity, impaired growth, and increased risks during childbirth for both mother and child. This study sought to investigate socio-demographic characteristics, determine nutrition knowledge and health conditions and effect of nutrition educationon nutrition knowledge and dietary practices, assess energy and micronutrient intake, determine physical activity levels, and determine pregnancy outcomes and associations between psycho-educational nutrition initiative and nutrient intake, physical activity and pregnancy outcomes among pregnant women in Migori County. A prospective cohort study design was used and simple random sampling was used to obtain a sample of 150 pregnant women from three sub-county hospitals purposively selected for study. Pregnant women of GA ≤26 weeks were recruited and enrolled into psychoeducational nutrition intervention study. Data was collected by 24 hour recall, International Physical Activity Questionnaire, biochemical analysis, anthropometric measurements and secondary data. Data was collected at baseline and after intervention for each woman and analyzed by Nutri-Survey computer package, IPAQ scoring protocol and SPSS. Data was summarized by descriptives and relationships between variables was tested by Chi square, regression model and pearson’s product moment correlation.ANOVA and t-tests were used to test for differences between means. Findings showed that the pregnant women were of low economic status. Nutrition education had positive significant associations with nutrition knowledge and practices. Most women had good health with on conditions interfering with their food consumption. Generally, there was improved dietary intake of all nutrients after the intervention although some did not meet the RDA even after intervention There was a slight reduction in physical activity factors and increased time for rest was observed after intervention although there was no significant reduction in activity levels (p ≤ 0.05). Weight gain (5.98 kg) was lower than recommended, mean gestation age was normal (37.74 weeks) but lower for preterm births category and mean BW (3039±489.5 g) was normal although 7% of new bornes had LBW. The study found significant effects of nutrition knowledge from the psycho-educational initiative on nutrient intake and pregnancy outcomes but found no effect on physical activity. The study concludes that nutrition education can be used to enhance pregnancy outcomes and nutrient intake among pregnant women. The finding is important to central and county governments, civil society, intergovernmental agencies, research groups, business enterprises and community under study.