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CHAPTER ONE

INTRODUCTION

1.1  Background to the Study

Pregnancy is the most vital time for having a proper nutrition plan. The high demand for nutrients is to deposit energy in to the new and developing tissues, the growth of maternal mother tissues including the breast and the uterus, and the increased energy necessities for tissue synthesis make pregnant women more susceptible to the dangers of malnutrition (Daba, 2011). In line with finding of Daba (2011), Pregnant women more at risk of malnutrition. In 2010, maternal and child malnutrition was accountable for 1.5 million deaths worldwide.

Maternal nutrition continues to gin populaity in many part of the world (Ojo, 2010). this may be attributed to the reality that pregnancy is associated with growth in physiological, metabolic and nutritional necessities imparted to the women by her growing infant (Arkkola, 2008). throughout pregnancy, the body’s energy requirements, protein and minerals increase by 13%, 54% and 50% respectively (Hoffmann, 2013). Therefore, the pregnancy period becomes a vital point to meet those needs for macro and micronutrients. Proper eating at some point in pregnancy assist prevent complications of pregnancy, facilitate postpartum recovery, assist breastfeeding, and additionally prevent the onset of disease in adulthood. However, if nutrients isn’t always maintained throughout pregnancy, malnutrition ensues.

It has being established by Saha (2007) that Socio economic and demographic status is one of the most critical factors related to pregnancy outcome and dietary desposition of expectant mothers. When Socio economic and demographic status is low, medical care will consequently be insufficient which can further lead to other unfavourable outcomes (kruger 2012). In pregnant women, low Socio economic and demographic status which is often described as financial hardship and low exposure to globalization, can increase the danger of detrimental pregnancy outcome. several studies have discovered that low Socio economic status is also associated with pregnancy complications such as abortion, preeclampsia, preterm delivery and eclampsia (kings, 2013; Obasi, 2015; Demin, 20016). women with low Socio economic don’t often have the means to acquire enough prenatal care and this may affect their dietary decision,  leading to insufficient consumption of precise nutrients at some during pregnancy.

Inadequate intake of particular vitamins during pregnancy has been reported to result in terrible maternal nutritional status, which has resulted in many unfavorable effects for the mother and baby (Black et al., 2008). Some of the factors that determine the nutritional repute of  pregnant women include, the state of iron for the duration of pregnancy which relies upon at the requirements of the fetus, temporary modifications in blood quantity and body mass, adjustments in absorption capability and the bioavailability of iron in a predominantly vegetarian diet (Duggan, 2003). As a result, insufficient nutrient consumption can have an effect on maternal and infant health. For example, insufficient iron intake during pregnancy can result in maternal anemia and multiplied hazard of maternal mortality if anemia is extreme (Cheng et al., 2009). Globally, anemia accounts foor 20% of all maternal deaths and is responsible for about 60% of maternal deaths in developing countries (Karaoglu et al., 2010).

Malnutrition is expressed as insufficient food intake and poor quality of food. As a result, common infections, morbidity and mortality of children and women especially in rural areas of Nigeria due to to insufficient dietary intake (Lartey 2004, Ajani 2010). The lack of a quality diet is a critical hassle for poor people in developing nations, as their diet is particularly based on starchy foods containing little or no animal products and few clean fruits and vegetables. Food intake indicators with more food groups were greater strongly related to micronutrient adequacy for rural households, women inclusive (FAO, 2014). These plant-based diets tend to be low in several micronutrients and the micronutrients they contain are frequently in a form this is difficult to absorb (Popkin, 1994). Specifically, animal ingredients are not energy dense, but they’re an exquisite source of high quality and easily digestible protein (Bernal and Lorenzana, 2003). Consequently, it’s argued that if the energy intake in the scheme isn’t always taken into account, only the quality of the schemes with regards to the variety of the food plan would lessen the malnutrition.

Malnutrition is a critical public health challenge which has been directly related to increased mortality and morbidity rate specifically in many parts of developing countries (Sam, 2009). According to world health organisation (WHO), 585,000 deaths due to pregnancy and childbirth related complications arise globally with approximately 1,500 deaths recorded day by day, but most of those deaths arise in growing countries (Todaro, 2005). In Nigeria, there still remains dearth in the number of published studies showing the exact number of deaths recorded. But, an incidence rate of 10–40% has been stated in a rural community in the northern part of Nigeria (Mchintosh, 2001). Additionally 75% of pregnant women from the western part of Nigeria were mentioned to have had inadequate dietary despite the fact that, terrible nutrition in pregnancy negatively influences the mothers’s health and that of the unborn infant (Mikeli, 2013). To the mothers, it causes weakness and lethargy, anaemia and loss of life for both the mother and the fetus and additionally reduces the woma’s  lactation performance (Mikeli 2013).

Maternal malnutrition varies between 10% and 19% in most nations of the world. A extreme problem of malnutrition amongst mothers is evident in most nations in sub-Saharan Africa, South-East Asia and South-East Asia and Yemen, where extra than 20% of women are undernourished (Black and al., 2008). In Africa, it is predicted that between 27 and 51% of women of childbearing age are underweight (Conceição et al., 2011). Nutritional and hormonal elements related to pregnancy influence not only best immediate outcomes for the fetus, but additionally morbidity and mortality at older ages (Duggan, 2003). In Nigeria, on the regional level, proportion skinny women is better in the northeastern region (26%) and lower in Abuja (3%) and within the Rift Valley, where the study was conducted, with 14. 4% of malnourishment  (Nigerian countrywide Bureau of statistics [KNBS] and ICF) Macro, 2010).

The connection between socioeconomic status and nutritional practice of expectant mothers was brought into lame light by Baird & Wyper (1941) after they analyzed the association between unfavourable financial conditions, and malnutrition and fatigue of the mother. The Baird & Wyper (1941) study show the influence of social class, poverty, parental level of education and residence as factors that have an effect on nutritional rate and practice of expectant mothers. In analyzing nutritional practice and social class, an inverse relationship was observed between malnutrition and social class. The research of Dasvarma (1980), also confirmed an inverse relation between nutritional practice and maternal education. It also provided evidence on a negative relationship between income and pregnancy outcome in Australia. Lumley (1985) found an inverse relationship between level of education and malnutrition status of expectant mothers in Tasmania.

Long‐standing socio cultural nutritional practices can also have an effect on food consumption during different life stages, including pregnancy. According to Bassendowski (2017), these socio cultural nutritional practices encourages the segmentation of food items into classes based totally on social functions rather than nutritional profiles, it also dictate the quantities and kinds of food women eat for the duration of pregnancy. Many of those taxonomies emerge from social beliefs peculiar to the immediate environment (Lennox, Petrucka, &; Mothupi, 2014). Across Nigeria settings, there is the notion of nutrient‐dense foods as being harmful to the developing fetus or undervaluing of locally available nutritive food items had been related to negative maternal and newborn nutrients (Ogbeide, 1974 and Uzuegbu, 2008).

The intent for emphasizing nutritional practice in developing countries stems in particular from the concern of nutrient deficiency and the recognition of the significance of increasing food and food group variety to ensure nutrient adequacy especially in expectant mothers. Therefore, nutritional practice is promoted to enhance the probabilities of achieving an adequate diet,lessen the risks of growing a deficiency or excess of any one nutrient, make sure there is perfect balance of micronutrients in addition to energy from fat, and reduce the likelihood of exposure to excessive amounts of diseases. access of entry to to an good enough supply of food is the most primary of human needs and rights (Sodhi 2000).

1.2 Statement of problem

Studies have validated that it’s far important for the nutritional status of a female before and during pregnancy to be precise (Black et al., 2008). A non varied diet can have poor consequences on individuals’ health, quality-being and development, especially by decreasing bodily capacities and resistance to contamination. Similarly, cognitive development, reproductive or even social capacities also can be impaired (Savy et al., 2005). Proper nutritional practice during pregnancy have shown to have an effect on the general nutrients of the women due to the fact there is a growth in nutritional requirements during pregnancy. Additionally studies have indicated that the nutrition of women has consequence for all the different age cohorts and the effects may be direct and/or indirectly.

Most of the women in parts of sub-Saharan Africa, which consist of Nigeria, enter pregnancy with a negative nutrients status which may produce other micronutrient deficiencies which adversely have an effect on her health and that of the fetus (GON, 2008) this therefore aimed toward determining social determinants of nutritional practice in pregnancy amongst expectant women in Kwale Delta state so as to growth knowledge in the place and for this reason improves the practice.

 

1.3 Research question

The specific research questions of this study are to;

1. What is the relationship between level of income and nutritional practice between expectant Mother’s in Kwale Delta State?
2. What is the relationship between level of education and nutritional practice of expectant Mother’s in Kwale Delta State?
3. What is the relationship between culture on the nutritional practice of the expectant Mother’s in Kwale Delta State?
4. What is the overall effect of maternal socio demographic factors on nutrition practice of expectant Mother’s in Kwale Delta State?

 

1.4 Objective of the study

1.4.1 General objective

The purpose of the study was to assess the Social determinants of nutritional practice between expectant Mother’s attending antenatal clinic in Federal medical center hospitals, Kwale Delta State.

1.4.2 Specific objective

The specific objectives are:

1. Assess the relationship between level of income and nutritional practice between expectant Mother’s in Kwale Delta State
2. Examine the relationship between level of education and nutritional practice of expectant Mother’s in Kwale Delta State
3. Examine the relationship between culture on the nutritional practice of the expectant Mother’s in Kwale Delta State?
4. Establish the overall effect of maternal socio demographic factors on nutrition practice of expectant Mother’s in Kwale Delta State?

1.5 Research Hypothesis

The research hypothesis for this study is thus:

HO_: Maternal socio demographic factors does not have a significant effect on  nutrition practice of expectant Mother’s in Kwale Delta State.

H1: Maternal socio demographic factors have a significant effect on  nutrition practice of expectant Mother’s in Kwale Delta State

 

1.6 Significance of study

The findings of the study may be used by Ministry of health and different companies operating in the promoting of maternal health to put into effect programmes aimed toward enhancing nutritional practice amongst expectant mothers as a way to enhance maternal nutritional status within the County and different regions with similar situations. The study will also contribute to knowledge on nutritional practice and factors related to it.