Report on Maternal Nutrition Practices in Rural Nepal

Abstract

Background: Maternal nutrition refers to the nutritional needs of women during the antenatal and postnatal period (i.e., when they are pregnant and breastfeeding) and also may refer to the time period before conception (i.e. adolescence). Now, Government of Nepal is developing a maternal nutritional strategy and searching some intervention on focusing maternal nutrition but limited research have been conducted on maternal nutrition practices during pregnant and lactation. The purpose of this study was to document current maternal nutrition practices, motivation and barriers. Methods: This was a cross sectional study conducted in 6 districts representing three eco regions of Nepal. Mixed method (qualitative and quantitative) was used in this study and carried out in fiscal year 2069/070. Pregnant and lactating mothers were taken as a respondent for quantitative information from each district. Similarly, Female Community Health Volunteer (FCHV), Health center in charge and nutrition focal person of District Public Health Office (DPHO) were taken for qualitative information. Multistage sampling was applied in this study. 80 pregnant and 80 lactating mothers were taken for quantitative information from each district (16 pregnant and 16 lactating mothers from each VDC). So, all together 480 pregnant and 480 lactating mothers were included in the study for quantitative study. Similarly, from each District, 2 FGD with mothers (1 with pregnant and 1 with lactating), 1 FGD with FCHV, 1 KII with DPHO/DHO and 1 KII with health center incharge from each selected VDC were done. So, altogether, there were 12 FGDs with mother, 6 FGDs with FCHVs, 27 KIIs with health center in charge and 6 KIIs with DPHO for qualitative information. Data was entered in Epidata and analyzed in SPSS. Results: The study revealed that there was no change in the dietary quantity and quality during lactating and pregnancy period. Lowest percentage of women from Sarlahi, Jumla and Achham were taking fruits, vegetables and animal products more than usual in their pregnancy and lactation. Only forty one percent women consumed food 4 and more times in a day during their pregnancy. Most of the people of Sarlahi (99.4%), Achham (89.4%), and Jumla (81.9%) used untreated drinking water in comparison to other districts. Almost 80% respondents were unknown about to take vitamin A dose up to 42 days after delivery. Mostly nutrition programme are focused for under 5 children in the district. There was provision of distributing iron tablets, albendazole and TT injection to pregnant women and vitamin A to postnatal women as well as nutrition education. There was shortage of iron tablets in most of the health centers due to the low supply form the central level. Health workers felt the need of organization of nutrition training. Conclusions: Health education activities should be conducted for husband and other family member. Nutritional education training, visual aids and information booklets for health worker and female community health volunteer need to be provided. Keywords: barriers; lactation; maternal nutrition; motivation; nutrition; practices; pregnant women.