ABSTRACT
The interaction between a
pregnant mother and her developing baby are numerous and varied ranging from
the food she eats to the kicks of the baby that she feels. What the developing
baby feeds on goes a long way in determining its state of health at birth. For
a pregnant mother to eat healthfully, she needs to have adequate knowledge of
the different component of food. But if the knowledge is not put in practice,
it becomes meaningless.
The major objective of this
study therefore was to examine the nutritional knowledge and practice of the
pregnant women in Onitsha North and South Local Government Areas of Anambra
State. Because of the large number involved, and the fact that most of the
hospital had no maternity, only two hundred and fifty expectant mothers were
used. Eight specific objectives and corresponding research questions and six
hypotheses were stated and used for the study.
The instrument for data
collection was a questionnaire which had three sections. The personal data of
the respondents, fourteen questions each on nutritional knowledge and practice
respectively. The questionnaire responses on knowledge were two-point scale of
Yes and No while that of practices were in three-point scale of “Practice
Always”. “Do not practice” and “Practice Rarely”. Data were analyzed using
correlation analysis, percentage, ANOVA and multiple t-test of paired
comparison. The results showed that all the hypothesis of the study were
rejected. The mean (x) percentage of the subjects who indicated knowledge of
what constituted good nutrition was greater than those who indicated regular
practice. Some correlation existed between the subject’s knowledge of nutrition
and their nutritional practice. Education, age and parity influenced their
knowledge and practices of nutrition. Based on these results some
recommendations were made such as:- (a) Health educators and nutritionists
should be invited to give health talks to pregnant women during antenatal
clinic. (b) The age, educational level and parity levels
of these expectant mothers should be considered during the lessons.
CHAPTER ONE
INTRODUCTION
Background
of Study
Eating is one activity most of
us take for granted (Donatelle & Davis 1989). At times, according to
Donatelle and Davis we are concerned about eating sufficient food that would
get us though the day and less attention is given on their nutritional
contents. The trend towards a healthful lifestyle calls for healthy eating yet
in the effort to eat nutritionally, many people, wonder if they are actually
eating a balanced diet or if they have been duped by fed while for some others,
any food can go.
Although our choices of food
are determined by many factors such as the availability of food in the locality,
the money available to purchase these foods, the food supplies including the
ways the foods are being processed or prepared and the knowledge and
appreciation the individual feels about certain food values (Okafor, 2002), it
is important that we realize that we are what we eat and that nutrition has
become very important in both preventive and curative healthcare system (United
Nations Children Fund, UNICEF 1995). According to UNICEF,
dietary factors have been implicated in the etiology of many diseases such as
diabetes, heart diseases, cancer and several diseases of children, UNICEF
(1995) also pointed the out that Nutrition has shifted from its previous focus
on the minimum amount needed to prevent or cure acute deficiency diseases, for
example scurvy, and beriberi, to the need to promote health, longitivity and
resistance to chronic disorders like cardiovascular diseases, cancer,
hypertension, diabetes and even acquires immune deficiency syndrome (AIDS). In
pregnancy, the importance of nutrition is being emphasized in the newspapers,
magazines and health journals and even in many health related television shows
to mention but a few.
Nutrition can be defined as the
science of food, its use within the body, and its relationship to good health.
It includes the study of the major food components – proteins, carbohydrates,
fats, vitamins and minerals including water and more than 50 various nutrients
of which they are composed (Levy, Digman & Shirref, 1984). It is therefore
clear that for somebody to eat healthfully he or she must have adequate
knowledge of the different components of food we eat.
Nutrition
also can be defined as the science that investigates the relationship between
physiological functions and the essential elements of the food we eat
(Donatelle & Davis 1998). The world book encyclopedia on health (1996)
simply puts nutrition as the process by which living things take in foods and
use it. It is therefore the study of food and the process of receiving
nourishment from the food we eat after digestion and metabolism. Brien (2010)
defines it as the study of food and nourishments, examining the nutritional
contents of foods, the amount of nutrients required for healthy growth and
function and varies for different people.
The extent of practices of
nutrition is dependent among other things on the level of knowledge one has
about nutrition. According to Ayo (2003) Nutritional knowledge refers to that
aspect of education that prepares one for meaningful nutritional practices. Ayo
emphasized that every living thing has the right to have access and the right
to affordability of nutritious food and at when due. However, Donatelle et. al.
(1998) were of the view that many were accessible to vast number of choices of
food or to almost every nutrient by implications should have fewer nutritional
problems than their counterparts who do not have such affluence but
unfortunately, nutritionists according to them,
believe that “diet of affluence” were responsible for many of their diseases
and disabilities such as heart diseases, certain types of cancer, hypertension,
cirrhosis of the liver, tooth decay and chronic obesity.
Nutritional knowledge without
practice is not meaningful. Nutritional practice is outward demonstration of
nutritional knowledge in our homes, outside our homes and even in social
gatherings. Knowledge about nutrition prepares one for meaningful nutritional
practices and it is acquired through formal and non-formal education and it is
as old as culture itself since the knowledge is passed on from generation to
generation and from parents to their offspring. As such every locality has
different kinds of foods available to them and are being prepared differently.
Nutritional knowledge and
practices are being emphasized upon according to Williams (2007), because of
their role in determining the pregnancy outcome as well as the state of health
of the mother after childbirth. In support of this, Karger and Basel (2010)
emphasized that nutrition is important to expectant mothers because it can
spell the difference
between a healthy new born and a sickly child. Karger and Basel advised the
expectant mother to follow scientifically – proven – practices to make sure
that the baby is healthy and strong when it is bor. This according to them will
be achieved by eating food rich in vitamins and nutrients.
An expectant mother according
to Crowder (1995) is a woman that is pregnant. According to him, pregnancy is
the fertilization of an Ovum and its implementation in a woman’s uterus. He
noted further, that for approximately nine months the mother carries the
developing child within her and that the pregnancy terminates with delivery of
the child, Nash (2002) observed that the relationship that exists between the
mother and her unborn child is much. According to her, “even while the child is
still in the womb, its genes engage the environment of the womb in an elaborate
conversation, which is a two-way dialogue that involves not only the air the
mother breathes and the water she drinks but also what drugs she takes, what
diseases she contacts and what hardship she suffers” pg24. According to Nash
(2003;19) once the beginning embryo is able to obtain good nutrition directly
from the mother, development can proceed more rapidly. But if what is obtained form the
mother is not nutritional healthy or balanced, so many complications are bound
to arise in pregnancy. Williams (1981) noted that hazards increase with age,
the number of pregnancies and the intervals between pregnancies influence the
nutritional needs of the mother and the out come of pregnancy. Furthermore, Zhn
et al (1999) observed that pregnant women that are underweight or overweight
and those advanced or young maternal age need nutritional support and
counseling programmes that will improve birth weight, decrease infant mortality
and improve participant’s diet. Also, White head, (1994) maintained that those
women delivering first child at over 30 years old were not nutritionally
prepared. This is because at that age upwards, many women had been on some type
of weight reduction diet which makes their nutritional status not better than
that of many teenagers.
More so, an expectant mother
who lacks good education and exposure may be easily deceived by smooth talks of
nutritional quacks who advocate fad diets. Not only that, the habits and
practices of those who lack good education would be affected by taboos,
superstitions and prejudices as Mankinde (1980) noted.
Pre-study
investigation from some hospitals within the Local Government Areas revealed
that, majority of the women of study start antennal care very late and as such
do not start their nutritional supplements early enough. The expectant mothers
of these local Government Areas still at these century have children with birth
defects of the brain and spinal cord (Neural tube), and other malformation of
the bone, have very low birth weight while some are over weight most of the
expectant mothers themselves have low resistance, diabetes and many are anemic.
All these problems may be associated to poor eating habits. It becomes
necessary therefore that an expectant mother should have adequate knowledge of
nutrition and should be able to eat nutritionally. The writer therefore, is of
the view that if the level of knowledge and practices of nutrition among
expectant mothers in Onitsha North and South Local Government Areas are
identified and adequate information about what constitutes good nutrition is
given to them, their nutritional behaviour will improve with motivation.
It is against this background
that this topic has been chosen to survey the nutritional knowledge and
practices of expectant mothers in Onitsha North and South Local Government Area
of Anambra State.
Ayo (2003:20) mentioned that in
the World Health organization (WHO) sponsored conference of delegates on 134
countries and 67 United Nations members in 1978, adequate nutrition was
classified as “a fundamental human rights” the aim being in pursuance of an
acceptable level of nutrition for the people of the world. The women of Onitsha
North and south Local Government Area lack the knowledge of good nutrition and
this will expose them to diseases associated with malnutrition for example,
chronic obesity, tooth decay, overweight & low birth weight and associated
problems.
Williams (1981) pointed out
that optimal nutrition is a fundamental aspect of therapy for many complication
of pregnancy like iron deficiency anemia, Hemorrhagic anemia, megloblastic
anemia and toxemia. These health problems have a high morbidity and mortality
consequences. Poor nutrition according to Ramakrishna (2008) is a known cause
of low birth weight which remains the significant public health problem in many
development countries. Nash (2002) clearly stated that although there may be
long-term health threat to the fetus, maternal
undernourishment which stunts growth even when they are born full-term, may top
such lists.
Onitsha is a business city and
experience revealed that it has the biggest market in West Africa. Quite a
great number of pregnant women in Onitsha are traders. They also travel a lot
to various parts of the country, especially to the northern parts to buy goods
for sale. The result is that most times a good number of them sleep many days
on the road. Some of the expectant mothers are busy bankers in several banks
located in the city. There are nurses, teachers and others, some prefer dining
out because they are very busy. A very close look at the expectant mothers
revealed that they were lean and not well fed. This is exactly what prompted
this study. Also from experience and observation many maternity homes or
antenatal clinics in Onitsha rarely give nutritional-talks to expectant mothers
and some that give nutritional-talks to expectant mothers do so with inadequate
emphasis on its importance to pregnancy outcome. This is far from right and is
unlike what is obtainable from some other parts of Nigeria and abroad
(overseas) where pregnant women are being educated about what constitutes good
nutrition before, during and after childbirth. Pregnant women should
be thought what constitutes a healthy diet especially from the local rich foods
obtainable for such locality.
To the best knowledge of the
researcher no work has been done on these women in the two LAGs to determine
how much they knew and practice nutrition. It is against his background that
this study that this study has been designed to find out the following purpose
of the study.
Purpose
of the Study
The main purpose of this study
was to: determine the nutritional knowledge and practices among expectant
mothers in Onitsha north and south local Government Area of Anambra State. The
specific purposes were:-
1.
Ascertain the level of nutritional
knowledge possessed by the expectant mothers in Onitsha North and South Local
Government of Anambra State.
2.
Determine the level of nutritional
practices, of those expectant mothers of study.
3.
Ascertain the relationship between
the nutritional knowledge of these expectant mothers’ and those of their
practices.
4.
Ascertain the nutritional knowledge
of the subjects of study based on their level of education, age and parity.
5.
Determine the nutritional practice
of the subjects of study based on their level of education, age and parity.
6.
Determine the relationship between
the nutritional knowledge and practices of the subjects of study in relation to
their education.
7.
Determine the relationship between
the nutritional knowledge and practices of the subjects of study in relation to
age.
8.
Determine the relationship between
the nutritional knowledge and practices of the subjects of study in relation to
parity.
Significance
of the Study
This study is expected to
access the levels of knowledge and the practices of nutrition among the
expectant mothers in Onitsha North and South. The anticipated results of the
study will help in the overall improvement of the health status of the
community since the pregnant mothers who prepare meals for the family will get
an insight to what constitutes adequate nutrition. This information will be
useful to other health professionals who are seeking ways of improving health
care. To the
government ministries of health and education, this study will help the
planners to know the state of knowledge of these women and make preparation for
enlightening them. It will help the curriculum planners to incorporate
nutrition in school curriculum as well as findings ways of making the students
appreciate the need for good nutrition and practice them. Fellow researchers
reviewing literature and who wish to learn from the experience of previous
researchers on a similar subject will also find the work both useful and
stimulating. For future researchers, it will form a baseline for those
interested in such areas of study.
Scope
of the Study
This study would not cover
every aspect of nutrition. It will be limited to five essential food nutrients
including water and fiber as they play important roles in the body. The six
essential nutrients to be studied are proteins, vitamins and minerals, simple
carbohydrates and fats. Although there are many categories of pregnant women,
this study will consider only those that are not vegetarians and those without
degenerative health problems that require specific nutrition or dieting like in
diabetic, heart and liver cases.
Research
Questions
This study is on the
nutritional knowledge and practices of the expectant mothers in Onitsha North
and South Local Government Areas of Anambra State. To achieve this, the
following specific research questions were asked.
1)
What are the levels of nutritional
knowledge of the sources of food substances possessed by the expectant mothers
in Onitsha North and South Local Government Areas.
2)
What are the levels of nutritional
practice of those expectant mothers of the study?
3)
What is the strength of relationship
between the nutritional knowledge and practices of the expectant mother of the
study?
4)
What is the level of nutritional
knowledge of he expectant mothers of the study based on their levels of
education, age and parity?
5)
What is the level of nutritional
practices of these expectant mothers of study in relation to their level of
education, age and parity?
6)
What is the relationship between the
nutritional knowledge and practices of the subjects of study based on their
levels of education?
7)
What is the relationship between
nutritional knowledge and practices of the subjects in relation to their ages?
8)
What is the relationship between
nutritional knowledge and practices of the subjects of study based on their
levels of parity?
Research
Hypotheses
The major hypothesis of this
study was that there was no significant difference between the nutritional
knowledge and practices of the expectant mothers of Onitsha North and South
Local Government Areas of Anambra State.
From
this major hypothesis, the following sub-hypotheses have been
formulated for the study.
1.
There was no significant difference
in the nutritional knowledge and practices of mothers of the study.
2.
There was not significant difference
in the level of knowledge of nutrition based on their level of education, age
groups and parity.
3.
There was no significant difference
in the nutritional practices of expectant mothers of this study in relations
education, age groups and parity.
4.
There was no significant in the
relationship between the nutritional knowledge and practices of the subjects of
study based on their level of education.
5.
There was no significant difference
in the relationship between the nutritional knowledge and practices of the
subjects of the study in relation to their ages.
6.
There will be no significant
difference in the relationship between the nutritional knowledge and practices
of the subjects of study based on their parity levels.
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