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
section
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
11
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.
12
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
13
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
14
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
15
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.
16
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.
17
Statement of the Problem
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,
18
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
19
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.
20
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
21
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.
22
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?
23
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.
24
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.