Despite strong policy and program commitment, essential maternal nutrition services are not reaching enough women in many countries. This paper examined multi-factorial determinants (personal, family, community, and health services) associated with maternal nutrition practices in Uttar Pradesh, India. Data were from a household survey of pregnant (n=667) and recently delivered women (n=1,835).
Multivariable regression analyses were conduct to examine the determinants of four outcomes; consumption of diverse diets, consumption of iron folic acid (IFA); and calcium tablets, and weight monitoring during pregnancy. Population attributable risk analysis; estimate how much the outcomes can be improve under optimal program implementation. During pregnancy, women consumed 28 IFA and 8 calcium tablets; 18% consume diverse diet and 17% weigh ≥3 times.
Nutrition knowledge was associate with consumption of diverse diet (OR=2.2 times); IFA (2.3 times); calcium (11.7 times) and weight monitoring (1.3 times). Beliefs and self-efficacy were associate with IFA (OR=2.0) and calcium consumption (OR=4.6). Family support and adequate health services were also associate with better nutrition practices. Under optimal program implementation; we estimate 51% women would have adequate diet diversity, an average consumption of 98 IFA; and 106 calcium tablets, and women would be weighed 4.9 times during pregnancy.
Maternal nutrition practices
Strengthening existing program operations and increasing demand for services has the potential to result in large improvements in maternal nutrition practices from current baseline levels, but may not be sufficient to meet WHO-recommended levels without creating an enabling environment including improvements in education and income levels to support behavior change.
Alive & Thrive (A&T) is an initiative that supports scaling up of nutrition interventions to save lives, prevent illnesses, and contributes to healthy growth and development through improved maternal nutrition and infant and young child feeding practices in several countries. To address the challenges of maternal under-nutrition in Uttar Pradesh, A&T aims to test the feasibility of improving the provision.
Package of maternal nutrition
The uptake of a package of maternal nutrition interventions which include provision of and counseling on IFA and calcium supplements, adequate weight monitoring during pregnancy and counseling on this article is protected by copyright. All rights reserved. Weight gain, interpersonal counseling on diet during pregnancy and on breastfeeding during postpartum, and community mobilization.
The study provides novel findings on the multiple determinants of specific maternal nutrition practices in Uttar Pradesh, India. While the current situation is bleak, many of the key factors associated with maternal dietary diversity, IFA/calcium consumption and weight gain monitoring are modifiable. Under optimal program implementation that explicitly tackles the specific determinants of each maternal nutrition practice, we could expect half of the women to achieve adequate diet diversity, consume an average of 100 IFA and 90 calcium tablets,