Abstract

Background; : Pregnancy is considered to be a delightful experience for the expectant mother. Evidence manifested that adequate intake of nutrition is a key component for individual’s health and well-being, particularly during pregnancy (Nicholson et.al, 2006).

Objective: the general objective of this studies was to assess the knowledge and challenges of nutrition in pregnancy among pregnant women of the molyko community Buea. Methods:  A cross-sectional, descriptive study design was used, with a quantitative method of data collection. Data was collected using a structured questionnaire based on the objectives of this study.

Methods; This study adopted a hospital based cross sectional design. The subjects were made of women of various ages with different socio-economic levels. A total of 100 pregnant women were selected as sample size of the study. The research questions were analysed using the sample percentage frequency counts.

Results; Overall women showed good general knowledge about nutrition and the need for increased and varied food during pregnancy, but little technical knowledge about nutrients and sources of nutrition. 87% have favorable responses regarding their beliefs about nutrition while 13% had negative responses. Lastly,75% of participants had good practices on nutrition while 25% had poor practices

Conclusion; According to results obtained majority of the participants had knowledge relating to nutrition in pregnancy. They also had good beliefs as well as good practices on nutrition in pregnancy.

CHAPTER ONE

INTRODUCTION

1.0 Introduction

The reproductive period is a critical time for establishing risks of chronic diseases in offspring later in life. Nutrition plays a vital role during the developmental period, and because it is a determinant of lifetime risk of disease, it is potentially a modifiable risk factor. Although the World Health Organization (WHO) provides guidelines for antenatal care (WHO, 2020), comprehensive guidelines detailing nutritional needs of women throughout reproduction from preconception through pregnancy and lactation.

The role of optimal nutrition for the continuum beginning at preconception, during pregnancy, at birth, and beyond extending through childhood and adolescence has received too little attention from research, clinicians and policy experts in the past but has recently become a frequent topic of discussion including a recent National Academies of Science, Engineering and Medical workshop (National Academics of Sciences, 2020).

1.1 Background of the Study

The first 1000days post conception are regarded as a sensitive window of time that can define the child’s health and in which the risk of later non-transmissible disease can be modified (Koletzko et al 2010). The importance of a healthy lifestyle with a balanced diet and exercise in this phase of life is an important building block for the prevention of these diseases and is underlined by, amongst others, the national health goal “before and after birth” of 2017. (Bundesmininisterium fur et al 2018).

Nutrition plays a vital role during the developmental period and because it is a determinant of lifetime risk of disease, it is potentially a modifiable risk factor. Although the World Health Organisation (WHO) provides guidelines for antenatal care, comprehensive guideline detailing nutritional needs of women throughout reproduction from preconception through pregnancy and lactation are lacking (WHO, 2020).

The role of optimal nutrition for the continuum beginning at preconception, during pregnancy, at birth and beyond extending through out childhood and adolescence has received too little attention from researchers, clinicians and policy experts in the past but has recently become a frequent topic in discussion, including a recent National Academics of Science, Engineering and medicine workshop (NASEM, 2020). The need for additional well- designed research on this topic became apparent in a recent series of systematic reviews from US department of agriculture.

In the world, as outlined in the National Standards for Safer Better Maternity Services, focus is on supporting women to make positive lifestyle changes while being mindful of social determinants and the ability or limitations to change. The Department of Health is also committed to underpinning health and wellbeing in policy and service delivery to ensure women are empowered to make necessary changes (DOH, 2016).

On a global scale, the World Health Organization supports this strategy as they recognize that a woman’s positive experience during pregnancy can create the foundations for healthy motherhood (WHO, 2016). Over 25 years ago, the “Barker Hypothesis” first described the link between fetal nutrition and later development of chronic diseases in adulthood (Barker, 1993; Barker et al, 1995).

Poor in utero nutrition can increase adult risk of cardiovascular disease (Kajantie et al, 2005), high blood pressure (Huxley et al, 2000), obesity (Tounian, 2011; Boney, 2005) and metabolic syndrome (Barker et al, 2005). The critical window of opportunity, occurring from conception until 24 months of age, is now commonly referred to as “the first 1000 days”. During pregnancy a number of key nutrients are fundamental to the developing fetus. These nutrients and the recommended intakes are outlined in this guideline.

This guideline uses the current evidence to guide health care recommendations. Maternal weight at conception and gestational weight gain also play roles in health outcomes for pregnancy. Babies have increased risk of cardiac death in later life if malnourished in utero (Barker et al, 2012). Maternal diet can influence the type of fetal adipose tissue, which may explain the baby’s risk of developing insulin resistance and subsequent diabetes in later life (Symonds et al, 2012)

In Africa, In the antenatal period, the nutritional demand of women upsurges to compensate for physiological and psychological changes and nutritional computations by the growing foetus for energy, macro and micro nutrients (Fanos Cagliari V, et al).

However, many women, whether in preconception or even during pregnancy, do not get enough nutrients in their diets, a problem that is particularly prevalent in the world’s poorest regions, including sub-Saharan Africa Wubishet Gezimu, Firomsa Bekele, and Getu Habte 4  Women’s malnutrition (of any kind) not only affects their health but also has the potential to harm the health of their infants.1,5,6 Nutritional deficiency was responsible for 1.5 million deaths in women and children worldwide (Cetin I, Laoreti A, et Al).

Despite the fact that maternal under nutrition has decreased over the last 16 years, from 30% in 2000 to 22% in 2016, Ethiopia remains one of the countries with the highest burden of maternal malnutrition (Meija L, Rezeberga D). Undernutrition remains a public health concern.

In Cameroon, underscored by persistently high rates of stunting, wasting, and multiple micronutrient deficiencies (particularly iron among children and women). Although the rates in Cameroon have improved in recent decades, the burden of stunting remains high, with 29 percent of children under the age of five being classified as stunted (DHS, 2018)

Micronutrient deficiencies remain high in Cameroon, particularly among children under 5 and women of childbearing age. 57 percent of children aged 6–59 months and 39 percent of women aged 15–49 years suffer from anaemia resulting from iron deficiency. Another nutrition-related challenge is low birth weight. 12 percent of infants are affected, with the Far North having the highest prevalence rate of 12.7 percent (MICS 2014). Economic access to nutritious diet is an important underlying driver of nutrition outcomes in Cameroon.

According to the 2021 Fill the Nutrient Gap study in Cameroon, 48 percent of households do not have the means to afford a nutritious diet, and up to 70 percent in the Far North and East regions. Infant and young child feeding (IYCF) practices are vastly inadequate in the country and can also be seen as an important cause of undernutrition. On average, only 11 percent of children under two have minimum acceptable diet. The exclusive breastfeeding rate is also low at only 40 percent.

1.2 Problem Statement

According to UNICEF, each year, more than half a million women die from causes related to pregnancy and childbirth. Nearly 4 million newborns die within 28 days of birth. Many of the 200 million women who become pregnant each year, most of them in developing countries, suffer from ongoing nutritional deficiencies repeated infections and the long-term cumulative consequences of under nutrition during their own childhood.

Many women suffer from a combination of chronic energy deficiency, poor weight gain in pregnancy, anemia, and other micronutrient deficiencies. These along with inadequate obstetric care, contribute to high rates of maternal mortality and poor birth outcomes. Maternal under- nutrition diminishes a woman’s productivity, causing repercussions for herself, her family, her community, and the broader society.

Even though, maternal nutrition during pregnancy is crucial in reducing maternal mortality and infant mortality which are the target area in achieving millennium development goal number 5 and 6, no study was traceable in the Molyko intergreted health center of BUEA that was conducted on the assessment of knowledge of pregnant women on the importance of nutrition during pregnancy. It is against this background that the study is undertaken to best assess the nutritional knowledge and its challenges among pregnant women in the Molyko Intergreted health of Buea Cameroon.

1.3 Rationale

It is well documented that inadequate maternal nutrition results in increased risks of short-term consequences such as; Intra Uterine Growth Restriction (IUGR), low birth weight, preterm birth, prenatal and infant mortality and morbidity.

Moreover, excessive intake of nutrients during pregnancy can lead to some pregnancy complications such as, pre-eclampsia and gestational diabetes, microsomia, dystocia and higher prevalence of cesarean section. (Luigi et. al, 2015). It is very important that pregnant women practice appropriate nutrition reasons why I had to assess the knowledge and challenges of nutrition in pregnancy among pregnant women of the molyko intergreted health center buea.

1.4 Research Question

1.4.1 General research Question

The assess the knowledge and challenges faced by pregnant women on nutrition in the molyko intergreted health center Buea

1.4.2 Specific Research Question

1. What knowledge do pregnant women of the molyko intergreted health center have about nutrition in pregnancy?
2. What challenges do the pregnant women of the molyko intergreted health center face regarding nutrition in pregnancy?

Check out: Nursing Project Topics with Materials