Abstract

Background: Pregnancy is considered to be a delightful experience for expectant mothers. Evidence manifest that adequate intake of nutrients is a key component for individual health and well- being particularly during pregnancy (Rocco et al., 2005). It is well documented that inadequate maternal nutrition result in an increased risk of short term consequences such as Intra Uterine Growth Restriction, Low Birth Weight, Pre Term Birth, prenatal and infant mortality and morbidity (Orboto et al, 2005).

Method: This research made use of a quantitative research design. The instrument used to collect data were both closed and open ended questionnaire were the respondents at one point were expected to give further explanation about their knowledge on maternal nutrition.

Results: The study found out that 60% had adequate knowledge on the definition of nutrition and 65% of the mothers had adequate knowledge on the definition of maternal nutrition. This implies that the knowledge level of pregnant women on maternal nutrition high and adequate while70% of the women sampled were aware of the role of balance meals during pregnancy.

Conclusions: The knowledge of maternal nutrition is high and adequate amongst the pregnant women in Limbe Regional Hospital; this high knowledge level is due to their high educational level and socioeconomic status more so most of the study population had a positive attitude towards maternal nutrition and this attitude was mostly influenced by their high and stable socioeconomic status and access to adequate health facilities like the Limbe Regional Hospital. The women had major challenges amongst which are financial limitations and inadequate access to constant food supply which hinder them in implement adequate nutrition during pregnancy. This study therefore conclude that despite the high knowledge on maternal nutrition the pregnant women still face major challenges in implementing proper nutrition during gestation and a nutritional intervention and policy should be reviewed to improve on the situation.

CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Globally, adequate and quality maternal nutrition is important for the health and reproductive performance of women as well as the health, survival, and development of children (Bloomfield &Spiroski., 2013). Particularly, the first 1000 days of life, from conception to age two, is often considered as “the window of opportunity to prevent chronic malnutrition, childhood obesity, and medical complications arising later in life” (Adv Practice Nurs.).

Improvements in maternal and child nutrition can reduce multiple risks of Adverse Pregnancy Outcomes such as: fetal growth restriction, low birth weight babies, and small-for-gestational-age births. It also helps to prevent micronutrient deficiencies (Islama, 2013). As the high nutritional cost of pregnancy contributes significantly to their poor nutritional status, healthy nutrition intake during pregnancy is critical for pregnant women (McGowan., & McAuliffe.,2013).

Pregnancy is considered to be a delightful experience for expectant mothers. Evidence manifest that adequate intake of nutrients is a key component for individual health and well- being particularly during pregnancy (Rocco et al., 2005). It is well documented that inadequate maternal nutrition result in an increased risk of short term consequences such as Intra Uterine Growth Restriction, Low Birth Weight, Pre Term Birth, prenatal and infant mortality and morbidity (Orboto et al, 2005). Moreover excessive intake of nutrients during pregnancy can  lead to pregnancy complications such as preeclampsia and gestational diabetes, macrosomia, dystocia and high prevalence of cesarean section. On the other hand, as long run outcome, inadequate intake of nutrients was found to have physiological or metabolic negative effects on the pregnant women and also retard the growth a d development of the foetus (Rocco et al., 2005).

In Africa and South East Asia, an estimate of 19.1 million pregnant women (the highest proportion in Africa and South East Asia) had low serum retinol concentration (Monica, 2005,). Deficiency in micronutrients may lower infant birth weight and jeopardized development and survival. Maternal iodine deficiency is associated with congenital malformation and mental retardation in children and a link between Vitamins B12 deficiency and increase risk of diabetes have been described in India (Monica, 2005,).

A recent study from the United State, found that less than 30% of women reported receiving weight gain recommendation during pregnancy which is critical, nearly half of the women in the country gain excessive weight during pregnancy (WHO, 2012). A large number of women experience micronutrient deficiencies of Iron, Vitamin A and Folic acid. Almost half of all pregnant women in the world are thought to have anaemia and 9.8 million pregnant women have night blindness due to deficiency of Vitamin A.

Insufficient intake of specific fatty acid such as docosahexaenoicacid also impedes children’s development (WHO, 2012). Obese women have an increased risk of complication in pregnancy such as congenital malformation or preeclampsia compared with women of normal body mass index (BMI). They have higher plasma concentration of glucose and their fetus have higher insulin concentration.

Maternal nutrition is a fundamental determinant of fetal growth, birth weight and infant morbidity. Poor nutrition often leads to long term, irreversible and detrimental consequences to the fetus (WHO, 2011).

In Sub Sahara Africa (SSA), pregnant women are at risk of poor nutritional status and adverse outcome as a result of pregnancy, food insecurity, sub optimal health care facilities, frequent infections and frequent pregnancies (Monica, 2005). Studies in Nigeria has revealed a high prevalence of both under and over nutrition as well as nutrients deficiency including Iron, Vitamin D that may lead to complications including hypertension, anemia ,low birth weight, maternal and prenatal mortality (Hum., 2012).

According to World Health Organization (WHO, 2011) many women do not get enough nutrient and micronutrient in their diet during pregnancy. They are also unaware of how much their nutritional status impact their pregnancy and infant outcome. An increase number of studies have shown that nutrition of the mother will have an effect on the child’s entire life including risk of cancer, cardiovascular disease, throughout life. (Park et al., 2011).

Moreover, the leading cause of maternal deaths like hemorrhage and infection are related directly or indirectly to nutrition. Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth reproduction, health and disease of an organism (National Food Service Management Institute, 2004). Nutritional inadequacy of a pregnant woman will not only affect the health of the mother, but that of the baby. Inadequate nutrition during that period can lead to weight loss, infant morbidity and mortality (WHO, 2002).

In the southwest region of Cameroon, evidence on maternal knowledge and attitudes towards nutrition during pregnancy, and its association with their dietary diversity practices is hardly available. Existing studies (WHO; 1995.) reported maternal awareness levels or association with some pregnancy outcomes but lacked explanations of how awareness levels relate to attitudes and dietary diversity practices during pregnancy. Therefore, in this study, we aimed to assess the level of maternal knowledge and attitude towards nutrition during pregnancy and their relations with dietary diversity and nutritional practices of pregnant mothers Limbe, Southwest Region of Cameroon.

In Cameroon, even if the right to adequate nutrition is enshrined and tremendous nutrition interventions have been undertaken, nutritional problems and infectious diseases are still amongst the major health problems of the country (Ferede.&, Lemessa., 2013,). Cognizant to this, evidences from the country and other similar settings shows that high under nutrition rates prevail, even among regions and households where food is plenty. Nutritional knowledge and attitude are important factors of dietary practices and are, thus, potential targets for appropriate planning of nutrition interventions for vulnerable population groups like those lactating and women that are pregnant (Popa AD,& Niţă ,. 2013). Nutrition education enhances nutritional knowledge, thereby influencing attitude and practices towards good nutrition (Girard ,& Olude ., 2012) Mother’s knowledge of nutrition is a very important nexus in good pregnancy outcomes and a crucial skill in improving children’s nutritional status.

1.2 Statement of the Problem

Studies have shown that, each year, more than half a million women die from causes related to pregnancy and childbirth. Nearly 4 million new-borns die within 28 days of birth (UNICEF, 2009). 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 (Mora and Nestel, 2000; Huffman, 2001; UNICEF, 2009).

Many women suffer from a combination of chronic energy deficiency, poor weight gain in pregnancy, anaemia, and other micronutrient deficiencies, as well as infections like HIV and malaria. 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 (AED-LINKAGES, 2004). Maternal malnutrition is influenced not only by lack of adequate nutrition but also influenced by factors like socio demographic factors, nutritional knowledge of mothers during pregnancies (Daba et al., 2013).

Although, several researches have been conducted on pregnancy and material health worldwide, very few literatures have looked at the issues of maternal nutrition in the area.  Research, program reports, and other materials specifically related to maternal nutrition principles, practices, and programs are not available either in the study area.

1.3 Research questions

1. What knowledge do pregnant mothers have with regards to nutrition in Limbe Regional Hospital?
2. What is the attitude of pregnant woman towards maternal nutrition in Limbe Regional Hospital?
3. What are the challenges faced by pregnant women on maternal nutrition in Limbe Regional Hospital?

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