Level and predictors of micronutrient intake inadequacy among pregnant women attending public health facilities in Bahir Dar City, Northwest Ethiopia: a multicentre, cross-sectional study

Abstract

OBJECTIVE: To determine the level and predictors of micronutrient intake inadequacy among pregnant women attending antenatal public health facilities in Bahir Dar City, Northwest Ethiopia. DESIGN: A multicentre, cross-sectional study. SETTING: The study was conducted in public health facilities in Bahir Dar City, Northwest Ethiopia from January to March 2024. PARTICIPANTS: About 420 pregnant women aged 18 years and older attending antenatal care at public health facilities in Bahir Dar. Pregnant women diagnosed with chronic diseases, sick and unable to communicate, and who had attended weddings, birthday celebrations or religious festivals within the past 24 hours were excluded. PRIMARY OUTCOME MEASURES: Micronutrient intake inadequacy among pregnant women was measured using a single multiphasic 24-hour dietary recall. The Nutria-Survey Food Processor software, the Ethiopian food composition table and the World food composition table were used for the calculation of the nutrient value of micronutrients. The nutrient intakes were assessed by nutrient adequacy ratio and mean adequacy ratio. Data were analysed using SPSS V.26. Multivariable logistic regression analysis was done to identify the predictors of micronutrient intake inadequacy. RESULTS: A total of 411 pregnant women were recruited in the study, yielding a 97.8% response rate. The overall prevalence of micronutrient intake inadequacy was 76.4% (95% CI 72.0% to 80.3%). The proportions of zinc, vitamin A, iron and calcium intake inadequacies were 48.2%, 66.7%, 14.8% and 74%, respectively. Having nutrition counselling (adjusted ORs (AOR)=3.5; 95% CI 2.00 to 6.48), having <4 meal frequency (AOR=3.66, 95% CI 1.93 to 6.94), having <4 dietary diversity score (AOR=4.78; 95% CI 2.67 to 8.55) and being food insecure (AOR=3.04, 95% CI 1.68 to 6.23) were significant predictors of overall micronutrient inadequacy. CONCLUSIONS: Micronutrient intake among pregnant women was lower than the recommended levels. Therefore, strengthening community efforts to promote the consumption of a diversified diet for pregnant women, encourage nutrient-dense food production and enhance food security is essential.