ABSTRACT
This study was carried out
to examine the effect of nutritional knowledge on nutritional practice and
belief among pregnant women in Oshodi/Isolo Local Government Area of Lagos
State. The study focused on women attending the ante-natal clinic at five Health
Centres in Lagos State. The subjects were made of women
of various ages with different socio-cultural and economic levels. The
descriptive research survey design was used to assess the opinions of selected
respondents from five health centres in the Local Government under review. A
total of 200 (two hundred) pregnant women were selected as sample size of this
study, which represented the entire population of the study. Three research
questions were raised in the study, while three hypotheses were formulated and
tested. The research questions were analysed using the simple percentage
frequency counts, while the hypotheses were tested with the application of the
independent t-test and Pearson Product Moment Correlational Coefficient at 0.05
level of significance. At the end of the exercise, the results that emerged
showed that: there is a significant effect of nutritional-knowledge on
nutritional practice among pregnant women in Lagos State, there is a
significant relationship between nutritional-knowledge and health vitality of
the new born child in Lagos
State, and there is a
significant relationship between nutritional-knowledge and belief system among
pregnant women in Lagos
State. Based on the data
analyses carried out and the conclusions thereafter, the following
recommendations among others were made: every pregnant woman, should be aware
of the importance of intake of good foods and drugs that are helpful to the
unborn child and the mother and it is recommended that women who are pregnant
should be exposed to the values inherent in good foods and effective drugs.
CONTENTS
Cover Page i
Title Page ii
Declaration iii
Certification iv
Acknowledgements v
Abstract vi
Contents vii
List of Tables ix
CHAPTER ONE 1
1.1
Introduction 1
1.2
Background
of the Study 5
1.3
Statement
of Problem 7
1.4
Research
Questions 8
1.5 Purpose of the Study 9
1.6 Research Hypotheses 9
1.7 Significance of the Study 10
1.8 Scope of the Study 11
1.10 Limitations 11
1.11 Research
Method 11
1.7
Operational
Definition of Terms 12
CHAPTER TWO: LITERATURE REVIEW 13
2.1 Concept
and Nature of Nutrition 13
2.2 Traditional
Beliefs and Practices of Nutrition in Nigeria 15
2.3 Importance
of Nutrition in Pregnancy 17
2.4 Nutrition
from Breast Feeding 18
2.5 The Importance of Beta-Carotene as a
Source of Vitamin A to Pregnant Women 20
2.6 Effects of Milk Intake, Calcium and
Vitamin D on Maternal, Fetal and Infant
Bone in Low/High Income
Countries 22
2.7 Effects of Vitamin D in Pregnancy and
Lactation on Maternal, Fetal, and
Neonatal Outcomes 23
2.8 Effective Nutritional Practices and
Policies for Childbearing and Childbearing Women 24
2.9 Implications
for Development and Policy 29
2.10 Summary
of Review 30
CHAPTER
THREE: RESEARCH METHODOLOGY 32
3.1 Introduction 32
3.2 Research Design 32
3.3 Study Population 33
3.4 Sample and Sampling Technique 33
3.5 Research Instrument 34
3.6 Administration of Instrument 34
3.7 Procedure for Data Analysis 34
CHAPTER FOUR: DATA ANALYSES AND RESULTS 35
4.0 Introduction
35
4.1 Descriptive
Analyses of Bio-Data 35
4.2 Analyses of Research Questions Based on
Responses from the Questionnaire 37
4.3 Testing of Hypotheses 43
4.4 Summary
of Findings 45
CHAPTER FIVE: SUMMARY,
CONCLUSIONS AND RECOMMENDATIONS 47
5.0
Introduction
47
5.1
Summary
of the Study 47
5.2
Conclusions
48
5.3
Recommendations
48
References 51
Project Questionnaire 58
LIST OF TABLES
Table 1: Mother’s Educational Qualification 35
Table 2: Descriptive Analysis of Samples’ Age
Range 36
Table 3: Nutritional Knowledge among Pregnant
Women 37
Table 4: Nutritional Belief System among
Pregnant Women 39
Table 5: Pregnant
Women and Practice of Nutrition 41
Table
6: Effect of Nutritional
Knowledge on Practice of Nutrition
among Pregnant Women 43
Table
7: Relationship between
Nutritional-knowledge and Health
Vitality of the New
Born Child 44
Table
8: Relationship between
Nutritional-knowledge and Belief
System among Pregnant
Women in Lagos
State 45
CHAPTER ONE
1.1 Introduction
Nutrition is a process of
getting the right food for good health, growth and development. It is also the
kind of food you eat and the way it affects your health. Good nutrition is
vital for good health and it is one of the requirements to meet physiological
changes and activity needs of different ages. Nutrition is the process of
supplying and receiving nourishment; it is the science of food values (Advance
Learners’ Dictionary, 1980).
Nutrition as the process
of giving or getting the right kind of food for good health and growth (Krause,
2004).
The knowledge of nutrition
by pregnant women is very important, as this will enable them to know the kind
of food or drugs to take at any given time. The knowledge of nutrition enables
pregnant women to be aware of the type of nutrition to be taken, helps pregnant
women to identity and eat those foods that assist their unborn babies to be
healthy (Uzor, 2006).
Believing in an intake of
particular foods by pregnant women is very essential, because pregnant women
who believe in taking certain foods and drugs not only remain healthy, but
assist their unborn babies to be healthy. Pregnant women who believe in taking
certain diets, deliver their babies strong and healthy (Siimon, 2000).
The practice of nutrition
among pregnant women is equally important. This is because, it is one thing to
have the knowledge of nutrition and or believe in intake of particular foods,
it is very crucial and recommendable for pregnant mothers to form the regular
habits of practicing eating good and healthy diets or foods as the benefits
therefrom are great (Barnes, 1990).
The knowledge, believe and
practices of food nutrition differ in different places. For instance, in India and any
other developed countries of the world, pregnant women compulsorily develop the
habit of practicing nutrition due to the kind of environment they are in. For
instance, pregnant mothers in the developed world, are more exposed to better
nutrition than those in the developing world (Lewis, 2001). They have the
wherewithal to purchase and eat whatever diet they want.
In Nigeria, many
women who are pregnant are not exposed to knowledge, belief and practice of
nutrition. This is due to the level of education among Nigerian women. Most
pregnant women in Nigeria
are illiterate and dwell in the rural areas where information dissemination is
difficult and therefore, most pregnant women in Nigeria do not practice nutrition
(Onuoha, 2002). Not only being illiterates, they lack the wherewithal to
purchase and at whatever diet they need due to poverty.
The practice and belief in
nutrition among women who are pregnant in Lagos State,
cannot be different from what is obtainable in Nigeria. Except that most pregnant
women who dwell in the city of Lagos
are aware of nutrition and its effect on health vitality of both mothers and
their unborn babies. Most women who live in cities of Lagos State, have much
information on nutrition and do develop positive belief and exhibits good
practices of the intake of certain foods and drugs during their pregnancies
(Nkemdirim, 2007).
Good food is a basic
necessity for normal organ development and function, reproduction, growth and
maintenance of optimum resistance to infection and ability to repair body
damages (Banks, 1993).
Good nutrition is a
fundamental part of a healthy life-style. It is very essential if you are planning
to become pregnant. Both mother and father to be need to be healthy to provide
strong genetic material for the child to be and a healthy womb to grow into it
(Almond, 2000).
Nutritional beliefs of
pregnant women mean traditional beliefs regarding harmful and beneficial foods
for women during pregnancy. There are also beliefs regarding the optimal amount
of food to be taken during pregnancy for a successful reproductive out come.
These beliefs may or may not conform to the modern biomedical notions about the
proper type and amount of food needed by pregnant women to safeguard maternal nutrition,
adequate growth of foetus and safe delivery (Allport, 1999). For instance, “An
economy and political weekly published, September 10 2004”, revealed that in
India, the food taken by a large section
of pregnant women is deficient in caloric content, protein, and other nutrients(a
leading cause of maternal and child mortality) (Monde, 2001).
Three well known reasons
for low nutritional status of pregnant women in India are wide spread poverty; discrimination
against women and female children in household food distribution and health
care; and lack or poor quality of antenatal care (Alpha, 1998).
Whether or not the beliefs
and practice regarding food during pregnancy are significant additional reasons
for the low nutritional status of pregnant and undesirable reproductive outcome
in India
is an important question which has been hardly addressed by scholars (Bruce,
1999).
The practices about food during
pregnancy by women are generally by choice (Bruke, 1991). For instance, the
concept of hot and cold food are quite wide spread in India and many other
countries, but the underlining criteria for classifying food as “hot” or “cold”
are often not clear.
A balance of hot and cold
is necessary for body wellbeing and since pregnancy generates a state of
hotness, it is desirable to bring a balance by cold foods (Mathew and Benjamin
1999; Nichter and Nichter 1989).
Generally, adequate
nutrition in pregnant women is one of the most crucial components of healthy
society. Many of the chronic, on going problems that women experience in
health, employment and productivity can be alleviated if they receive adequate
nutrition through out their life cycle (Edward, 1996).
Poor nutrition in pregnant
women creates a self-perpetuating cycle. Infants born with low birth weight or
presenting with retarded growth are at risk for higher-than-average rate of
morbidity and mortality during infancy and childhood (Betty, 1999). The need
for balance diet during pregnancy to meet the nutritional needs foetus and mother
(Betty, 1999).
On the other hand reported
that various types of nutrients needed during pregnancy for physical and mental
wellbeing of pregnant women, the developing foetus and the placenta includes
protein, carbohydrate, fats vitamins, minerals, roughages or fibers and water(Zinger
1999). Krause laid an emphasis on the body condition resulting from the
utilization of essential nutrients available to the body as body nutritional
status (Krause, 2001).
The pregnant woman during
the last trimester needs small but frequent needs rather than several large
ones at a time, she needs high energy diet for labour and lactation, the
requirements for food differs from those of non-pregnant women (Krause, 2001).
During this period also,
all dietary essentials must be increased proportionally in order to supply the
additional demands of the mother and the developing foetus. When there is
nutritional inadequacy, the mother immune system reduces, thereby exposing her
to various illnesses, intrauterine death may occur, pregnancy may be threatened
and the woman may loose her life. Poor nutrition during this period may result
in foetal abnormalities plus brain damages and low birth weight (Osareren,
1996).
Nutritional status of the pregnant
woman must be maintained prior to conception, especially the adolescent girl.
Health education of the mother at antenatal, postnatal and child welfare clinic
should be emphasized according to (Nzeribe, 2003). Demonstration with local
food should be used by midwives to highlight on the preparation, quantity and
combinations required to get a balance diet. This will help prevent and reduce
complications due to malnutrition.
1.2
Background
of the Study
This study was carried out
on the assessment of nutritional knowledge beliefs and practices of pregnant
women and their effect on their nutritional status. The study focused on pregnant
women. The subjects were made up of women of various ages with different
social- culture and economic levels. Energy given food items (starches) were
considered good most often, while easily available protective (vegetable and
fruits) and body building food items (proteins) were infrequently mentioned or
avoided for cultural, religious and health reasons. Nearly three quarter of the
women did not gain enough to meet the commended weekly weight gain 24.6% lost
weight (Nwosu, 1990).
Traditional beliefs rather
than the more frequently cited reasons of poverty and non-availability of foods
are seen as major factors limiting the quality of diet among respondents
(Osondu, 1994).
The importance of
nutrition, its knowledge and practices by a pregnant mothers cannot be overemphasized.
This is because, the awareness of diet, the belief in it and the practices of
eating well during pregnancy help a pregnant woman not only to deliver a
healthy baby, but to be healthy herself (Uzor, 2000).
A woman eats during
pregnancy greatly affects both herself and her growing child. According to
them, the fetus depends on the mother for an adequate prenatal diet, since so
much demands are made on the woman’s system, there is the need for her to be
well nourished (Bhatia, Katiya and Agarwaal, 1990). Researchers have carried
out a study on the effect of knowledge of nutrition and its practices on health
vitality of the unborn child (Mundi, Allport and Allport, 1991). Their finding
showed that good diet is helpful for the formation, growth and development of
the fetus. Not only that, the knowledge and practices of nutrition, the belief
in eating the correct diet by pregnant mothers to delivery of babies who are
not only healthy, but weigh normally.
Having the knowledge of
nutrition or diet and believing in the same are one thing, but practicalizing
what one knows and believes is another and most important for the pregnant
woman (Uzomah, 2007).Knowledge of certain foods and drugs and belief in them,
will cause pregnant women to practice their intakes (Amaonye, 2000). For
instance, for pregnant women to take foods rich in vitamin and protein such as:
meat, milk, fish, eggs, liver, kidney, beans, vegetables, fruits, bread, and
should take folic acid and fergon tablets for healthy babies to be formed and
delivered without problems (Barnes, 2001).
Globally speaking, women
who are pregnant should be aware of the intake of foods and drugs that promote
health vitality in both the unborn child and the mother (World Health
Organisation (WHO), 1979). In Nigeria,
awareness has been created on the kind of foods pregnant mothers should take
for them to be healthy and maintain balance. Also, in Lagos State,
a sensitization mechanism has been put in place for the promotion of
nutritional knowledge, beliefs and practices among pregnant women. This has
helped most pregnant women to be aware of certain food-intakes and drugs that
give them the necessary health vitality in pregnancy (Nkwor, 2001).
1.3
Statement of
Problem
In our society, there is
strong attachment to beliefs and cultural norms even among the educated ones.
While we agree that some of these beliefs and the practices are good, the
others may not be so good. Recorded advances in medicine and medical services
not withstanding, majority of the pregnant women seem to prefer taking
instruction on nutrition and antenatal healthcare from traditional birth
attendants. This diverse information have effect on the health of pregnant
women thus the need to carry out this study on effect of nutritional knowledge,
beliefs and practices among pregnant women.
Understanding what they
eat and what they forbid or abhor will enable the health worker structure a
balance diet for them in line with available local food stuffs. Also, finding a
means of spreading health talk on nutrition during pregnancy.
1.4 Research Questions
The following research
questions were raised in this study:
(1) Is there any nutritional knowledge among
pregnant women in Lagos
State?
(2) Is there any nutritional belief system
among pregnant women in Lagos
State?
(3) Do women practice nutrition during their pregnancy?
(4) Is there any relationship between the
knowledge of nutrition and health vitality of the newborn child?
(5) Is there any relationship between the
nutritional-knowledge of pregnant women and their practice of it?
1.5 Purpose
of the Study
The main purpose of this
study is to examine assessment of nutritional0knowledge, beliefs and practices
of pregnant women and their effect of their nutritional status in Lagos State.
The following are the
specific objectives of the study:
(1) To find out whether pregnant women have knowledge of
nutrition.
(2) To examine whether pregnant women have nutritional belief
system.
(3) To investigate whether pregnant women
practice the intake of good food/drugs.
(4) To find out whether there is
relationship between the knowledge of nutrition and health vitality of the new
born child.
(5) To examine whether there is relationship
between nutritional knowledge of pregnant women and their practice of it.
1.6 Research Hypotheses
These null hypotheses were
formulated and tested in this study:
(1)
H0: There will be no significant effect of
nutritional-knowledge on practice of it among pregnant women.
H1: There
will be significant effect of nutritional-knowledge on practice of it among
pregnant women.
(2)
H0: There will be no significant
relationship between the knowledge of nutrition and health vitality of the new
born child.
H1: There
will be significant relationship between the knowledge of nutrition and health
vitality of the new born child.
(3)
H0: There will be no significant
relationship between nutritional knowledge and practice of it among pregnant
women in Lagos State.
H1: There
will be significant relationship between nutritional knowledge and practice of
it among pregnant women in Lagos
State.
1.8
Significance
of the Study
The significant of this
study to the pregnant women is for them to be more informed and enlightened on
the importance of balanced diet during pregnancy, which will result in a
healthy mother and child, as well as dispelling some rumors, superstition and
old wives tale about nutrition in pregnancy.
Findings from this study
will help health workers to identify the areas of concentration during
antenatal health education/ health talk.
The findings will also
contribute toward the improvement of the nutritional knowledge and practices of
pregnant women, promote their well-being and prevent complications which may
endanger their lives during delivery as a result of poor nutrition. Such complications
like anemia, abortion, sepsis, bleeding, post-partum shock and eventually
maternal death.
To correct any wrong
beliefs and practices of pregnant women attending these centers and beyond. To make
intelligent suggestions that would improve their nutrition and health status.
This study is also
important to the nation because its findings could assist in mortality and
mortality and morbidity rate among women as well as number of hospitalized
ones.
1.9
Scope of the
Study
The study examined
assessment of nutritional knowledge, beliefs and practices of pregnant women
and their effect of their nutritional status in Lagos State.
Despite the fact that there are many hospitals and health centers for pregnant
women in Lagos,
the scope of this study is limited to Oshodi/Isolo health centre in Lagos state only.
1.10
Limitations
The under listed
constraints limitations to the study:
Time – The period within which the study id to be carried out is
too short for a detailed research.
Finance – The researcher is also faced with financial constraints
and could not meet the need for future studies.
1.11
Research
Method
A descriptive design
employing a questionnaire with a convenience sample of women from child bearing
age, including interview as necessary.
1.12
Operational
Definition of Terms
The following terms were
operationally defined:
Nutrition: This
is the way of taking in food substances into the body in order for the body to
function.
Pregnant Women: This means women of age 18 years and above carrying
baby inside their womb, which lasts for 9 months.
Knowledge: Information
that someone knows about something.
Beliefs: This
is what one has in mind as regards to things. Example – Food and its substances
Practices: Things
you do as regards to eating. The type of food you eat in real practices.
Food Substances: These are different type of food we eat. E.g.
Yam, Beans, Vegetable etc.
Feotus: This
means an unborn baby. That is baby still inside the mothers’ womb.
Superstition: This
means negative belief against something.
Culture: This
means practice of a particular group of people.
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