KNOWLEDGE AND PRACTICE OF USE OF NUTRIENT SUPPLEMENT AMONG WOMEN OF REPRODUCTIVE AGE IN ENUGU NORTH L.G.A., ENUGU STATE

ABSTRACT

The aim of this study was to evaluate the knowledge and practice of use of nutrient supplements among women of reproductive age in Enugu North Local Government Area of Enugu State. This study was a cross-sectional survey used to assess the personal and socio-economic characteristics and anthropometric status of 255 women of reproductive age in Enugu North Local Government Area of Enugu State was randomly selected. A multi-stage sampling techniques was used to select the study sample and respondent. In the first stage, Enugu North L.G.A. was purposefully selected as the study area. In the second stage, nine (9) wards out the 12 wards in Enugu North L.G.A. was randomly selected by balloting. In the next stage, 25 women of reproductive age were randomly selected from the ward to make a total of 225 sample size. The study revealed that the respondent were of different age range. Majority (48.6%) of the respondents were of 31-40 years of age while the minority (7%) were of 50 years and above. More than half (54.5%) of the respondent were Christians while the few (23.9%) of them were Islam. Most (60.8%) of the women of reproductive age were married while few (10.2%) were widows.  Most (72.5%) of the respondent has 1-3 household size while the least (7.2%) had 10 and above household size. Majority (59.2%) of the respondent had tertiary institutions while the minority (9.8%) had no formal education. Majority (46.3%) of the respondents were of the view that liver, chicken and beans provides the body with high protein while minority (12.2%) stated that nuts, cabbage, beans, pawpaw provides the body with least protein. Majority (76.5%) of the women of reproductive age said that they take dietary supplements while few (23.5%) of them does not take. The majority (39.2%) of the respondents opined that they take more mineral dietary supplements while few (8.2%) said they take protein supplement. Most (32.2%) of the respondents got their dietary supplements from pharmacies. Many (47.8%) of them said that doctor prescribe the dietary supplements for them while few did self-medication (2.5%). The nutritionist should provide health talks on adequate nutrition and healthy life style behavior such as physical activity and alcohol consumption are to be given significant consideration among women of reproductive age promote their health and reduce risk of disease.

TABLE OF CONTENTS

Title page                                                                                                                    i

Certification                                                                                                               ii

Dedication                                                                                                                  iii

Acknowledgement                                                                                                      iv

Table of contents                                                                                                        v

List of tables                                                                                                               vii

Abstract                                                                                                                      viii

CHAPTER 1

INTRODUCTION   

1.1       Background of the study                                                                                 1                     

1.2       Statement of the Problem                                                                               2                                                                                             

1.3       Objectives of the Study                                                                                  4

1.3.1    General objective                                                                                           4

1.3.2    Specific Objective                                                                                          4

1.4       Significance of the Study                                                                               4

CHAPTER 2 

LITERATURE REVIEW

2.1       Nutritional Status of Women of Reproductive Age                                       6

2.1.2    Nuttition Supplementation                                                                             7

2.1.3    Factors Affecting Nutrition Supplementation among Women of

Reproductive Age                                                                                           11

2.1.4    Nutritional Knowledge and practice among Women of Reproductive Age       14

2.1.5    Causes of Malnutrition among Women of Reproductive Age                        15

2.1.5.1 Inadequate Food Intake                                                                                  15

2.1.5.2 Disease                                                                                                            16

2.1.5.3 House Hold Food Insecurity                                                                          16

2.1.5.4 Poor Public Health                                                                                         17

CHAPTER 3

MATERIALS AND METHODS

3.1       Study Design                                                                                                  18

3.2       Area of Study                                                                                                  18

3.3       Population of the Study                                                                                  18

3.4       Sampling and Sampling Techniques                                                              18

3.4.1    Sample Size                                                                                                    18

3.4.2    Sampling Procedure                                                                                       19

3.5       Preliminary Activities                                                                                    19

3.5.1    Preliminary Visits                                                                                           20

3.5.2    Training of Research Assistants                                                                     20

3.5.3    Informed Consent                                                                                           20

3.6       Data Collection                                                                                               21

3.6.1    Questionnaire Design                                                                                     21

3.6.2    Questionnaire Administration                                                                        21

3.7       Data Analysis                                                                                                  21

3.8       Statistical Analysis                                                                                         22

CHAPTER 4

DATA PRESENTATION AND DISCUSSION                                                      23

CHAPTER 5

CONCLUSION AND RECOMMENDATION

5.1       Conclusion                                                                                                      32

5.2       Recommendation                                                                                           33

REFERENCES                                                                                                         34

 APPENDIX                                                                                                              40

LIST OF TABLES

Table 4.1         Socio-Economic Characteristics                                                         24

Table 4.2         Nutrition Knowledge                                                                          27

Table 4.3         Practice Towards Nutrition Supplement                                            30

CHAPTER 1

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Pregnancy is a crucial period in women’s lives where they tend to experience many changes in their bodies. Pregnant women are exposed to physical, physiological and mental changes all along the pregnancy period (Ramakrishnan et al., 2018). Increased needs for energy, macronutrients and micronutrients are required throughout the pregnancy period to provide the needed nutrients to the growing fetus and to ensure health and wellbeing of the mother. Women in developing countries are at risk of malnutrition and nutritional deficits during pregnancy resulting in negative pregnancy outcomes such as delay in fetal growth and development, pre-term delivery, low birth weight and maternal anemia (Müller and Krawinkel, 2015).

According to the World Health Organization (WHO, 2018), many women do not get enough micronutrients in their diets during their reproductive age as well as during pregnancy. They are also unaware of how much their nutritional status impacts their pregnancy and infant outcomes (Berti et al., 2016).

In Nigeria, women are usually responsible for producing and preparing food for the household, so their knowledge of good nutrition or lack of it can affect the health and nutritional status of the entire family. Studies from Nigeria have revealed a high prevalence of both under nutrition and over nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A (Fasola et al., 2018). According to Nigeria Demographic and Health survey, the 11% of women of reproductive age are thin or undernourished (BMI less than 18.5kg/m2). 17% of women are overweight (BMI of 25-29 kg/m2), and 8 percent are obese (BMI of 30 kg/m2 or above). Overweight or obesity is most prevalent in Lagos (44%) (Shulman and Kottke, 2016). Consequently, obstetric complications such as hypertension, anemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality are common.

In Lagos State, the maternal mortality rate is 650 deaths per 100 000 live births (NDHS, 2018). Many of these deaths have malnutrition as the predisposing factor, either directly or indirectly. Similar studies have been conducted in Western Kenya and Northern Nigeria however few studies have been done in South east Nigeria. It is hoped that in doing this study, it will shed more light on the Knowledge, attitude and practice of nutrient supplement among women of reproductive age in Enugu North LGA and provide a basis for developing nutrition education programs and interventions that will improve quality of life and reduce morbidity, mortality and health-care costs.

1.2       STATEMENT OF THE PROBLEM

Maternal nutrition is one of the most important health and welfare problems among women in developing countries. In women of reproductive age, malnutrition can result in adverse pregnancy outcomes. Maternal nutrition is the major public health problem. Malnutrition is one of the most important health problems among women in developing countries (Müller and Krawinkel, 2015). It is usually a result of a combination of inadequate nutrient supplement intake and infection. Inadequate food intake is a consequence of insufficient food available at the household level, improper feeding practices, or both. Nutrient supplement practices include both the quality and quantity of foods taken by the individual (Ramakrishnan et al., 2018).

Enugu state is one of the six states in the southeast geopolitical zone of Nigeria. Available data indicate that maternal mortality ratio is high in Enugu State, with figures ranging from 772 to 998 per 100,000 (NPC, 2018). This is almost thrice the figure (286 / 100,000) reported for the entire southeast zone (Onah et al., 2015), and almost double the 545 national average for the seven years period preceding the 2008 National Demographic and Health Survey (NDHS, 2017) . Currently, maternal mortality ratio for Enugu State approximates rather closely to the national ratio of 1,100 maternal deaths for every 100,000 live births (Ezugwu et al., 2015). Early in 2000, several reports indicated that maternal health in Enugu State was deplorable, and that maternal mortality was more than 3000 deaths per 100,000 live births in the Nsukka senatorial zone of the State. More so, some women of reproductive age are vulnerable to deficiencies of calcium, vitamin D, and vitamin B12. Despite the availability of fortified foods in the country, intakes of these nutrients among women of reproductive age remain inadequate. These deficiencies as a result of inadequate supplementation of single vitamins, multivitamin and mineral (MVM) has led to increased risks for chronic diseases. It is against this backdrop that the study intends to assess the knowledge and practice of nutrient supplement among women of reproductive age in Enugu North Local Government of Area of Enugu State.

1.3       OBJECTIVES OF THE STUDY

1.3.1    General objective

The general objective of this study is to assess the knowledge and practice of nutrient supplement among women of reproductive age in Enugu North Local Government of Area of Enugu State.

1.3.2    Specific objectives                                  

The specific objectives are to:

1.     determine the effect of socio-economic characteristics on nutrient supplement

2.     evaluate the knowledge of respondents towards nutrient supplement

      3.  ascertain the practice of respondents towards nutrient supplement

      4. determine the type of nutrient supplement used among women of reproductive age in the study area

1.4       SIGNIFICANCE OF THE STUDY

Identifying and understanding the knowledge and practice (KAP) level of women of reproductive age will help to reduce maternal mortality. The result of this study will assist the government and policy makers to understand better, develop and implement policy that will not only improve the nutritional status of women of reproductive age in the short term but also seek to maintain and prevent future cases of malnutrition in the long term. It will also benefit the general public by highlighting the nutritional status of women in reproductive age aiding in the advocacy for improved nutrition.

The findings of the study will be of immense help to pregnant woman and intending mothers by providing them with the knowledge that will guide them during nutrient supplement . The study will help primary health workers and other health practitioners in handling the issues of attitude among women of reproductive age towards nutrient supplement. Through the study, the management of health practitioners will be exposed with the practice of respondents towards nutrient supplement. The study will help to establish the relationship between their knowledge  on practice of nutrient supplement.

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