ABSTRACT
This study assessed the knowledge, attitude and practice of nutrient supplementation among women of reproductive age in Aba South L.G.A, Abia State. The study was cross-sectional and descriptive in design. A multi-stage sampling technique was used to select 422 women of reproductive age residing in the study area. A well-structured and validated questionnaire was used to collect information on socio-economic characteristics, nutrition knowledge and attitude and practice towards nutrient supplementation. Data were analyzed using descriptive statistics (frequency, percentage, mean and standard deviation) and correlation analysis. Significance was accepted at P<0.05. The result showed that 42.2% of the women were between 26-35 years, 54.5% were married, 34.1% were civil servants, 58.8% had secondary school certificate and 65.4% were 4-6 persons in their households. The nutritional knowledge result showed that 52.4% of the women had poor nutritional knowledge. The result further showed that 80.3% took dietary supplements, 79.9% do so daily and 78.2% took them for medical reasons and majority (62.3%)of the Supplements were prescribed by the pharmacist. Finally the result showed that nutrient supplementation had a significant (P<0.05) relationship with BMI and WHR The study concludes that dietary supplement consumption can positively affect the nutritional status of the women. The study therefore recommends that there is need for women to be armed with enough nutritional knowledge as this will aid them in making nutritional choices that will improve their health positively and also further studies should be carried out to ascertain the role of dietary supplements on the nutritional status of breastfeeding mothers and their children.
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 study 1
1.2 Statement of
the Problem 4
1.3 Objectives
of the Study 5
1.4 Significance
of the Study 6
CHAPTER 2:
LITERATURE REVIEW
2.1 Nutrient
Supplements 7
2.2 Types of Nutrient supplements 10
2.2.1 Reasons for Nutrient supplement Use 19
2.3 Sources of Nutrient supplement Information 21
2.4 Health Issues Associated with Nutrient
supplements 23
CHAPTER 3: MATERIALS AND METHODS
3.1 Study
Design 29
3.2 Area
of Study 29
3.3 Population
of the Study 30
3.4 Sample
and Sampling Technique 30
3.4.1 Sample Size 30
3.4.2 Sampling Procedure 32
3.5 Preliminary
Activities 32
3.5.1 Preliminary visit 32
3.5.2 Training of research assistants 33
3.5.4 Informed Consent 33
3.5.5 Ethical
Approval 33
3.6 Data
Collection 33
3.6.1 Questionnaire Validation 34
3.6.2 Questionnaire
Administration 34
3.6.3 Questionnaire
pretesting 34
3.6.4 Anthropometric measurements 34
3.7 Data
Analysis 35
3.8 Statistical
Analysis 36
CHAPTER
4
RESULTS
AND DISCUSSION
4.1 Personal
and Socio-Economic Characteristics of the Women of Reproductive Age 37
4.2 Nutrition
Knowledge of Women of Reproductive Age about Nutrient
Supplementation 40
4.3 Practice of Women of Reproductive Age towards
Nutrient
Supplementation 45
4.4 Relationship between Nutrient
Supplementation and Nutritional Status Of
The Women 47
CHAPTER
5: CONCLUSION AND RECOMENFATION
5.1 Conclusion 49
5.2 Recommendations 49
REFERENCES 50
APPENDIX
55
LIST OF TABLES
Table 4.1 Personal and socio-economic
characteristics of the women 39
Table 4.2a
Nutritional knowledge of the women of reproductive age 43
Table 4.2b
Nutritional knowledge of the women of reproductive age 44
Table 4.3 Practice of women of reproductive age towards
nutrient
Supplementation 46
Table 4.4 Relationship between Dietary supplements and Nutritional status
of the women 48
CHAPTER 1
INTRODUCTION
1.1
Background of the study
Nutritional
supplements also known as dietary supplements are considered as nutraceutical
preparations that can be formulated in certain dosage forms containing certain
micronutrients to meet the deficiency of certain nutrients. However, these
supplements can’t replace the nutritional values of natural food. Additionally,
micronutrients as: vitamin and minerals contributed in competing many chronic
diseases and maintaining a balanced health (American Dietetic Association
[ADA], 2011). In this study, we define
nutritional supplementation as any nutritional intervention aimed at improving
the quantity (macronutrients) or quality (micronutrients) of the dietary intake
of the participants. This supplementation is possible as enriched drinks on the
basis of juice or milk. Another possibility is to provide multivitamin tablets
or vitamin injections.
Nutrient supplements are products containing one or
more of a vitamin, mineral, herb, botanical, amino acid, or other dietary
substance used to supplement the diet by increasing total dietary intake; or an
extract, constituent, concentrate, metabolite, or combination of previous
ingredients (Federal Food, Drug, and Cosmetic Act [FFDCA], 2013). Spending $37
billion on products annually, half to two-thirds of Americans take some form of
nutrient supplement with multivitamins
being the most frequently used (Dickinson and MacKay, 2014; National Institutes
of Health Office of Nutrient supplements [NIHODS], 2016). Nutrient supplements
are intended to add further nutritional value to the diet when nutrient
adequacy cannot be met from food intake alone (Food and Drug Administration
[FDA], 2017).
Reproductive age in women
are those years of life between menarche and menopause, roughly between 12 and
49 years of age. However the term is imprecise since some women can become
pregnant and bear child at a younger or older ages. Furthermore, Healthline
(2020) states that Technically, women can get pregnant
and bear children from puberty when they start getting their menstrual period
to menopause when they stop getting it, and therefore the average woman’s
reproductive years are between ages 12 and 51 (Healthline,
2020). The question however is, how important is nutrition to women of child
bearing age?
Maternal malnutrition not only negatively
affects the mother and fetus during the period of pregnancy, but also manifests
through intergenerational effects. It can significantly alter the short-term
and long-term health and development outcomes in offspring, including growth,
neurodevelopment and cognition, and cardio-metabolic, pulmonary and immune
functions (Germand et al., 2016).
Poor nutritional status in mothers shortchanges a newborn’s chance to reach
their fullest potential in growth and development in the short term and
establishes a trajectory for chronic illness and other diseases in adolescence
and adulthood. Poor fetal and infant health due to maternal malnutrition are
associated with stunting that can be sustained into adulthood, chronic diseases
relating to nutrition, lower educational attainment, reduced income, and even
decreased birth weight in the subsequent generation (Victora et al., 2018).
Several strategies exist globally to
address micronutrient malnutrition in women and children. Common strategies
include diet diversification, bio-fortification of staple crops, large-scale,
targeted, and home fortification (Bhutta et
al., 2018). Nutrient supplementation is another common strategy, often used
for short-term, preventive purposes targeting specific at-risk population
groups (Bailey et al., 2015).
Nutrients are ingested in the forms of tablets or other vehicles (e.g., syrup,
drops, capsules, powder, or food matrices) and bio-converted to their active
form. Thus, supplementation is a recommended part of routine antenatal care to
overcome complications associated with macro and micronutrient deficiencies
during pregnancy, and to support maternal health and fetal development.
According
to American Society of nutrition, there is a large proportion of population
using nutrient supplements in their routine life. However, previous studies
have not been able to show a correlation between knowledge and nutrient
supplement consumption. On the other hand, some studies revealed that the lack
of knowledge regarding the nutritional values of nutrient supplements
contributes in an improper consumption; in which consumers are unable to figure
out the goals of their food (Wardle et al., 2010). In 2007, the
journal of ADA reported that the attitude of nutrient supplementation is
relevant to the good knowledge of nutrient supplementation. Despite that, a
large number of women who regularly use nutrient supplementation, don’t have an
accurate knowledge of nutrient supplementation. Additionally, many factors
could contribute to the knowledge, attitude and practice of nutrient
supplementation among women of reproductive age; such as social and educational
factors. Although pharmacists themselves are the most knowledgeable team about
nutritional supplements, they still have poor knowledge regarding the proper
usage of Nutrient supplements. This study is therefore poised to examine the
knowledge, attitude and practice of nutrition supplementation among women of
child bearing age in Aba South L.G.A, Abia state.
1.2
Statement of the Problem
Nutrition
among women of reproductive age is very important and a delicate issue as it
affects not just them alone but also may affect the health of their unborn
children and after birth. In a bit to cub malnutrition, especially during
pregnancy many women receive nutrient supplements from health care
professionals (Hoyte et al., 2013).
However
women of reproductive age are more open to experimenting with health
alternatives as a result of many factors that are mostly health related, and
they tend to express a strong perception of nutrient supplement effectiveness
(Jackson et al., 2010). Women that
used nutrient supplements reported feeling more knowledgeable about products
and self-reported having better health compared to nonusers (Valentine et al., 2018).
Many
studies have been conducted in other locations especially in the United States
with respect to nutrient supplementation, however no study have been carried
out in the study area with regards to knowledge, practice and attitude of
nutrient supplementation among women of reproductive age. Moreover this studies
have concentrated more on the students and elderly population. Based on this
gap therefore, the present study have
been established to evaluate the knowledge, attitude and practice of nutrient
supplementation among women of reproductive age in Aba South L.G.A, Abia State
so as to help fill the research gap that have existed in this area.
1.3
Objectives of the Study
The
general objective of this study is to evaluate the knowledge, attitude and
practice of use of nutrient supplement among women of reproductive age in Aba
South L.G.A, Abia State.
The
specific objectives include to:
1.
determine
the socio-economic characteristics of the women of reproductive age in the
study area
2.
assess the
nutrition knowledge of women of reproductive age about nutrient supplementation
3.
determine
the practices of women of reproductive age on nutrient supplementation
4.
determine
the relationship between nutrient supplementation and nutritional status of the
women
1.4
Significance of the Study
The findings of this study will be vital
in enhancing the body of knowledge in nutrient supplementation. In addition,
the recommendations gathered from this study will help future development of
policies and curriculum that will give comprehensive training programmes on
nutrient supplementation so that people can be aware of the good practice of
nutrient supplementation.
The findings of this
study will help understand the overall knowledge and practice of nutrient
supplementation among women of reproductive age, this will help the food and
drug administration and control to understand the level of education that needs
to be carried out so as to make women aware of the advantages and disadvantages
of nutrient supplementation and thus make informed choices.
Furthermore, this study
will contribute to the pool of existing knowledge in this area of study and may
be used as a yardstick by future researchers interested in further studies. The
study also provides an important basis for formulating well-targeted policy
support for nutrient supplementation. By this, it is expected that adequate
rules guiding the sale and distribution of nutrient supplements be implemented
by the National Food and Drug Administration and Control (NAFDAC), so as to
help curb the mismanagement of nutrient supplementation.
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