Quality of nutrition services provided at reproductive and child health clinics in addressing maternal undernutrition in Temeke district, Dar-es-salaam

Maternal undernutrition is a significant nutrition problem in Tanzania. Chronic energy deficiencies, iron deficiency anaemia, iodine deficiency disorder and vitamin A deficiency are the major manifestations of maternal undernutrition. This study examined the quality of nutrition services at RCH clinics in addressing maternal undernutrition in Temeke District. A cross sectional study design, involving 100 pregnant women and 108 RCH providers from 12 selected health facilities was employed. Structured questionnaires, checklists with key informants, client exit interviews, structured observations and focus group discussions were used in data collection. SPSS software version 16 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and in-service training. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. Understaffing and lack of teaching aids contributed to the failure in the delivery of quality nutrition education. Most pregnant women (81%) started attending antenatal care in the second trimester and were neither aware of nutritional needs during pregnancy nor the relationship between maternal dietary intake and birth outcomes. About 54% of pregnant women were not satisfied with antenatal services provided at the surveyed clinics. Reasons mentioned included, spending long hours at clinic, high costs of some services and inadequate number of service providers. Common foods consumed by these women were maize flour, rice, tomatoes, carrots, green vegetables and fruits, while less commonly consumed foods were legumes, sea foods, meat, milk and milk products. The overall quality of nutrition services provided at the surveyed RCH clinics was low, mainly due to inadequate nutrition knowledge among RCH providers and inadequate education tools. This study recommends a review of nursing curriculum to add more nutrition courses, conducting of regular in service nutrition training and formulation of nutrition guidelines.Belgian Technical Cooperation (BTC

Quality of nutrition services provided at reproductive and child health clinics in addressing maternal undernutrition in Temeke district, Dar-es-salaam

Maternal undernutrition is a significant nutrition problem in Tanzania. Chronic energy deficiencies, iron deficiency anaemia, iodine deficiency disorder and vitamin A deficiency are the major manifestations of maternal undernutrition. This study examined the quality of nutrition services at RCH clinics in addressing maternal undernutrition in Temeke District. A cross sectional study design, involving 100 pregnant women and 108 RCH providers from 12 selected health facilities was employed. Structured questionnaires, checklists with key informants, client exit interviews, structured observations and focus group discussions were used in data collection. SPSS software version 16 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and in-service training. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. Understaffing and lack of teaching aids contributed to the failure in the delivery of quality nutrition education. Most pregnant women (81%) started attending antenatal care in the second trimester and were neither aware of nutritional needs during pregnancy nor the relationship between maternal dietary intake and birth outcomes. About 54% of pregnant women were not satisfied with antenatal services provided at the surveyed clinics. Reasons mentioned included, spending long hours at clinic, high costs of some services and inadequate number of service providers. Common foods consumed by these women were maize flour, rice, tomatoes, carrots, green vegetables and fruits, while less commonly consumed foods were legumes, sea foods, meat, milk and milk products. The overall quality of nutrition services provided at the surveyed RCH clinics was low, mainly due to inadequate nutrition knowledge among RCH providers and inadequate education tools. This study recommends a review of nursing curriculum to add more nutrition courses, conducting of regular in service nutrition training and formulation of nutrition guidelines.Belgian Technical Cooperation (BTC

The prevalence and risk factors associated with Iron, vitamin B12 and folate deficiencies in pregnant women: A cross-sectional study in Mbeya, Tanzania.

Maternal nutrition is an important forecaster of infant's and mother's health status in most developing countries. This study aimed at assessing the prevalence and associated risk factors of iron, vitamin B12, and folate deficiencies among pregnant women in Mbeya Tanzania. A cross-sectional study using a cluster randomized sampling was conducted among 420 pregnant women. A structured questionnaire was used to collect socio-demographic and dietary assessment. Body iron store was assessed using serum ferritin measured by immunoturbidimetric assays using a Roche Cobas 400+ biochemistry analyzer. Serum folate was measured by folate microbiological assay, while serum vitamin B12 was measured by immunochemiluminescence assay using a Roche Cobas e411 immunoassay analyzer. Multivariate analysis was performed using Poisson regression. The prevalence of iron, folate, and vitamin B12 deficiencies among pregnant women in Mbeya was 37.8%, 24.0%, and 9.7% respectively. Higher odds of iron deficiency were seen in pregnant women aged 20-24 years older [Adjusted OR = 1.20 (95%CI 1.03, 1.35)], not employed [Adjusted OR = 3.0(95%CI 1.03-1.77)] and, not received iron/folic acid supplementation [Adjusted OR = 1.11 (95%CI 1.003-1.23)]. Pregnant women with highest and middle socio-economic statuses had lower odds of vitamin B12 deficiency [Adjusted OR = 0.83 (95%CI 0.76-0.92)] and [Adjusted OR = 0.89 (95%CI 0.81-0.98)] respectively. Pregnant women who were not employed, not received iron and folic acid supplement during pregnancy and, not consumed edible vegetable cooking oil had significant higher odds of serum folate deficiency [Adjusted OR = 3.0 (95%CI 1.58-5.68)], [Adjusted OR = 1.53 (95%CI 1.21-1.93)] and, [Adjusted OR = 2.77 (1.03-7.44)] respectively. This study confirms that iron, folate and vitamin B12 deficiencies are still a major challenge among pregnant women in Tanzania. We recommend for public health interventions for the provision of vitamin B12 along with iron and folic acid supplementations, especially in pregnant women belong to low socio-economic status and limited knowledge of healthy diet