1.1 Introduction
The nutritional practices of pregnant women may be based on the accessibility and availability of nutritional reserves, which include stores of some special micronutrients like iron and calcium, which is considered as a building block of the maternal body, starting from the consumption of diets containing these important micronutrients (Gebreyesus et al., 2015). It is essential to states that low birth weight stems primarily from the mother's poor health and nutrition, and inadequate nutrition during pregnancy accounts for a large proportion of growth retardation (Hareyan, 2005).
Epidemiological evidence shows that there is an increased incidence of diseases, which can be attributed to changes in lifestyle as well as changes in nutritional habits. Nutritional education is also one of the important aspects that play a big role in nutritional knowledge by raising awareness and ultimately the health of the society (Stampfer et al., 2000).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.
1.2 Background of Study
Nutritional knowledge has been proven to play a very vital role in adopting optimal nutrition practices in the health of every expectant mother. As a matter of fact, health and nutritional status of the population of a nation is an important indicator of development of the country. A nutrition survey carried out in India observed that the nutritional status of pregnant and lactating and infants is not satisfactory. This is probably due to lack of basic knowledge regarding proper nutrition and wrong customs prevalent in the community besides non availability and low intake of food.In Nigeria, there are some adverse socio-cultural and economical factors that produced negative consequences and reduce women's access to effective ante-natal services needed to reduce maternal morbidity and mortality.
The most important of these are the low socioeconomic status of women that deny them access to appreciable decision-making with regard to their reproductive functions, high level of female illiteracy which is a leading cause of poor health seeking behaviour for maternity services among Nigerian women and high rate of poverty that predominantly affects women leading to inadequate dietary intakes, high rate of pregnancy complications and women's reduced access to evidence based maternity services (Ogunjuyibe, 2000).
Maternal nutrition before and during pregnancy is an important determinant of birth weight. High rate of Low Birth Weight (LBW) in developing countries has been attributed to poor maternal nutrition (Ogunjuyigbe et al., 2008) Pregnancy is a time of tremendous physiological change that demands healthy dietary lifestyle choices. Growing foetus draws a lot of energy and nutrients from the mother to enhance physical and psychological development (Ojo and Briggs, 2010).
Malnutrition has been recognized as one of the underlying factor for maternal death during the process of procreation. The causes of malnutrition are multidimensional and multi-factorial with poverty, food inadequacy and maternal illiteracy being the main culprit of the menace in developing countries. The health of the mother and her nutritional status can influence the health and survival of the child because of the biological links that exist between her and her child during pregnancy and lactation (Ogunjuyigbe et al., 2008).
There is an important factor under nutrition that is responsible for high infant mortality rate, maternal mortality rate and also for low birth weight of infants. Appropriate nutritional practice on the other hand plays a pivotal role in determining optimal health and development of infants. (Bamji Ms, 2003). There is abundant epidemiological evidence that poor prenatal nutrition predisposes the offspring to diseases in its later life. Inadequate nutrition is the predominant factor leading to malnutrition, which can be expressed as either under nutrition or over nutrition. Under nutrition occurs when there is not only inadequate energy but also a lack or imbalance of specific food components and nutrients.
In addition to sufficient energy, adequate supplies of macronutrients and micronutrients are required to promote optimum growth. The proportions and amounts of these nutrients may change according to the various stage of growth. There have been considerable changes in human lifestyle all over the world in the recent decades. Especially in recent years, the lifestyle has rapidly been changed. These changes appeared in diet, types of food, cooking time, etc. Nowadays processed foods are rapidly replacing organic food. Another change is the rapid increase in the number of restaurants and in people's tendency to eat fast food. Proper nutrition is one of the most important aspects of lifestyle (Amamoto and Andoyama, 2004).
In order to remain healthy and physically active and enjoy a healthier life style it is necessary to obtain good nutritional knowledge and implement it. The knowledge, attitude and practice must be considers in expectant mothers in order to promote society health. From time immemorial it has been recognized that the pregnant and lactating women form one of the most nutritionally vulnerable segments of the population; the ill effects of maternal under nutrition affect not only the mother but also her offspring. In order to bring about change in the level of nutritional knowledge and practices prevailing people regarding nutrition, an attempt was made here to provide an awareness regarding nutritional knowledge practices among the mothers who are visiting a private and government hospitals.
Nutrition, throughout the life of human beings, has a major effect on health. This is special for pregnant women as good maternal nutrition is one of the crucial options to safeguard maternal and fetal welfare in both developed and developing countries. A mother’s nutritional status, from early conception to lactation periods, plays a vital role in defining the well- being of the mother and child.
Therefore, in St Charles Borromeo Specialist Hospital Onitsha where the research was carried out, the activities that was conducted is to know the Nutritional Knowledge and Practices Among Pregnant Women.
1.3 Statement of Problems
Investigation revealed that the most important factor responsible for high infant mortality rate is under nutrition, maternal mortality rate and also for low birth weight of infants. Nutrition is a multi-sectoral issue that needs to be tackled at various levels. Nutrition affects the development as much as development affects nutrition. It is therefore, important to tackle the problem of nutrition through direct nutrition intervention for vulnerable groups such as pregnant mothers.
Adequate knowledge regarding various aspects of feeding practices during pregnancy and during infancy is very essential especially among females as they are going to influence the feeding practices of this vulnerable group. This led to the study on nutrition knowledge and practice among expectant mothers.
1.4 Aim and Objectives of Study
The aim of the study is to examine the Nutritional Knowledge and Practices Among Pregnant Women in St Charles Borromeo Specialist Hospital Onitsha. In achieving this aim, the following specific objectives were laid out as follows:
- To ascertain the relationship between dietary intake, physical activity and maternal nutritional status;
- To enumerate factors associated with deterioration in maternal nutritional status;
- To outline common pregnancy outcome with poor maternal nutrition; and
- To examine the role of contraception in maternal nutrition, and the preventive measures, treatment of micronutrient deficiencies.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- Is there any significant relationship between dietary intake, physical activity and maternal nutritional status?
- Are there factors associated with deterioration in maternal nutritional status in the area under study?
- What is the common pregnancy outcome with poor maternal nutrition?
- What is the role of contraception in maternal nutrition, and the preventive measures, treatment of micronutrient deficiencies?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: Age of expectant mothers at pregnancy has no significant influence on level of nutritional knowledge
- H1: Age of expectant mothers at pregnancy has a significant influence on level of nutritional knowledge
Hypothesis Two
- H0: There is no significant relationship between dietary intake, physical activity and maternal nutritional status of expectant mothers
- H1: There is a significant relationship between dietary intake, physical activity and maternal nutritional status of expectant mothers
1.7 Significance of Study
It is unbelievable to discover that many expectant mothers in this era still lack the fundamental idea or basic knowledge of nutrition during pregnancy. It is believed that at the end of this study the findings will be of utmost benefits to every expectant mothers and women as it serves as a means of curtailing the effects of malnutrition on their reproductive health.
The ministry of health will make a great deal from the findings as it serves as a material for onward sensitization within cities and communities. The findings will be relevant to those who intend to carry out a similar research topic as it has contributed to the existing literature.
Finally, the research will serve as a fuel of new reasoning and further research work in nutritional knowledge and practice among expectant mothers, and to health science students, lecturers and the general public.
1.8 Scope of Study
The scope of this research is focused on the Nutritional Knowledge and Practices among Pregnant Women using St Charles Borromeo Specialist Hospital Onitsha as a case study.
1.9 Limitations of the Study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
- Lack of Initial Cooperation from Respondents: A particular limitation of this work came as a result of the respondent refusal to offer their cooperation at the initial time they were contacted. This contributed in making the success of this research study difficult.
1.10 Definition of Terms
Knowledge:
Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts, information, descriptions, or skills, which is acquired through experience or learning.
Nutrition:
Nutrition is the science that interprets the interaction of nutrients and other substances in food in relation to maintenance, growth, reproduction, health and disease of an organism. It includes food intake, absorption, assimilation, biosynthesis, catabolism and excretion.
Expectant Mothers:
Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. Pregnancy can occur by sexual intercourse or assisted reproductive technology. Childbirth typically occurs around 40 weeks from the last menstrual period.
Health:
Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental or social changes.
1.11 Organization of the Study
This research work is organized in five chapters, for easy understanding, as follows:
Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study.
Chapter two highlight theoretical framework on which the study its based, thus the review of related literature.
Chapter three deals on the research design and methodology adopted in the study.
Chapter four concentrate on the data collection and analysis and presentation of finding.
Chapter five gives summary, conclusion and also recommendations made of the study.
