UDS, School of Allied Health Sciences- Tamale   Household food insecurity, coping strategies and nutritional status of pregnant women in rural areas of Northern Ghana PRESENTED BY Dr Mahama Saaka (PhD) UDS, School of Allied Health Sciences- Tamale

Study Rationale &Purpose A good understanding of the factors that contribute to household food insecurity is critical for designing effective strategies to address poor maternal dietary intake. However, there is limited information on the magnitude of household food insecurity and how it relates to the nutritional status of pregnant women in Northern Ghana.

Study Rationale &Purpose This study assessed household food insecurity, its determinants and relationship with nutritional status of pregnant women belonging to different gestational ages in the Africa RISING West Africa project intervention communities of Northern Ghana.

Study Design, study Population and Sampling A household-based cross-sectional study involving 400 pregnant women in different stages of gestation was conducted in 25 communities. In each community, a complete list of all households was compiled and were serially numbered. Systematic random sampling was then used in selecting study households

Study Design, study Population and Sampling The Household Food Insecurity (HFI) was quantified using the Household Hunger Scale and the reduced coping strategy index (rCSI) Mid upper arm circumference (MUAC) was used to assess the nutritional status of the women.

Study Design, study Population and Sampling Binary logistic regression was performed to test whether HFI significantly predicts maternal nutritional status, controlling for potential confounding factors. A P value of < 0.05 was considered statistically significant.

Results The mean dietary diversity score (DDS) of study population from ten food groups was 4.2±1.5 (95 % CI: 4.08 to 4.37). Of the 400 women, 46.1 % (95 % CI: 40.0 to 52.2) met the minimum dietary diversity for women (MDD-W).

Results The majority (77.5 %) of households experienced some degree of food insecurity in the month prior to the survey. The prevalence of moderate and severe household hunger were 25.9 % (95% CI: 19.0 – 34.3) and 6.8 % (95% CI: 4.2 – 10.9) respectively.

Results Logistic regression analysis showed that households with larger number of children (> 4) under five years were 6 times more likely (AOR=6.85, CI:2.13, 22.05) to be food insecure.

Results Compared to the Nadowli District, women resident in the Kasena-Nankana/Bongo District were 6 times more likely of experiencing food insecurity (OR=6.91, CI: 3.16, 15.11) and households having lower wealth index (AOR=5.14, CI: 2.88, 9.18) were 5 times more likely to be food insecure.

Results Significant proportion of women in food insecure households adopted coping strategies to minimize the impact of food insecurity. The strategies included relying on less expensive foods, limiting portion size of meals and reducing number of meals eaten in a day.

Results Correlation analysis showed that coping strategy index (CSI) was positively associated with overall household food insecurity as measured by household hunger scale (HHS) among pregnant women in rural households (r = 0.60, p <0.001).

Results CSI associated negatively with dietary diversity score for women (r = -0.17, p <0.001). The independent predictors of maternal thinness were region of residence, gestational age and maternal age. Gestational age was the greatest predictor of maternal thinness.

Results Compared to women in the first trimester, women in the third trimester were 2.2 times more likely of being underweight (OR=2.19, CI: 1.02, 4.70). Women who were under 20 years of age were 11.9 times more likely of being thin compared to women aged more than 35 years (OR= 11.97, CI: 2.55, 5. 67)

Conclusion and Recommendation Though perceived food insecurity was highly prevalent, it was not associated with maternal thinness of this sample of rural pregnant women. The risk of maternal thinness increased as the gestational age increased and this has a great potential of adversely influencing pregnancy outcomes and overall quality of life.

THANKS END OF PRESENTATION