Assessment of Nutritional Needs and Factors Associated with Food Diversification among Pregnant Women in the Community of Gitaramuka-Karusi-Burundi

Abstract

The dietary diversity of pregnant women in Gitaramuka is largely inadequate and influenced by multiple socio-economic and knowledge-related factors. Promoting diversified diets through education, income-generating activities, and supplementation, alongside leveraging locally available nutrient-rich foods, is crucial for improving maternal and fetal health outcomes. This study aimed to assess the dietary diversity, associated factors, and micronutrient content of commonly consumed foods among pregnant women in Gitaramuka commune, Burundi, to inform strategies for improving maternal nutrition. A cross sectional study with a descriptive and analytical component was conducted. The study was conducted in five health facilities (HEFA) of Gitaramuka commune, Karusi province, Burundi, during April and August 2024. A sample of 224 pregnant women was selected using systematic random sampling. Data were collected via a pre-tested questionnaire using KoboCollect, assessing socio-demographic, economic, and dietary factors. Dietary Diversity Scores (DDS) and Food Consumption Scores (FCS) were calculated according to FAO guidelines. Laboratory analyses at the National Food Technology Centre (CNTA) determined the iron, zinc, protein, and iodine content of the six most consumed foods (amaranth, avocado, beans, sweet potato, corn flour, palm oil). Data were analyzed using SPSS version 20, with bivariate analysis (Chi-square, Fisher tests) performed to identify factors associated with dietary diversity (p<0.05). The results revealed a low level of dietary diversity among pregnant women: 44.64% had a low DDS, 45.09% a medium DDS, and only 10.27% a high DDS. Similarly, 27.68% had a poor FCS. Significant factors associated with inadequate dietary diversity included low education level (p=0.036), large household size (≥5 persons, p=0.007), low household income (p=0.012), agricultural occupation of the woman or household head (p=0.006 and p<0.001, respectively), lack of knowledge about nutritional advice (p<0.001), and lack of iron-folic acid supplementation (p<0.001). Laboratory analysis showed varying micronutrient levels; for instance, sweet potatoes were rich in iron (54.9 mg/kg), while beans were high in protein (16.45%) and zinc (148.6 mg/kg). No single food contained all essential nutrients in sufficient quantities to meet daily requirements.