CHAPTER 1

1.0 Introduction
This chapter deals with the background of the study, statement of
research problem, aims and objectives of the study, research questions,
significance of the study, scope of the study, aims and objectives of the study,
operational definition of terms.

1.1 Background
Nutrition during pregnancy has a major impact on the outcome of pregnancy
and accredited as an important determinant for a healthy and successful
pregnancy including the life-long health of future generation (Adikari et al,
2016). Even though nutrition is the intake of food necessary for optimal
health, several studies has revealed that inadequate maternal nutrition could
lead to malnutrition which causes poor pregnancy outcomes, such as fetal
growth failure, low birth weight, preterm birth, prenatal and infant mortality
and morbidity (Abu-saad & fraser 2010). On the contrary, excessive nutrition
intake during pregnancy can lead to complications such as preeclampsia,
diabetes mellitus, macrosomia, dystocia, and higher prevalence of caesarean
section ( Rocco et al, 2015).

According to (Mugyia et al, 2016) Knowledge on nutrition is a vital element

to ensure positive pregnancy outcome and is the integral to achieve healthy
dietary behaviours and subsequently improves their diet quality.

Nutritional knowledge during pregnancy is necessary to ensure optimal

gestational weight gain reduces complications both which are linked to
positive birth outcomes and contributes to mother’s overall health. However
evidence revealed that antenatal mother’s during pregnancy do not always
adopt these recommendations and the reasons for this are poorly understood
(Malaysian Dietary Guidelines, 2017)

(Schmitz, 2012) defined nutrition as the sum of all processes involved in how
organisms obtain nutrient, metabolize them and use them to support all of
life’s process .

All human beings need balanced amount of nutrients for proper functioning
of the body system. Nutrition is a fundamental pillar of human life, health and
development throughout the entire life span. There are various nutrients that
are essential for health, if any one of these is deficient in the diet, the person
will not be fully healthy and able to resist the agents of disease (Collins,
2017).

Nutrition Practice refers to an individual’s action that could affect her

nutrition such as eating, feeding, cooking, and selecting of foods. According
to (Nzeribe, 2012) Practice of adequate nutrition among pregnant women
most be maintained prior to conception, especially the adolescent girls.
Health education of the mother at antenatal, postnatal and child welfare clinic
should be emphasized. Demonstration with local food should be used by
midwives to highlight on the preparation, quantity and combinations required
to get a balance diet. This will help prevent and reduce complications due to
malnutrition.

Most nutritional practice have stemmed from deeply rooted traditions and
customs. It can lead to malnutrition, which is linked to food insecurity,
unhygienic practices and traditional beliefs. These beliefs are the product of
social interactions and faith which are entrenched in the mind of the
community. Many of these food practices arise from the ignorance about the
nutritive value of food (Lakshmi, G. (2013). So health care providers should
be knowledgeable about importance of nutrition during pregnancy, nutritional
beliefs, practices and potential hazard associated its deficiency during
pregnancy. Such information will help them to identify nutritional problems
and unhealthy dietary practices among pregnant women.

Globally the prevalence of malnutrition, in all forms is still unacceptably

high. Malnutrition (underweight, overweight, anemia) affects millions of
women around the globe including during pregnancy and breastfeeding which
are periods that are marked by increased nutritional needs. Globally, about
170 Million women (9.1%) are underweight and thrice as many, 610 Million
(32.5%) are overweight. Prevalance of Malnutrition among women of Sub-
Saharan and South asia is still very high (UNICEF,2022). Due to poor
nutritional practices, globally, an estimated 15 million babies are born
prematurely and about 20 million are born with low birth weight more than
95% occurring in resource-poor countries according to WHO. In Nigeria,
nutritional disorders are among the main causes of poor pregnancy outcomes.
Pregnancy is a time of increased energy and nutrients needed for a woman in
order to meet the needs of the growing fetus and maternal tissues associated
with pregnancy, proper dietary balance is necessary to ensure sufficient
energy intake for adequate growth of fetus without drawing on mothers own
tissues to maintain her pregnancy (Subarnalata & Panda, 2016).

The poor health and nutrition of women and lack of care that contributes to
their death in pregnancy and child birth also compromises the health and
survival of their infants and children.

Acording to (Shekare, 2016) under nutrition has the most damaging effect on
the fetus during pregnancy and in the first two years of life, and the effects of
this early damage on health, brain, intelligence, education, ability, and
productivity are largely irreversible.
The pregnant women’s diet should contain a substantial increase in calories,
protein, calcium, folic acid, iodine and iron. Pregnant women at particular
risk of nutritional deficiencies are: adolescents, underweight women, obese
women, women chronic with nutritional problems, women who smoke or
consume alcohol or hard drugs, low income women and women with chronic
illness such as diabetes mellitus or anemia (Edris, 2015).

According to Nagi et al.(2016) knowledge of healthy nutrition is very

important in determining the extent at which individuals will indulge in
health behaviour increasing pregnant women’s knowledge of nutrition will
have a great impact on their health and of the growing fetus.

It was found that deficiency in nutrients during gestation may cause the fetus
to receive suboptimal micro and macro nutrients; causing inadequate
intrauterine growth and development, inherited malformations, preterm
deliveries , and pregnancy complication. Eating well during pregnancy
means do more than simply increase how much the mothers eats. The mother
most also consider what she eats. The ability of the mother to provide
nutrients and oxygen for her baby is a critical factor for fetal health and its
survival and failure in supplying the adequate amount of nutrients to meet
fetal demand can lead to fetal malnutrition (Daba et al, 2013) .

1.2 Statement of Research Problem

Malnutrition in all its forms affects women all over the world but its effects
are worse during pregnancy period. Malnutrition is influenced by factors like
socio-demography, nutritional knowledge and dietary practices of pregnant
women (Beyene, 2013). In an antental set up, provision of nutrition education
is crucial in improving the knowledge of pregnant women about maternal
nutrition. Likewise there is a lot of pregnant women who are underweight
which leads to the emergence of so many diseases and many are underweight
due to improper consumption of or inadequate diet and most of these are
neglected. During my clinical experience at Federal Teaching Hospital
Katsina, I observed that a lot of women are underweight and anemic that is
why I want to carry a research on ”Knowledge and practice of adequate
nutrition among pregnant women attending A.N.C unit at federal Teaching
hospital Katsina” that is why this research will go along way on knowledge
and practice on nutrition among pregnant women.

1.3.1 Objectives of the Study

1. To determine the awareness of pregnant women attending antenatal unit of
federal Teaching Hospital Katsina on various sources of the essential
nutrients needed for them and their fetuses.

2. To assess the level of knowledge of pregnant women on adequate nutrition

attending antenatal unit of Federal Teaching Hospital Katsina.

3. To assess the level of practices on adequate nutrition among pregnant

women attending antennal unit of Federal Teaching Hospital Katsina.

1.4 Research Questions

1. What is the level of knowledge of pregnant women on adequate nutrition
attending antenatal unit of Federal Teaching Hospital Katsina 

2. What are the various sources of essential nutrients needed for them and
their developing fetuses among pregnant women in antenatal unit of Federal
Teaching Hospital Katsina

3.What is the level of practice on adequate nutrition among pregnant women

attending antenatal unit of Federal Teaching Hospital Katsina 

1.5 Significance of the Study

The significance of this study to the pregnant women attending antenatal unit
is for them to be more informed and enlightened on the importance of
balanced diet during pregnancy, which will result in a healthy mother and
child, as well as dispelling some rumor, superstition and old wives tale about
nutrition in pregnancy.

Finding from this study will help health workers to identify the areas of
concentration during antenatal health education/health talk

The findings will also contribute towards the Improvement of the nutritional
knowledge and practices of pregnant women, promote their wellbeing and
prevent complications which may endanger their lives during delivery as a
result of poor nutrition, such complication like anemia, abortion, sepsis,
bleeding, postpartum shock, and eventually maternal death.

1.6 Scope of the Study

Research conducted among pregnant women attending antenatal care at
Federal Teaching Hospital in Katsina and is only delimitated to those women
attending antenatal unit.

1.7 Operational Definition of Terms

1. ANTENATAL CARE: Is the type of care and supervision given to
pregnant women attending the antenatal care unit of Federal Teaching
Hospital Katsina from the time of conception until the beginning of labor.

2. ANEMIA: is the reduction in quantity and quality of red blood cell of the
blood leading to decrease oxygen carrying capacity of the blood among
pregnant women attending ANC at Federal Teaching Hospital Katsina.

3. PREGNANT WOMEN: Are women with Pregnancy in the antenatal unit

at Federal Teaching Hospital Katsina.

4. KNOWLEDGE: refers to the pregnant women understanding on various

aspect of maternal nutrition including energy and protein requirements at
Federal Teaching Hospital Katsina.
5. PREGNANCY: is a period from the conception is confirmed until
beginning of labor or it is the state of carrying developing embryo or fetus
within the female body that is in the uterus.

6. PRACTICE: This is the act of taking adequate nutrition during pregmancy.

7. REQUIREMENT: what is needed or required for the pregnant women in

the antenatal unit of Federal Teaching Hospital Katsina to be taking during
pregnancy.

8. NUTRITION: Is the process of providing or obtaining the food necessary

for the health and growth of pregnant women and their fetuses in the antenatal
unit of Federal Teaching Hospital Katsina

9. FEDERAL TEACHING HOSPITAL: Is a Federal health facility along

Murtala Muhammad way within Katsina town

10. FETUS: Is an unborn baby or baby in the womb.

11. HEALTH: To be free from any deficiency or problem.

12. CONGENITAL ABNORMALITY: Is a birth defect in which the fetus is

born with problem of one or more of the body organ or system
KNOWLEDGE AND PRACTICE OF ADEQUATE NUTRITION
AMONG PREGNANT WOMEN ATTENDING ANTENATAL
CLINIC AT FEDERAL TEACHING HOSPITAL KATSINA.

BY

FATIMA KABIR TSANNI

CHERISH COLLEGE OF NURSING AND MIDWIFERY BATSARI.

KATSINA STATE

JANUARY,2023.