ABSTRACT

A total of450 questionnaires were administered among the pregnant women attending

antenatal care at primary healthcare Makera to determine and assess the factors which

affect the nutrition status of the pregnant women in Kakuri metropolis. the result

obtained shows that 65% of the respondents were within 26-35 age group, 70% of the

respondents got information about factors which affect nutrition value of food through

health facilities and 62% of the respondents takes one class of food (protein) regular,

also 91% of the respondents consume multiple number of square meal per day, where as

48% of the respondent obtained primary school certificate as their level of education.

The result also indicates 42% of the respondents regard inadequacy of nutrition food

supply as the major factor affecting their nutritional value. The pregnant women

therefore, merits high priority for the supply of nutrition food to obtained balance diet

and also provision of health programmes from the concerned authorities for their better

nutrition.
 CHAPTER ONE
1.0 Introduction

The chapter one of this research work titled "Assessment of Evaluation of Nutrition

education programs for Pregnant Women (A Case Study of Kaduna south, kakuri Local

Government Area of Kaduna State)" is been discussed under the following headings:

1.1Introduction

1.2Background to the Study

1.3Statement of the Problem

1.4Purpose of the Study

1.5Significance of the Study

1.6Scope of the Study

1.7Limitations of the Study

1.8Research Questions and Hypothesis

1.9Definition of Terms
1.1 Background to the Study

Nigeria is the most populous country in Africa, with a population of 162,471,00million

persons. Where sixty percent (60%) of the population resides in the rural areas and the

remaining forty four percent (44%) of the population comprises of children and mothers

(National Bureau of statistics, 2010).The nutritional and health status of women is of

great concern in the contemporary world, because the multiple roles played by women

give rise to serious health and nutritional problems (MC Guire and Popkin, 2012).Women

are vulnerable to malnutrition for social and biological reasons, the nutritional status of a

mother is important, both as an indicator of her overall health and as a predicator of

pregnancy outcome for both mother and child (Prentice, 2013). The nutritional status of

food simply means the quantity, range and quality, energy (calories), (nutrients) that are

found in a food (Desai, 2011). The factors affecting nutritional status of food taken by

pregnant women are the conditions that influence the effects on the nutritional status of

food or nutritional status of the food taken by the pregnant women, (Krasovec and

Anderson, 2010).Already you can see that with plant-based foods, nutritional status is

probably higher than the other foods, especially when eaten during pregnancy, because

plants contains special nutrients not found anywhere else (Desai, 2011). All of us need

balanced amount of nutrients for proper functioning of our body system (Prentice, 2013).

However, the nutritional requirement varies with respect to age and gender. And

pregnancy is such a critical phase in a woman's life (Rao et-al,2010),when the expecting

mother needs optimal nutrients of superior quality to support the developing fetus,

naturally the urge to eat more foods is expected by nearly all pregnant women (Krasovec

and Anderson, 2010). However, one should be aware of what would happen if there is

lack of nutrients in the gestation period and the effects of malnutrition during this phase,
(Mc Guire and Popkin, 2012). It is quite obvious that it would negatively affect the health

of both the mother and the baby (fetus),(Guire and Popkin 2012).

1.1.1 Pregnancy and Malnutrition

Pregnancy is defined as the development of one or more offspring known as embryo or

fetus in a woman's uterus. And malnutrition is defined as the lack of sufficient nutrients,

which are essential for the body's normal functioning,(Kikafunda et-al, 2012).

Malnutrition is the condition that results eating a diet that is lacking certain nutrients in

excess (too high intake), or in wrong proportion (Arthur et-al, 2009). Malnutrition is a

state in which prolonged lack of one or more nutrients retards physical development, or

causes the appearance of specific clinical conditions (Nancy, 2011). Malnutrition is one

of the most important health and welfare problems among pregnant women in the

developing world. It is usually a result of a combination of inadequate dietary intake and

infection (Kikafunda et-al, 2012), feeding practices include both the quality and quantity

of foods taken by the pregnant women. Both inadequate food intake and poor

environmental conditions reflect underlying social and economic conditions (U. B. Os,

2011). Malnutrition increases vulnerability to infections, and infections aggravate

malnutrition,(Tomkins and Watson,2012).

1.1.2 Pregnancy and Under-Nutrition:

Under-nutrition, which may be related to an individual's inability to obtain foods that

contains essentially nutrients, failure to consume essential nutrients, body's inability to

use the nutrients, disease condition that increase the body's need for nutrients to be

excreted too rapidly from the body (Gibney et-al, 2009). It occurs when people do not eat

(absorb) enough nutrients to cover their needs for energy and growth, or to maintain a

healthy immune system.

Micronutrients deficiencies are sub-category of under nutrition and occur when the body

lacks one or more micronutrients (e.g. iron, iodine, zinc, vitamin A, or folate). These

deficiencies usually affect growth and immunity but some cause specific clinical

condition such as anemia "iron deficiency”(Black et-al, 2015). Such poor diets have been

linked to the occurrence of chronic diseases, including; cardiovascular disease,type-2

diabetes, cancer, osteoporosis and anemia (Lyte et-al, 2012). Under-nutrition is an

important underlying cause of illness and death in Africa especially among pregnant

women and young children. However, under nutrition and malnutrition are linked to

suboptimal health outcomes (Gibney et-al, 2009). So, the nutritional status of pregnant

women contributes a good deal to their own general well-being, also the health of their

children (fetus) and the member of the family,(Arthur et-al,2009).

1.2 Statement of the Problem

1. The ignorance of the pregnant women attending Antenatal Care at primary

healthcare Makera, kakuri Local Government Area, kaduna State to know about

their nutritional status, which results to under-nutrition or malnutrition.

2. A number of the pregnant women attending Antenatal Care primary Healthcare

Makera, Kakuri Local Government Area, Kaduna State are from rural

communities around Kakuri which have less-availability of nutritious food supply.

3. Lack of access to information about nutritional status of foods available in the

community that is lack of health education programmes, seminars, and even

 special gathering to discuss about nutritional status of foods that are available in

the community.

4. Numerous studies have consistently concluded that maternal educational critical

resource for maternal and child health, nutritional and survival (Armar-Klemesu

et-al, 2010) which is also lacking in the study area of this research work.

1.3 Objectives of the Study

The objectives of this study are:
1. To determine the factors affecting the nutritional status of pregnant women
attending Antenatal Care at Primary Healthcare Makera, Kakuri Local
Government Area, Kaduna State

2. To assess the socio-economic status of pregnant women attending Antenatal Care

at Ambassador primary healthcare Makera, kakuri Local Government Area,
Kaduna State

3. To determine the level of knowledge and its utilization on the status of nutrition to
pregnant women attending Antenatal Care at Primary Healthcare Makera, Kakuri
Local Government Area, Kaduna State

4. To provide adequate health education on nutritional status among pregnant women

attending Antenatal Care at Primary Healthcare Makera, Kakuri Local
Government Area, Kaduna State

5. To help improve the nutritional status of the pregnant women attending Antenatal
Care at Primary Healthcare Makera, Kakuri Local Government Area, Kaduna
State
1.4 Significance of the Study

This research work titled "Nutrition Education programs for Pregnant Women in Makera
Kakuri, Local Government Area, Kaduna State" is significant to health personnel's
especially those in nutrition and dietetics department, the pregnant women in Kaduna
South Local Government especially those attending Antenatal Care in Makera, Kakuri
Local Government Area, kaduna State as well as the Kakuri community members, and
those in the academics who may be interested in conducting further research under this
area.

1.5 Research Questions and Hypothesis

1.5.1 Research Questions
1. Is there any awareness about nutritional status of foods taken during pregnancy
in Kakuri?

2. Is there adequate health education programme that provide knowledge on

nutritional status of food among pregnant women in kakuri?

3. Is there available of balanced diet among the pregnant women in Kakuri?

4. Do the pregnant women attending antennal care know the foods that have
nutritional status?
5. Is there any knowledge on the factors affecting the nutritional status of pregnant
women in Kakuri?
1.5.2 Research Hypothesis
1. There is no awareness about nutritional status of food taken during pregnancy in
Kakuri.
2. There is adequate health education programme that provides knowledge on
nutritional status of food among the pregnant women in Kakuri.
3. There is no availability of balanced diet among the pregnant women in Kakuri.
4. The pregnant women attending antenatal care does not know the foods that have
nutritional status.
5. There is no any knowledge provided on the factors affecting the nutritional status
of the pregnant women in Kakuri.
1.6 Scope of the Study
This study covers only pregnant women who were attending antenatal care in kaduna
south, kakuri Local Government Area, kaduna State, that is pregnant women from first
Galadima, second Galadima, Babadodo and Mekera respectively, which are the pregnant
women attending antenatal care at Kaduna South, Kakuri Local Government Area,
Kaduna State

1.7 Limitations of the Study

The study is limited by the following:
1. Weather conditions of the study area.
2. Financial problems at the time of the study.
3. It is limited due to lack of adequate instrument.
4. And also limited due to the mode and extend of communication with
the subject in the study area.
1.8 Definition of Terms
 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.

 Diet: These are foods and beverages that a person eats ad drinks which contain

correct proportion or right amount of all the six food substances required by an

organism or man. In terms of the percentage composition (%) of the food

substances, a balanced diet should contain 60% of carbohydrates, 15% of proteins,

15% of fats and oils and10%of vitamins, minerals and water.

 Food: Is any edible substances either solid or liquid that is consumed by the

pregnant women in Kakuri which will provide them with nourishment, promote

growth and maintenance of their health status.

 Nutritional Status: Is a term that explains the amount of nutrients contained in

the food consumed by the pregnant women in Kakuri

 Malnutrition: Are conditions that occur as result of eating diet which certain

nutrients are lacking in excess or in wrong proportions.

 Under-Nutrition: Is a condition that occurs when the pregnant women do not eat

(absorb) enough nutrients to cover their needs for energy and growth or to

maintain a healthy immune system.

 Food Storage: Is the process of keeping food for a long period of time in order to

maintain the shelf life of the food.

 Pregnant Woman: Is a female individual which develop one or more offspring

known as embryo or fetus in her uterus.

 Fetus: This refers to the offspring developed in the uterus of pregnant women.

 Antenatal Care: Refers to the care received by pregnant women from health care

professionals during pregnancy to monitor the health of the mother and the baby

also supports sand makes right plans for the pregnant mother.

 Immunity: Refers to the condition that permits either natural or acquired

resistance to disease.

 Nutritional Assessment: is an in-depth evaluation of both objectives and

subjective date related to an individual's food nutrient intake, lifestyle and medical

history.

 Body Mass Index (BMI): BMI is an estimate of body fat based on height and

weight. It doesn't measure body fat directly, but instead uses an equation to make

an approximation. BMI can help determine whether a person is at an unhealthy or

healthy weight.
 Obesity: Obesity is a medical condition in which excess body fat has accumulated

to an extent that it may have a negative effect on health. People are generally

considered obese when their body mass index (BMI), a measurement obtained by

dividing a person's weight by the square of the person's height, is over 30 kg/m 2;

the range 25-30 kg/㎡ is defined as overweight.