Project – Knowledge and Household Practices Regarding Antenatal Nutrition among Pregnant Women: A Study of Women Attending Primary Healthcare Centres in Ogbomosho, Oyo State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Pregnancy is a critical period of increased nutritional requirements because the health and nutritional status of a woman directly influence her own wellbeing as well as the growth and development of the unborn child. During pregnancy, physiological changes occur in the maternal body, including increased blood volume, tissue development, fetal growth and preparation for lactation. These changes increase the demand for energy, protein, iron, folate, calcium, iodine, zinc and other essential nutrients. Adequate nutrition during pregnancy is therefore important for preventing maternal nutritional deficiencies and supporting appropriate fetal development and birth outcomes. The World Health Organization (WHO, 2016) identifies antenatal care as an important platform for health promotion, disease prevention and the provision of nutritional counselling to pregnant women. WHO specifically recommends that antenatal care should include counselling on healthy eating and appropriate nutrition throughout pregnancy.

Knowledge of antenatal nutrition is an important determinant of whether pregnant women understand and adopt appropriate dietary behaviours. Nutritional knowledge involves awareness and understanding of the foods, nutrients, supplements, meal patterns and dietary practices required to maintain maternal and fetal health during pregnancy. Women need adequate knowledge of the importance of dietary diversity, consumption of fruits and vegetables, adequate protein and energy intake, iron and folic acid supplementation, appropriate hydration and the avoidance of harmful substances. WHO (2023) emphasizes that nutrition counselling during pregnancy should promote a healthy and diverse diet, adequate energy and protein intake and consistent use of appropriate micronutrient supplements. The organization further notes that nutrition education and counselling can support optimal gestational weight gain, reduce the risk of anaemia and improve birth outcomes.

However, having knowledge about appropriate nutrition does not necessarily mean that pregnant women will practise what they know within their households. Household food practices are influenced by food availability, household income, cultural beliefs, food preferences, cooking patterns, family influence and women’s decision-making power concerning food. In Nigeria, evidence has shown that nutritional practices among pregnant women may remain inadequate despite awareness of the importance of good nutrition. Balogun, Fadupin and Deniran (2019), in a study of pregnant women attending antenatal clinics at University College Hospital and Adeoyo Maternity Hospital in Oyo State, found that 65% of respondents had fair knowledge of adequate nutrition while 35% had good knowledge. The researchers also reported that many women did not increase the quantity and variety of foods consumed during pregnancy and some reported difficulties in affording adequate quantities and quality of recommended foods.

Dietary diversity is another important component of appropriate antenatal nutrition. A diverse diet increases the likelihood that pregnant women will obtain a broad range of nutrients required for maternal health and fetal development. In a Nigerian study conducted among 350 pregnant women attending primary healthcare centres in Lagos, Oche et al. (2021) found that only 30.8% of respondents had a high dietary diversity score, while only 16.7% consumed five servings of fruits and vegetables daily. The study also found that dietary diversity was associated with factors such as education, parity and socioeconomic status. These findings demonstrate that household food practices during pregnancy may be influenced by socioeconomic circumstances and that access to nutritional information alone may not guarantee a sufficiently diverse diet.

The nutritional practices of pregnant women are also shaped by their broader dietary patterns and socioeconomic characteristics. Adeoye and Okekunle (2022), using data from 1,745 pregnant women enrolled in the Ibadan Pregnancy Cohort Study, identified five major dietary patterns among pregnant women in Ibadan, including protein-rich diets, fruit-based diets, legumes, refined grains and a typical diet involving alcohol. Their findings showed that maternal education, employment and income were associated with some dietary patterns. The study is particularly relevant to the present research because Ibadan is located within Oyo State and provides evidence that pregnant women’s food choices can vary according to socioeconomic and demographic circumstances. Consequently, examining knowledge and household practices in Ogbomosho may provide additional evidence concerning maternal nutrition in another important urban setting within Oyo State.

Antenatal care provides an important opportunity to bridge the gap between nutritional knowledge and actual household practice. Pregnant women attending primary healthcare centres interact with nurses, midwives, community health workers and other healthcare professionals who can provide nutrition education and counselling. WHO (2016) recommends nutritional counselling as an integral component of antenatal care, while WHO (2023) indicates that counselling should address healthy eating, dietary diversity, appropriate energy and protein intake and the continued use of recommended micronutrient supplements. Evidence from Ibadan further demonstrates the importance of the quality and level of antenatal services. Olukemitan, Eyinla and Samuel (2024) found that about one-third of pregnant women studied had poor knowledge of essential nutrition actions and that practice was generally poor; women attending tertiary facilities demonstrated higher knowledge and practice than those attending smaller primary healthcare centres and mission homes.

The situation in Ogbomosho, Oyo State, therefore deserves specific investigation because evidence from other parts of Nigeria cannot automatically be assumed to represent pregnant women attending primary healthcare centres in Ogbomosho. Although studies in Ibadan and other Nigerian locations have examined maternal dietary knowledge, dietary diversity and nutritional practices, there is a need for localized evidence on what pregnant women attending primary healthcare centres in Ogbomosho know about antenatal nutrition and how that knowledge translates into household food practices. Recent evidence from semi-urban areas of Oyo State also suggests that nutritional education can improve pregnant women’s knowledge, attitudes and healthier food choices, indicating the potential value of strengthening nutrition education through antenatal services (Adekanmbi & Kadri, 2025). Therefore, this study seeks to assess the knowledge and household practices regarding antenatal nutrition among pregnant women attending selected primary healthcare centres in Ogbomosho, Oyo State, with a view to identifying areas requiring improved nutritional education and maternal health interventions.

1.2 Statement of the Problem

Adequate nutrition during pregnancy is essential for protecting maternal health and promoting normal fetal growth and development. Despite the availability of antenatal care services, however, pregnant women may not always possess adequate knowledge or practise recommended nutritional behaviours. Evidence from Ibadan, Oyo State, indicates that a considerable proportion of pregnant women had only fair rather than good knowledge of adequate dietary practices, while some reported difficulty obtaining sufficient quantities and quality of recommended foods (Balogun et al., 2019). Similarly, Olukemitan et al. (2024) found that approximately one-third of pregnant women studied in Ibadan had poor knowledge of essential nutrition actions and that nutritional practices were generally poor. This suggests that attendance at antenatal care does not necessarily guarantee adequate knowledge or appropriate household nutritional practices.

A second concern is the persistence of inadequate dietary diversity among pregnant women. Pregnancy increases the need for several nutrients, making the consumption of a variety of foods particularly important. Nevertheless, research among pregnant women attending primary healthcare centres in Lagos found that only 30.8% had high dietary diversity, while only 16.7% consumed five servings of fruits and vegetables daily (Oche et al., 2021). The study also found that socioeconomic and demographic factors were associated with dietary diversity. If similar patterns occur among women attending primary healthcare centres in Ogbomosho, inadequate dietary diversity could constitute an important nutritional concern. There is therefore a need to determine the actual household food practices of pregnant women in the study area rather than assuming that knowledge of recommended nutrition translates into healthy dietary behaviour.

Another problem concerns the possible gap between nutritional knowledge and its practical application in the household. Women may receive information about balanced diets, micronutrient supplementation, fruits and vegetables, protein-rich foods and foods to avoid during pregnancy, yet household income, food prices, cultural beliefs, family preferences and availability of food may prevent them from applying such knowledge. The Ibadan Pregnancy Cohort Study demonstrated that dietary patterns among pregnant women were associated with education, income and employment status, suggesting that socioeconomic conditions can shape maternal dietary behaviour (Adeoye & Okekunle, 2022). Consequently, it is important to investigate not only what pregnant women know about antenatal nutrition but also how that knowledge is reflected in their everyday household practices.

Furthermore, there is limited empirical evidence specifically focused on pregnant women attending primary healthcare centres in Ogbomosho, Oyo State. Existing Nigerian studies have provided useful evidence from Lagos and Ibadan, while a recent intervention study in semi-urban areas of Oyo State demonstrated that nutritional education could significantly improve knowledge, attitudes and healthier food choices among pregnant women (Adekanmbi & Kadri, 2025). However, findings from these locations may not fully reflect the experiences of women attending primary healthcare centres in Ogbomosho because differences in socioeconomic conditions, cultural practices, food availability, household structure and healthcare delivery may affect nutritional behaviour. The absence of sufficient localized evidence creates a knowledge gap concerning the level of nutritional knowledge and household practices among pregnant women in Ogbomosho. This study therefore seeks to provide empirical evidence on the knowledge and household practices regarding antenatal nutrition among pregnant women attending selected primary healthcare centres in Ogbomosho, Oyo State.

1.3 Purpose of the Study

The main purpose of this study is to assess the knowledge and household practices regarding antenatal nutrition among pregnant women attending primary healthcare centres in Ogbomosho, Oyo State.

Specifically, the study seeks to:

1. determine the level of knowledge of antenatal nutrition among pregnant women attending selected primary healthcare centres in Ogbomosho;
2. assess the household dietary practices of pregnant women attending selected primary healthcare centres in Ogbomosho;
3. determine pregnant women’s knowledge of recommended food groups and dietary diversity during pregnancy;
4. assess the level of knowledge of micronutrient supplementation among pregnant women

1.4 Research Questions

The following research questions will guide the study:

1. What is the level of knowledge of antenatal nutrition among pregnant women attending selected primary healthcare centres in Ogbomosho?
2. What are the household dietary practices of pregnant women attending selected primary healthcare centres in Ogbomosho?
3. What level of knowledge do pregnant women have regarding recommended food groups and dietary diversity during pregnancy?
4. What is the level of knowledge of micronutrient supplementation among pregnant women?

1.5 Research Hypothesis

The following null hypothesis will be tested at the 0.05 level of significance:

H₀: There is no significant relationship between knowledge of antenatal nutrition and household nutritional practices among pregnant women attending selected primary healthcare centres in Ogbomosho, Oyo State.

1.6 Significance of the Study

The findings of this study will be beneficial to pregnant women because it will provide information on the importance of appropriate nutrition during pregnancy and the relationship between nutritional knowledge and household food practices. The findings may encourage pregnant women to pay greater attention to dietary diversity, appropriate meal patterns, micronutrient supplementation and other recommended nutritional behaviours.

The study will be useful to nurses, midwives, community health officers, nutritionists and other healthcare providers working in primary healthcare centres. The findings may help healthcare professionals identify specific nutritional knowledge gaps among pregnant women and strengthen nutrition counselling during antenatal clinic sessions.

The study will also benefit primary healthcare centre administrators and programme planners. Information generated from the study may assist in improving antenatal nutrition education programmes and developing health education materials that respond to the actual nutritional challenges experienced by pregnant women in Ogbomosho.

The findings will be useful to public health practitioners and policymakers in Oyo State. Evidence from the study may contribute to the development of maternal nutrition interventions that are appropriate for women receiving antenatal services at the primary healthcare level. This is consistent with the WHO position that antenatal care provides an important platform for nutritional counselling and health promotion.

The study will also be useful to families and household members of pregnant women. Since household food availability, purchasing decisions, cooking practices and family preferences can influence what pregnant women consume, increased awareness among household members may encourage greater support for appropriate maternal nutrition.

Finally, the study will contribute to academic knowledge and future research. It will provide localized evidence concerning antenatal nutrition in Ogbomosho and may serve as a reference for researchers in public health, community health, nutrition, nursing, maternal and child health and related disciplines.

1.7 Scope of the Study

The study will focus on knowledge and household practices regarding antenatal nutrition among pregnant women attending selected primary healthcare centres in Ogbomosho, Oyo State.

The study will cover pregnant women’s knowledge of:

• balanced diets during pregnancy;
• dietary diversity;
• energy and protein requirements;
• fruits and vegetables;
• iron and folic acid;
• other relevant micronutrients;
• foods recommended during pregnancy;
• foods that should be limited or avoided; and
• the importance of adequate fluid intake.

The study will also examine household nutritional practices such as:

• meal frequency;
• food variety;
• consumption of fruits and vegetables;
• consumption of protein-rich foods;
• consumption of legumes and nuts;
• consumption of dairy products;
• use of prescribed nutritional supplements;
• meal skipping;
• food taboos and restrictions; and
• household factors affecting food choices.

The study will be limited to pregnant women who attend antenatal services at selected primary healthcare centres in Ogbomosho. It will not cover pregnant women receiving antenatal care exclusively at tertiary hospitals or private specialist hospitals outside the selected study facilities.

1.8 Operational Definition of Terms

Antenatal Nutrition: The dietary and nutritional requirements, recommendations, education and practices intended to maintain the health of a pregnant woman and support the growth and development of her unborn child.

Antenatal Nutrition Knowledge: The extent to which a pregnant woman understands appropriate nutritional requirements, recommended foods, dietary diversity, micronutrients, supplements and healthy dietary practices during pregnancy.

Dietary Diversity: The consumption of foods from a variety of food groups within a specified period, providing a wider range of nutrients required during pregnancy.

Household Practices: The routine behaviours and activities within the home that influence what pregnant women eat, including food purchasing, preparation, meal frequency, food selection and consumption patterns.

Nutritional Practices: The actual dietary behaviours of pregnant women, including the type, quantity, frequency and variety of foods consumed during pregnancy.

Pregnant Women: Adult women who are currently pregnant and attending antenatal care services at the selected primary healthcare centres in Ogbomosho.

Primary Healthcare Centre: A health facility that provides basic and essential healthcare services, including antenatal and maternal health services, at the primary level of healthcare delivery.

Antenatal Care: Healthcare provided to women during pregnancy for the monitoring of maternal and fetal wellbeing, health promotion, disease prevention, nutritional counselling and preparation for childbirth.

Micronutrients: Vitamins and minerals required by the body in relatively small quantities but essential for normal physiological functions, maternal health and fetal development.

Food Taboo: A culturally, religiously or socially influenced restriction that prevents a pregnant woman from consuming particular foods during pregnancy.

Nutritional Counselling: The provision of individualized or group-based information and guidance by qualified health professionals concerning appropriate food choices, dietary behaviour and nutritional requirements during pregnancy.

1.9 Organisation of the Study

The study will be organised into five chapters.

Chapter One will present the introduction, background to the study, statement of the problem, purpose of the study, research questions, research hypothesis, significance of the study, scope of the study, operational definition of terms and organisation of the study.

Chapter Two will review relevant literature related to antenatal nutrition, nutritional knowledge, dietary diversity, household food practices, micronutrient requirements, food taboos and nutritional counselling during pregnancy. The chapter will also examine relevant theoretical and empirical literature.

Chapter Three will present the research methodology. It will discuss the research design, area of the study, population of the study, sample size, sampling technique, instrument for data collection, validity and reliability of the instrument, method of data collection and method of data analysis.

Chapter Four will present the analysis of data and findings of the study. The research questions will be answered using appropriate descriptive statistics, while the stated hypothesis will be tested using an appropriate inferential statistical technique at the 0.05 level of significance.

Chapter Five will present the summary of the study, conclusions, recommendations and suggestions for further studies.

Project – Knowledge and Household Practices Regarding Antenatal Nutrition among Pregnant Women: A Study of Women Attending Primary Healthcare Centres in Ogbomosho, Oyo State