Determinants of malnutrition among pregnant and lactating women under humanitarian setting in Ethiopia

Background: Despite significant gains and progress in the last decade, malnutrition remains a major public health problem in Ethiopia. Pregnant and lactating women (PLW), along with children, are among the most vulnerable groups of population during emergencies and droughts. Identifying and targeting of PLW with malnutrition is among the priorities in humanitarian emergencies. However, there is dearth of evidence on PLW nutritional status and its determinants in humanitarian context. Methods: A community-based cross-sectional study was conducted in 10 kebeles of Rayitu district of Ethiopia in June 2013. A total of 900 PLW were assessed for malnutrition using mid-upper-arm circumference (MUAC). Result: Using MUAC < 21 cm as a criteria, 216 (24%) surveyed mothers were found to be malnourished. In multivariable logistic regression analysis, those mothers who did not received antenatal care (ANC) during their pregnancy had 1.83 higher odds of (adjusted odds ratio[AOR] = 1.83, 95% confidence interval [CI]:1.10,3.02) to be malnourished (MUAC < 21 cm) as compared to mothers who received ANC. Housewives had lower odds of (AOR = 0.59, 95 %CI: 0.37, 0.95) to be malnourished compared to those who engaged in as a pastoralist. Mothers belonging to families from which at least one person did not receive targeted supplementary feeding (TSF) in the 6 months before the study had lower odds of (AOR = 0.38, 95 %CI:0.23,0.62) to have acute malnutrition compared to those who lived in families who received TSF. Conclusions: Malnutrition is common among PLW in humanitarian settings, including those with ongoing interventions. Attending antenatal care, maternal occupational status and being a member of families who received TSF were factors associated with maternal nutritional status in this study. This signifies the need for sustainable solutions that address the high prevalence of malnutrition among PLW. Interventions targeting health system responses such as comprehensive nutrition education, support through antenatal care and women empowerment are recommended.