The interaction between a pregnant mother and her developing baby are numerous and varied ranging from the food she eats to the kicks of the baby that she feels. What the developing baby feeds on goes a long way in determining its state of health at birth. For a pregnant mother to eat healthfully, she needs to have adequate knowledge of the different component of food. But if the knowledge is not put in practice, it becomes meaningless. The major objective of this study therefore was to examine the nutritional knowledge and practice of the pregnant women in Onitsha North and South Local Government Areas of Anambra State. Because of the large number involved, and the fact that most of the hospital had no maternity, only two hundred and fifty expectant mothers were used. Eight specific objectives and corresponding research questions and six hypotheses were stated and used for the study. The instrument for data collection was a questionnaire which had three sections. The personal data of the respondents, fourteen questions each on nutritional knowledge and practice respectively. The questionnaire responses on knowledge were two-point scale of Yes and No while that of practices were in three-point scale of “Practice Always”. “Do not practice” and “Practice Rarely”. Data were analyzed using correlation analysis, percentage, ANOVA and multiple t-test of paired comparison. The results showed that all the hypothesis of the study were rejected. The mean (x) percentage of the subjects who indicated knowledge of what constituted good nutrition was greater than those who indicated regular practice. Some correlation existed between the subject’s knowledge of nutrition and their nutritional practice. Education, age and parity influenced their knowledge and practices of nutrition. Based on these results some recommendations were made such as:- (a) Health educators and nutritionists should be invited to give health talks to pregnant women during antenatal clinic. (b) The age, educational level.

CHAPTER ONE

INTRODUCTION

1.1      BACKGROUND TO THE STUDY

Nutritional knowledge has been proven to play a very vital role in adopting optimal nutrition practices in the health of every expectant mother.As a matter of fact, health and nutritional status of the population of a nation is an important indicator of development of the country. A nutrition survey carried out in India observed that the nutritional status of pregnant and lactating and infants is not satisfactory. This is probably due to lack of basic knowledge regarding proper nutrition and wrong customs prevalent in the community besides non availability and low intake of food.In Nigeria, there are some adverse socio-cultural and economical factors that produced negative consequences and reduce women’s access to effective ante-natal services needed to reduce maternal morbidity andmortality.

The most important of these are the low socioeconomic status of women that deny them access to appreciable decision-making with regard to their reproductive functions, high level of female illiteracy which is a leading cause of poor health seeking behaviour for maternity services among Nigerian women and high rate of poverty that predominantly affects women leading to inadequate dietary intakes, high rate of pregnancy complications and women’s reduced access to evidence based maternity services ( Ogunjuyibe, 2000).Maternal nutrition before and during pregnancy is an important determinant of birth weight. High rate of Low Birth Weight (LBW) in developing countries has been attributed to poor maternal nutrition (Ogunjuyigbe et al., 2008) Pregnancy is a time of tremendous physiological change that demands healthy dietary lifestyle choices. Growing foetus draws a lot of energy and nutrients from the mother to enhance physical and psychological development (Ojo and Briggs, 2010).

In developing countries like Nigeria, it is essential to states that low birth weight stems primarily from the mother’s poor health and nutrition, and inadequate nutrition during pregnancy accounts for a large proportion of growth retardation (Hareyan, 2005). Malnutrition has been recognized as one of the underlying factor for maternal death during the process of procreation. The causes of malnutrition are multidimensional and multi-factorial with poverty, food inadequacy and maternal illiteracy being the main culprit of the menace in developing countries. The health of the mother and her nutritional status can influence the health and survival of the child because of the biological links that exist between her and her child during pregnancy and lactation (Ogunjuyigbe et al., 2008).

There is an important factor under nutrition that is responsible for high infant mortality rate, maternal mortality rate and also for low birth weight of infants. Appropriate nutritional practice on the other hand plays a pivotal role in determining optimal health and development of infants. (Bamji Ms, 2003). There is abundant epidemiological evidence that poor prenatal nutrition predisposes the offspring to diseases in its later life.Inadequate nutrition is the predominant factor leading to malnutrition, which can be expressed as either under nutrition or over nutrition. Under nutrition occurs when there is not only inadequate energy but also a lack or imbalance of specific food components and nutrients. In addition to sufficient energy, adequate supplies of macronutrients and micronutrients are required to promote optimum growth.

The proportions and amounts of these nutrients may change according to the various stage of growth.There have been considerable changes in human lifestyle all over the world in the recent decades. Especially in recent years, the lifestyle has rapidly been changed. These changes appeared in diet, types of food, cooking time, etc. Nowadays processed foods are rapidly replacing organic food. Another change is the rapid increase in the number of restaurants and in people's tendency to eat fast food. Proper nutrition is one of the most important aspects of lifestyle(Amamoto and Andoyama, 2004) Epidemiological evidence shows that there is an increased incidence of diseases such as (Cardiovascular diseases, obesity, high blood pressure and cancer), which can be attributed to changes in lifestyle as well as changes in nutritional habits.

Nutritional education is also one of the important aspectsthat play a big role in nutritional knowledge by raising awareness and ultimately the health of the society (Stampfer et al.,2000) In order to remain healthy and physically active and enjoy a healthier life style it is necessary to obtain good nutritional knowledge and implement it. The knowledge, attitude and practice must be considers in expectant mothers in order to promote society health.From time immemorial it has been recognized that the pregnant and lactating women form oneof the most nutritionally vulnerable segments of the population; the ill effects of maternalunder nutrition affect not only the mother but also her offspring.In order to bring about change in the level of nutritional knowledge and practices prevailing people regarding nutrition, an attempt was made here to provide an awareness regarding nutritional knowledge practices among the mothers who are visiting a private and government hospitals.

1.2  STATEMENT OF THE PROBLEM

The most important factor responsible for high infant mortality rate is under nutrition, maternal mortality rate and also for low birth weight of infants. Nutrition is a multi-sectoral issue that needs to be tackled at various levels. Nutrition affects the development as much as development affects nutrition. It is therefore, important to tackle the problem of nutrition through direct nutrition intervention for vulnerable groups such as pregnant mothers. Adequate knowledge regarding various aspects of feeding practices during pregnancy and during infancy is very essential especially among females as they are going to influence the feeding practices of this vulnerable group. This led to the study on nutrition knowledge and practice among expectant mothers.

1.3      OBJECTIVE OF THE STUDY

The main objective of this study is to examine the nutritional knowledge among expectant mothers, but the researcher intends to achieve the following sub objectives;

i)  To outline common pregnancy outcome with poor maternal nutrition

ii) To ascertain the relationship between dietary intake, physical activity and maternal nutritional status.

iii) To enumerate factors associated with deterioration in maternal nutritional status.

iv) To examine the role of contraception in maternal nutrition, and the preventive measures, treatment of micronutrient deficiencies.

1.4  RESEARCH HYPOTHESIS

The research hypotheses were formulated by the researcher in null and alternative statements.

Ho:age of expectant mothers at pregnancy has no significant influence on level of nutritional knowledge

H1:   age of expectant mothers at pregnancy has a significant influence on level of nutritional knowledge

Ho:  there is nosignificant relationship between dietary intake, physical activity and maternal nutritional status of expectant mothers.

H2:  there is a significant relationship between dietary intake, physical activity and maternal nutritional status of expectant mothers.

1.5     SIGNIFICANCE OF THE STUDY

It is unbelievable to discover that many expectant mothers in this era still lack the fundamental idea or basic knowledge of nutrition during pregnancy.It is believed that at the end of this study the findings will be of utmost benefits to every expectant mothers and women as it serves as a means of curtailing the effects of malnutrition on their reproductive health. The ministry of health will make a great deal from the findings as it serves as a material for onward sensitization within cities and communities.  The findings will be relevant to those who intend to carry out a similar research topic as it has contributed to the existing literature.Finally, the research will serve as a fuel of new reasoning and further research work in nutritional knowledge and practice among expectant mothers, and to health science students, lecturers and the general public.

1.6    SCOPE OF THE STUDY

This study is centered on examining nutritional knowledge and practice among expectant mothers. In the cause of the study, the researcher encounters some limitations which limited the scope of the study;

Time constraint: The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

Inadequate Materials: Scarcity of material is also another hindrance. The researcher finds it difficult to long hands in several required material which could contribute immensely to the success of this research work.

Financial constraint:Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

1.7 DEFINITION OF TERMS

Knowledge:Knowledge is a familiarity, awareness, or understanding of someone or something, such as facts, information, descriptions, or skills, which is acquired through experience or learning.

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.

Health: Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental or social changes. The World Health Organization (WHO) defined health in its broader sense in its 1948 constitution as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." This definition has been subject to controversy, in particular as lacking operational value, the ambiguity in developing cohesive health strategies, and because of the problem created by use of the word "complete

Expectant mothers: Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman. Pregnancy can occur by sexual intercourse or assisted reproductive technology. Childbirth typically occurs around 40 weeks from the last menstrual period.

1.8 Organization of the study

This research work is organized in five chapters, for easy understanding, as follows Chapter one is concern with the introduction, which consist of the (overview, of the study), statement of problem, objectives of the study, research question, significance or the study, research methodology, definition of terms and historical background of the study. Chapter two highlight the theoretical framework on which the study its based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding.  Chapter five gives summary, conclusion and also recommendations made of the study.