Suchergebnisse

OBJECTIVE: Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14% being underweight (BMI<18.5) and 42% experiencing iron deficiency anemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab. DESIGN: In-depth interviews and focus group discussions were conducted, and then analyzed using thematic analysis. SETTING: Three purposively selected rural districts (Sahiwal, Okara, and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan PARTICIPANTS: Mothers with children under age two (n=29), and healthcare providers with at least five years of experience working in the district (n=12) RESULTS: We identified a combination of physiological, socio-cultural, and structural barriers that inhibited healthful dietary intake during pregnancy. The primary physiological barriers to optimal dietary intake and dietary practices included food aversions and food cravings. Food classification, fear of a difficult childbirth, fear of high blood pressure, and household food politics were the principal socio-cultural barriers. Additionally, two structural barriers, inadequate antenatal counseling and a lack of affordable food options, were identified. CONCLUSIONS: Our study demonstrates that complex barriers prevent pregnant women in the Punjab area from consuming adequate dietary intake, and that antenatal health education programs and structural interventions are needed to support healthful dietary practices during this critical period.

Objective: Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab. Design: In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis. Setting: Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan. Participants: Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n 12). Results: We identified a combination of physiological, socio-cultural and structural barriers that inhibited healthful dietary intake during pregnancy. The primary physiological barriers to optimal dietary intake and dietary practices included food aversions and food cravings. Food classification, fear of a difficult childbirth, fear of high blood pressure and household food politics were the principal socio-cultural barriers. Additionally, two structural barriers, inadequate antenatal counseling and a lack of affordable food options, were identified. Conclusions: Our study demonstrates that complex barriers prevent pregnant women in the Punjab area from consuming adequate dietary intake and that antenatal health education programmes and structural interventions are needed to support healthful dietary practices during this critical period.

AbstractRacial concentration of neighborhoods is often associated with the risk of preterm birth (PTB) for women. This study examined differences between racially diverse and racially concentrated neighborhoods when examining preterm birth. Individual-level data were obtained from Texas natality files for 2009–2011, and neighborhood-level (i.e., census tract) data were obtained from the decennial census in 2010 and the American Community Survey 2005–2009. We used multilevel modeling to assess the association between neighborhood racial diversity and odds of PTB, after controlling for individual characteristics, neighborhood poverty, and population density. We found that neighborhood racial diversity and concentration matter for PTB. Results suggest that systemic racism is still key to understanding PTB. Furthermore, findings support policies that prevent displacement from gentrification of diverse neighborhoods and promote equal access to health-related resources for women in predominantly Black, Hispanic, and/or immigrant neighborhoods.