ArticlePloS one2024
Individual, household, and community-level determinants of undernutrition among pregnant women in the northern zone of the Sidama region, Ethiopia: A multi-level modified Poisson regression analysis.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
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- Multilevel Analysis of Women's Perceptions of Community-Based Health Insurance on Healthcare Access in Sidama Region, Ethiopia: A Community-Based Cross-Sectional Study.Health science reports · 2026Article
- Multilevel modified Poisson regression analysis of barriers to healthcare access among pregnant women in high and very high maternal mortality sub-Saharan African countries: insights from demographic and health surveys data.Archives of public health = Archives belges de sante publique · 2026Article
- Adherence, safety, bioavailability, and acceptability of amaranth grain flatbread during pregnancy: evidence from a cluster randomized trial in Sidama region, Ethiopia.BMC nutrition · 2026Article
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Abstract
introductionIn Ethiopia, maternal undernutrition is a major public health concern. However, comprehensive evidence is lacking in the southern part of Ethiopia, specifically the household and community-level related determinants of undernutrition. Besides, the evidence about the prevalence and determinants of undernutrition is not yet documented in the current study setting. Thus, this study aimed to determine the prevalence of undernutrition and identify its determinants among pregnant women in Hawela Lida district of the Sidama region, Ethiopia.
methodsA community-based cross-sectional study was conducted on a sample of 515 pregnant women from June 1-25, 2024. A multi-stage sampling method was utilized to select eligible pregnant women. We collected data using a structured and pretested interviewer-administrated questionnaire and an anthropometric measurement. Data were collected using the Open Data Kit smart phone device and exported it to Stata version 17 for further processing and analysis. A multi-level mixed-effects modified Poisson regression analysis with robust variance was used to account for confounders and between and with cluster effects.
resultThe prevalence of undernutrition among pregnant women was 41.7% (95% CI: 37.3-45.6). The prevalence of undernutrition was associated with planned pregnancy (adjusted prevalence ratio [APR]: 0.80; 95% CI: 0.66-0.98), household food insecurity (APR: 1.64; 95% CI: 1.26-2.13), inadequate dietary diversity (APR: 1.79; 95% CI: 1.43-2.25), and women's poor knowledge of nutrition (APR: 1.68; 95% CI: 1.32-2.12) at individual levels. The identified determinants of undernutrition at the community level were low community literacy rates (APR: 4.62; 95% CI: 1.13-18.79) and low community wealth status (APR: 1.91; 95% CI: 1.10-3.31).
conclusionTwo in five pregnant women had an undernutrition problem in the study setting. Individual and community-level determinants contributed to the high prevalence of undernutrition. Thus, any prevention and control approaches to undernutrition should consider inter-sectorial collaboration to account for determinants at various levels. Besides, any program must emphasize the delivery of nutrition education about dietary diversity, particularly targeting pregnant mothers who have poor knowledge of nutrition and unplanned pregnancy at the individual level. Moreover, creating a small business reform for the community with low wealth status using agricultural extension workers must be considered.
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