RELATIONSHIP BETWEEN DIETARY DIVERSITY AND HAEMOGLOBIN CONCENTRATION AMONG WOMEN IN THREE COMMUNITIES IN THE BINDURI DISTRICT OF THE UPPER EAST REGION OF GHANA

ABSTRACT

Background: Micronutrient deficiencies are a public health concern worldwide negatively affecting maternal and child health outcomes. Globally, micronutrient deficiencies have been found to be the major leading cause of maternal and child mortality. Deficiencies of these same nutrients are the most common among Women of Reproductive Age (WRA) and are associated with increased risk of adverse consequences such as anaemia during pregnancy and maternal mortality, low birth weight infants and birth defects among others. The 2014 Ghana Demographic Health Survey revealed that anaemia remains a major health problem among Women of the Reproductive Age, (WRA) (15-49 years), although there was a decrease from 59% to 42% from 2008 to 2014, the prevalence further increased to 46.4 % in 2016. In the Upper East Region, the prevalence of anaemia among WRA was 39.6% in 2014. Thus, adequate nutrition and dietary diversity among this group are key determinants for achieving good pregnancy, nutrition and health outcomes. Aim: To investigate the relationship between dietary diversity and haemoglobin concentration among Women of Reproductive Age (15-49 years) in the Binduri District, of the Upper East Region of Ghana. Methods: The study was cross-sectional and was carried out in April, 2018. Three (3) randomly selected communities from a total of about 54 communities, in the Binduri District, of the Upper East Region of Ghana were used. The Binduri District has a total population size of 61,576 and 13,367 WRA. A total of 153 WRA were randomly selected from the three communities. Fifty-one (51) houses were selected through a systematic random sampling from each community. A weighted sampling technique was employed to select 51 households in each house. A simple random sampling of one participant from each household was selected. A structured questionnaire was employed to collect socio-demographic information and 24-hour dietary recall of the women. A Minimum Dietary Diversity of Women (MDD-W) model questionnaire was then used to obtain their Dietary Diversity Scores (DDS). Anthropometric measurements and haemoglobin concentration of the study participants were measured. Anaemia was categorized according to the WHO standards. A linear regression analysis was deployed to assess the relationship between dietary diversity scores and haemoglobin concentrations and other socio-demographic variables of interest.

Results: The mean age and BMI of the participants were 32.76 ± 8.67 years and 22.72 ± 2.78 kg/m2 respectively. The prevalence of anaemia was found to be 66.67%. The Dietary Diversity Scores (DDS) of the women ranged from 2 to 7, with a mean score of 3.97 ± 1.15. Seven out of 10 women (71.24%) failed to achieve the minimum dietary diversity intake. Dietary Diversity Scores was a strong predictor of haemoglobin concentrations (p = 0.000, R2 = 0.475) and BMIs (p = 0.002, R2 = 0.064) in this study. However, DD scores did not significantly predict visceral fat status and total body fat percentage of WRA (all p-values > 0.05).

Conclusion: Findings from this study showed that two out of every three Women of Reproductive Age (WRA) were anaemic, with more than three quarters of the study participants having normal Body Mass Index (BMI). Most of them had low Dietary Diversity (DD) Scores. Dietary Diversity Scores was a strong predictor of haemoglobin concentration and BMI of the participants. However, DD scores did not significantly predict visceral fat status and total body fat percentage of WRA. Thus, programs or interventions that increase DD scores may be effective strategies at decreasing the risk of anaemia among women of child bearing age.