Higher Maternal and Child Undernutrition in Pulse than Cereal Growing Rural Communities of Ethiopia: A comparative Cross-sectional Study


  •  Getahun Ersino    
  •  Carol J. Henry    
  •  Gordon A. Zello    

Abstract

Background: Whether growing pulses (low fat legumes rich in protein and micronutrients) translates to nutritional health benefits has not been well documented in Ethiopia. In pulse- and cereal-based agricultural communities, we compared the nutrition of mothers and children (<5y) through anthropometric and dietary assessment to document evidence of pulse agriculture translating to nutritional health benefits. We also explored contextual factors influencing nutritional status.

Methods: Comparative study was conducted in purposively selected pulse- and cereal-growing Ethiopian communities, from rural Halaba and Zeway, with randomly selected individual participants of 413 and 217 mother-child dyads, respectively. Dietary diversity scores (DDS) and consumption indexes for selected food groups were assessed; median intakes of energy, protein, Fe, Zn, Ca were determined from a single-day weighed food records (in a subsample). Mother-child undernutrition was estimated using anthropometric assessments of weight, length/height and mid-upper-arm-circumference, MUAC.

Results: Median energy and nutrient intakes for pulse-mothers, but not children, were significantly higher than cereal-mothers (p<0.01); Median DDS for mothers-children were three, out of nine food groups, in both communities; consumption index of pulses, although higher in the pulse-community (p<0.001), was generally low amounting to consumption of only 1-2/week; consumption from animal sources was minimal. Undernutrition in mothers was 22% in pulse and 14% in cereal. Child stunting, wasting and underweight were 53.5%, 10.4% and 36.5% in pulse and 41.8%, 4.1% and 21.6% in the cereal group, respectively. Gender-sensitive factors, such as access to own-land and work-burden predicted maternal-MUAC. Stunting, household size, land size, antenatal-clinic visits and frequency of dairy consumption also predicted maternal-MUAC. Child age, community (i.e., pulse- or cereal-growing), household size and land size predicted chid height-for-age z-score (HAZ). Pulses were mostly sold and women had limited control; mothers’ knowledge of the nutrition benefits of pulses was lower in pulse community (p<0.01).

Conclusions: Poor DDS, pulse or animal-source food consumption and high levels of maternal and child undernutrition were found in both communities. The unexpected finding of greater undernutrition in the pulse-growing Halaba communities was of concern needing further investigation. The pulse-community could benefit from educational nutrition-intervention focusing on nutrition and other benefits of pulses.



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