Addressing barriers to maternal nutrition in low- and middle-income countries: A review of the evidence and programme implications.
Justine A KavleMegan LandryPublished in: Maternal & child nutrition (2017)
Adequate maternal nutrition during the "first 1,000 days" window is critical from conception through the first 6 months of life to improve nutritional status and reduce the risk of poor birth outcomes, such as low birthweight and preterm birth. Unfortunately, many programmes have targeted implementation and monitoring of nutrition interventions to infants and young children, rather than to women during pregnancy or post-partum. A literature review was conducted to identify barriers to food choice and consumption during pregnancy and lactation and to examine how low- and middle-income countries have addressed maternal nutrition in programmes. A literature review of peer-reviewed and grey literature was conducted, and titles and abstracts reviewed by authors. Twenty-three studies were included in this review. Barriers to adequate nutrition during pregnancy included cultural beliefs related to knowledge of quantity of food to eat during pregnancy, amount of weight to gain during pregnancy, and "eating down" during pregnancy for fear of delivering a large baby. Foods considered inappropriate for consumption during pregnancy or lactation contributed to food restriction. Drivers of food choice were influenced by food aversions, economic constraints, and household food availability. Counselling on maternal diet and weight gain during pregnancy was seldom carried out. Programming to support healthy maternal diet and gestational weight gain during pregnancy is scant. Tailored, culturally resonant nutrition education and counselling on diet during pregnancy and lactation and weight gain during pregnancy, as well as monitoring of progress in maternal nutrition, are areas of needed attention.
Keyphrases
- birth weight
- weight gain
- physical activity
- gestational age
- body mass index
- weight loss
- preterm birth
- pregnancy outcomes
- human health
- healthcare
- human milk
- systematic review
- primary care
- dairy cows
- risk assessment
- metabolic syndrome
- pregnant women
- white matter
- clinical trial
- drug delivery
- insulin resistance
- drug induced
- decision making