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Background: While lactation is a physiological process requiring high energy demand to fulfill the nutrient requirements of the mother and the breastfeeding child, many factors affecting maternal nutrient intake can lead to nutritional deficits. Previous studies in Ethiopia have reported the prevalence of maternal and child undernutrition and related complications. However, qualitative studies exploring potential barriers to utilizing available nutrition interventions are limited. This study, therefore, sought to qualitatively explore barriers hindering the uptake of nutrition services among lactating mothers from rural communities in Tigray, northern Ethiopia., Methods: We conducted 6 in-depth interviews, 70 key informant interviews, and 13 focus group discussions among purposively selected community groups, experts, and lactating mothers between November- 2017 and January- 2018. Audio records of all interviews and focus group discussions were transcribed verbatim (word-to-word) and translated into English. Then, translated data were analyzed thematically using qualitative data analysis software Atlas ti-version 7.4., Results: The participants in this study perceived that lactating mothers in their study area are not properly utilizing available and recommended nutrition interventions, and as a result, their nutrient intake was reported as inadequate. Participants identified inadequate accessibility and availability of foods, feeding practices, cultural and religious influences, focus on agricultural production and productivity, barriers related to health services and poor access to water, sanitation and hygiene as major barriers hindering the uptake of nutrition interventions by lactating women in Tigray, northern Ethiopia., Conclusion: The uptake of nutrition intervention services was low among lactating mothers and was hindered by multiple socio-cultural and health service related factors requiring problem-specific interventions at community, health facility, and administrative levels to improve the nutritional status of lactating mothers in the study area., Competing Interests: The authors have declared no competing interests.

Background: Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia., Methods: Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates., Results: The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively., Conclusions: Efforts to ameliorate maternal undernutrition need to consider the influence of the rising epidemiology of adult mortality from chronic diseases. Our data clearly indicate the need for channeling the integrated intervention power of nutrition-sensitive development programs with that of nutrition-specific sectoral services.

Introduction: Weight gain during pregnancy is an important indicator of maternal and fetal nutrition during pregnancy. However, information regarding the effect of pregnancy weight gain on birth weight is lacking from developing countries., Objective: To determine the effect of pregnancy weight gain on the newborn's birth weight in mothers attending antenatal care (ANC) services from private clinics., Methods: Health facility-based follow-up study was conducted among 332 pregnant mothers attending their antenatal care in Mekelle city, from October 2016 to June 2017. Before 28 weeks of gestation, pregnancy weight was collected retrospectively, then, mothers were followed-up until the time of infant delivery to record their birth weight. Data were also collected by a structured questionnaire and checklists and analyzed using SPSS version 21. The relationship between dependent and independent variables was assessed and presented using descriptive statistics, as well as t-test, ANOVA, and multivariable linear regression analysis. Variables:-pre-pregnancy BMI, maternal age, parity, decision making power on monetary resources, pregnancy interval, availability of housemaid, women dietary diversity score, maternal occupation, and pregnancy weight gain were included in the multivariable analysis., Results: Maternal weight increased monthly at a mean ± SD rate of 2 ± 0.7 kg in the second trimester, and 1.5 ± 0.7 kg in the third trimester. The mean ± SD of pre-pregnancy body mass index (BMI) and total pregnancy weight gain was 23.8 ± 4.6 kg/m2, and 12 ± 2.8 kg respectively. The mean ± SD of birth weight was 3440 ± 542 grams. Weight gain has a significant effect on infant birth weight, a 1 kg increase in the pregnancy weight was associated with 94 g increase in BW (β = 97, 95% CI: 73-120). After dividing the pre-pregnancy weight into four groups (< 18.5, 18.5-24.9, 25-29.9 and ≥30) kg/m2 based on the Institute of Medicine (IOM), we found a statistically significant birth weight difference between each group., Conclusion: Pregnancy weight gain has a significant effect on birth weight. Thus, ANC counseling services should focus on maternal weight gain to prevent sub-optimal birth weight., Competing Interests: The authors have declared that no competing interests exist.

Growth monitoring and promotion (GMP) is a prevention activity comprised of growth monitoring (GM) linked with promotion that serves as the core activity in an integrated child health and nutrition program. However, different methods of institutional studies have shown that utilization of GM services has remained to be inadequate. There is scarcity of studies conducted about GMP in quantitative method. Therefore, this study was conducted to address the proportion of GMP services and associated factors among children under two years of age in rural communities of Mareka district, Southern Ethiopia. Community based cross-sectional survey was conducted from August to September 2015. Single population proportion formula was used to determine the sample size with multi stage sampling technique. A total of 819 children under two years of age were included. Pretest was done on 10% of the total sample size. Data were analyzed using SPSS version 20.0 software. Bivariate and multivariate logistic regressions used to analyze data. The response rate was 95%. Utilization of GMP services was 16.9%. Institutional delivery AOR (95% CI): 3.01(1.65–5.50), index child age 12–17 months AOR (95% CI): 4.03(2.16–7.51) and 18–23 months AOR (95% CI): 3.08(1.70–5.57), family size 4–5 AOR(95% CI): 0.14(0.06–0.33), family size >5 AOR(95% CI): 0.34(0.14–0.82), regular GMP attendance AOR (95% CI): 4.37(2.45–7.80), medium wealth index AOR(95% CI): 3.14(1.51–6.52) and high wealth index AOR(95% CI): 3.24(1.59–6.62) were factors associated with utilization of GMP services. Utilization of GMP services was low. Thus, efforts should be made to improve utilization of GMP services through promotion of institutional delivery, different family planning methods, and regular GMP attendance. [ABSTRACT FROM AUTHOR]