Prevalence of undernutrition and associated factors among adolescent pregnant women in Dolo-Ado town, Somali region, Ethiopia – BMC Pregnancy and Childbirth

Sociodemographic characteristics of adolescent pregnant women in Dolo-Ado town

As seen in Table 1, 380 pregnant adolescents were interviewed with a response rate of 100%. The data reveals several key sociodemographic and maternal characteristics. Most mothers were aged 18–19 years, accounting for 297 (78.16%), while 173 (45.53%) were aged 15–17. The majority were Somali, representing 315 (82.9%), followed by Oromo at 40 (10.53%), Amhara at 23 (6.05%), and Tigray at 2 (0.53%). In terms of religion, 345 (90.79%) of the respondents identified as Muslim, with a smaller proportion being Orthodox Christians at 33 (8.68%) and Protestants at 2 (0.53%). Slightly more mothers resided in rural areas, 198 (52.11%), compared to 182 (47.9%) in urban areas.

Prevalence of undernutrition among adolescent pregnant women in Dolo-Ado, Somali Region

As shown in Fig. 1, the study assessed the prevalence of undernutrition among pregnant women in Dolo-Ado town using mid-upper arm circumference (MUAC) as an indicator. The mean MUAC of the participants was 24.2 cm (± 2.4 SD), reflecting the average nutritional status of the group and indicating some level of variability among individuals. Among the 380 women interviewed, 79 (21%) were classified as undernourished, defined by a MUAC measurement of less than 22 cm. Meanwhile, 3.2% of the women were found to be severely undernourished, indicating a critical level of nutritional deprivation that demands urgent intervention to prevent adverse maternal and neonatal health outcomes. The remaining 79% of the participants had a normal nutritional status (MUAC ≥ 22 cm), suggesting that the majority of the women met the minimum nutritional requirements to support pregnancy.

Prevalence of food security among adolescents pregnant in Dolo-ado town, Somali region

The study revealed that among the adolescent pregnant women surveyed, 127 (33%) were from food-insecure households, while 253 (67%) were from food-secure households. These findings indicate that two-thirds of the respondents lived in food-secure conditions, suggesting that the majority had relatively better access to food resources. However, one-third of the participants faced food insecurity, underscoring the urgent need for targeted interventions.

Minimum dietary diversity score of respondents in Dolo-Ado town, Somali region

The analysis of the Minimum Dietary Diversity Score (MDD-W) among the adolescent pregnant mothers in Dolo-Ado revealed that only 11 (3%) of them met the minimum recommended dietary diversity score by consuming five or more food groups in the previous 24 h. Conversely, a significant majority, 369 (97%), failed to meet the dietary diversity threshold, consuming fewer than five food groups.

Maternal-related characteristics of respondents in Dolo-Ado town

As shown in Table 2, the analysis of maternal health and nutrition factors reveals that most women had only one previous pregnancy, with 225 (59.21%) in this category, while 26 (6.84%) had five or more pregnancies. A significant majority of pregnancies were unintended 359(94.47%). Regarding the stage of pregnancy, 260 (68.42%) were in the first trimester, followed by 110 (28.95%) in the second trimester, and 10 (2.63%) in the third trimester. Antenatal visits were attended by 297 (78.16%), while 83 (21.84%) did not attend.

Bivariate logistic regression analysis of adolescent pregnant women in Dolo-Ado town

As shown in Table 3, the results indicate that several significant factors are associated with undernutrition among adolescent pregnant women in the Dolo-Ado district. The analysis shows that maternal education is a key determinant of undernutrition. Illiterate mothers had 13(3.42%) undernourished compared to 208(54.74%) who were not, with a COR of 4.4 (2.1–9.2) and a p-value of 0.13. Primary-educated mothers had 27(7.11%) undernourished versus 47(12.37%) not undernourished, with a COR of 1.4 (3.2–3.6) and a p-value of 0.03. Secondary-educated mothers reported 15(3.95%) undernourished compared to 30(7.89%) not undernourished, with a COR of 2.5 (1.5–5.7) and a p-value of 0.14. Mothers with college and above education served as the reference group.

Multivariate logistic regression analysis of adolescent pregnant women in Dolo-Ado town

As shown in Table 4, the results indicate that several significant factors are associated with undernutrition among adolescent pregnant women in the Dolo-Ado district.

In the context of maternal education, illiterate mothers were four times more likely to be undernourished compared to their literate counterparts, (AOR) of 3.9 (95% CI: 1.9–8.0). Additionally, pregnant adolescent mothers residing in rural areas were 12 times more likely to experience undernutrition than those living in urban areas (AOR of 12 (95% CI: 3.5–42.9). Regarding monthly family income, households earning less than 1500 Birr had approximately three times the likelihood of undernutrition compared to those with higher incomes, AOR of 2.6 (95% CI: 1.2–5.4).

Food insecurity was identified as a significant predictor of undernutrition. Pregnant adolescents from food-insecure households were six times more likely to be undernourished compared to those from food-secure households, (AOR of 6.2 (95% CI: 2.8–13.9). Furthermore, mothers who consumed five or fewer food groups were 13 times more likely to experience undernutrition, (AOR of 13.1 (95% CI: 2.2–77.3).

Lastly, regarding Iron and Folic Acid (IFA) supplementation, pregnant adolescent mothers who did not receive IFA supplementation were approximately four times more likely to be undernourished compared to those who did receive it, (AOR of 3.6 (95% CI: 1.7–7.5).

SDGs, Targets, and Indicators

SDGs, Targets, and Indicators

1. SDG 2: Zero Hunger

• Target 2.1: By 2030, end hunger and ensure access by all people, in particular, the poor and people in vulnerable situations, including infants, to safe, nutritious, and sufficient food all year round.
• Indicator: Prevalence of undernutrition among adolescent pregnant women (Table 1)
• Indicator: Prevalence of food security among adolescent pregnant women (Sec19)
• Indicator: Minimum dietary diversity score of respondents (Sec20)

• Target 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
• Indicator: Prevalence of undernutrition among adolescent pregnant women (Table 1)

• Target 4.1: By 2030, ensure that all girls and boys complete free, equitable, and quality primary and secondary education leading to relevant and effective learning outcomes.
• Indicator: Maternal education as a determinant of undernutrition (Sec22)

• Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
• Indicator: Family planning practices (Sec21)

• Target 6.1: By 2030, achieve universal and equitable access to safe and affordable drinking water for all.
• Indicator: Access to safe water (Table 1)
• Target 6.2: By 2030, achieve access to adequate and equitable sanitation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations.
• Indicator: Access to toilets (Table 1)

• Target 17.17: Encourage and promote effective public, public-private, and civil society partnerships, building on the experience and resourcing strategies of partnerships.
• Indicator: Multivariate logistic regression analysis of adolescent pregnant women (Sec23)

Table: SDGs, Targets, and Indicators

Source: bmcpregnancychildbirth.biomedcentral.com