Dietary diversity and its association with anaemia in pregnant women in the Roodepoort area of Johannesburg, Gauteng of Johannesburg, Gauteng

Abstract

Anaemia is a global public health concern, especially in low and middle-income countries such as South Africa. This dissertation aimed to investigate the association between anaemia prevalence and dietary diversity in pregnant women in the Roodepoort area of Johannesburg, Gauteng, South Africa. A cross-sectional study was conducted on 294 pregnant women attending the Discoverers Community Health Centre in Johannesburg. An interviewer-administered questionnaire and medical files were utilised to obtain socio-demographic and obstetric history data, respectively. Trained fieldworkers conducted anthropometrical measurements. Dietary diversity (DD) was assessed using the 24-hour recall method and a DD score (DDS) calculated, and haemoglobin levels were measured to determine anaemia status. Statistical analyses included descriptive data analysis, independent t-tests, ANOVA, Chi-square analysis and determining the Pearson’s correlation coefficient. The mean age of the participants was 28.6 (± 5.8) years. Most women were from South Africa (66.8%), Black African women (90%), single (44.9%), and unemployed (56.8%). The majority of the participants were in their second trimester (59.3%) and were HIV negative (78.9%). The mean Hb for the total sample was 11.6 (±1.35) g/dL. No participants in this study were classified as severely anaemic (< 7 g/dL), however 22.9% were anaemic (< 10.5 g/dL). HIV positive participants had lower Hb levels (11.0±1.50 g/dL) compared to HIV negative participants (11.8±1.26 g/dL) (p = 0.006). From the 24-hour dietary recall results, majority food groups consumed included grains, roots, and tubers (99.3%), meat, poultry and fish (82.9%), and vegetables not high in vitamin A (61.2%). Food groups consumed the least included nuts and seeds (11.5%), pulses (11.9%), eggs (17.5%), and dark green leafy vegetables (23.4%). The mean DDS was 4.21 (± 1.38). Majority of the study sample (60.8%) did not meet the required minimum DD for women ≥ 5 food groups. Contrary to some existing literature, this study found no correlation between anaemia prevalence and dietary diversity amongst pregnant women. Possible reasons for this dissociative relationship are discussed and include nutritional interventions such as the national food fortification program, the use of micronutrient supplementation and various socio-economic factors. The findings underscore the complexity of anaemia in pregnancy and highlight the need for tailored interventions to address nutritional deficiencies and socio-economic determinants. Further research is required to explore additional factors contributing to anaemia in pregnant women and to develop comprehensive strategies for the prevention and management thereof not only in the Roodepoort area in Johannesburg, but also in the wider population of South Africa.