The mean ± SD of household size was found to be 7.5±2.05 which is relatively higher than the mean household size (5.5) of the Northern region (Cooke et al., 2016). The majority (84.72%) of the heads of households were men with 72.02% of the men having no formal education. Overall, the mean ± SD of knowledge, attitude and practice were 6.3±1.6, 3.6±0.7, and 1.1±0.7 respectively. (Table 1)
Table 1: Summary statistics and sociodemographic characteristics of households
Variable
|
Mean
|
Standard Deviation
|
Minimum
|
Maximum
|
Household size
|
7.50
|
2.05
|
1.00
|
11.00
|
Knowledge variables
|
|
|
1
|
10
|
Practice variables
|
3.61
|
0.77
|
0
|
4
|
Practice variables
|
1.08
|
|
0
|
2
|
Gender of head of household
|
Frequency
|
Percent
|
|
Male
Female
|
77
427
|
15.28
84.72
|
Educational level of head of household
|
|
|
No education
|
363
|
72.02
|
Primary education
|
51
|
10.12
|
Secondary education
|
43
|
8.53
|
Tertiary education
|
47
|
9.33
|
Table 2 contain results on access to nutritional information of respondents. Anthropometric data on women revealed the majority of the women had normal weight (76.1%) with 10.6% and 13.4% of the women being underweight and overweight respectively. The majority (50.4%) of participants did not have access to a health facility, but, used antenatal services (96.5%) during their last pregnancy. Additionally, the majority (50.7%) of the women delivered their children in a health facility during their last pregnancy. With regards to access to nutrition information the majority (89.9%) of the respondents had access to nutrition information with the majority (44.4%) of them receiving nutrition information more than thrice in the year. The majority (79.78%) of the respondents obtained nutrition information from doctors and nurses. The main nutrition information received by respondents was about eating balance diets by combining different kinds of foods (55.4%). The results also showed that the majority (95.1%) of respondents found the nutrition information they received to be useful to them.
Table 2 Access to nutrition information and other services and nutritional status of women
Variable
|
Frequency
|
Percent (%)
|
Access to nutrition information
|
Household have access to nutrition information (1)
Household do not have access to nutrition information (0)
|
51
453
|
10.12
89.88
|
Sources of health extension
|
Ministry of Health (MOH)
Non-governmental organizations (NGO)
Private
Other sources (eg. Friends, TV etc)
Both MOH & NGO
Sources of nutrition information
|
449
6
14
5
14
|
92.01
1.23
2.87
1.02
2.87
|
Dietician/nutritionist
Doctors/nurses
NGO
Other sources (eg. Friends, TV etc)
Both doctors/nurses & NGO
|
27
363
22
4
36
|
5.93
79.78
4.84
7.91
5.93
|
Number of times nutrition information was received
|
|
|
Once
|
64
|
14.65
|
Twice
|
103
|
23.57
|
Thrice
|
76
|
17.39
|
More than thrice
|
194
|
44.39
|
Usefulness of nutrition information
|
|
|
Information was useful
|
407
|
95.09
|
Information was not useful
|
21
|
4.91
|
Kinds of nutrition information received
|
|
|
Education on how to combine different foods
|
245
|
55.43
|
Training on how to cook
|
87
|
19.68
|
Education on the quantity of food intakes
|
34
|
7.69
|
Education on how to combine different foods and how to cook
|
10
|
2.26
|
Education on how to combine different foods and others (eg. Exercise)
|
28
|
6.33
|
Education on how to combine different foods and quantity of food to eat
|
11
|
2.49
|
Access to a health facility
Have access to a health facility (1)
Do not have access to a health facility (0)
|
239
243
|
49.59
50.41
|
Woman used antenatal in last birth
Yes (1)
No(0)
|
413
15
|
96.50
3.50
|
Woman delivered in health facility in last birth
Yes (1)
No(0)
|
209
203
|
50.73
49.27
|
Association between KAP of women and access to nutrition information
Table 3 shows results of the association between the KAP of women and access to nutrition education. The results showed that out of the ten knowledge questions, five were found to be significantly associated with access to nutrition information. Particularly, knowledge of women on the first food to give to a baby (P=0.09), length of exclusive breastfeeding (P=0.000), causes of undernutrition (P=0.009) and prevention of undernutrition (P=0.087) were significantly associated with access to nutrition information. Association of attitude variables with access to nutrition information showed that women attitude towards handwashing (P=0.000), use of unsafe water (p=0.000) and prevention of undernutrition among children (P=0.08) were found to be significantly associated with access to nutrition information. There were no significant associations observed regarding association between practice variables (handwashing and use of clean water for drinking and household cooking) and access to nutrition information.
Almost all (98.4%) of women knew that breastmilk was the first food given to a new born baby, 99.4% knew the meaning of EBF, and 94.7% knew the duration of EBF to be six months. These results indicate that women had good knowledge on exclusive breastfeeding. Additionally, 62.6% of the women had good knowledge on when to wash one’s hands, 95% had good knowledge on preventing undernutrition in children 0-6 months old, and 78.4% had a good knowledge on the signs to look out for to indicate that food was well cooked. On the other hand, the results showed that, 69.1%, 87% and 77.3% of respondents had a poor knowledge on signs, causes and prevention (6-23 months) of undernutrition.
The results indicate that women had good attitude towards hand washing (90.6%), the effects of the use of unsafe water for household purposes (88.3%), the effects of weight loss (98.4%) and the effects of undernutrition in children (83.2%) and the associated illnesses with these variables. On practice variables, the majority (69.6%) practiced using water from protected sources such as the use of pipe bore water. However, 61.6% of the respondents practiced the proper steps in hand washing.
Table 3: Association of KAP of women and access to nutrition information
Knowledge Variables
|
Access to nutrition information
|
Chi2
|
Df
|
Pvalue
|
|
Have access
|
No access
|
|
|
|
What is the first food a new baby should receive?
|
|
|
|
Only breastmilk (98.35)
|
431
|
47
|
2.89
|
1
|
0.09*
|
Any other food (1.65)
|
14
|
4
|
|
|
|
Exclusive breastfeeding means that the infant gets only breastmilk and no other liquids or foods. Have you heard about it before?
|
|
|
|
|
|
|
Yes (99.37)
|
426
|
49
|
1.69
|
1
|
0.19
|
No (0.63)
|
2
|
1
|
|
|
|
How long should a baby receive nothing more than breastmilk?
|
|
|
|
From birth to six months (94.66) 420
|
41
|
17.7
|
1
|
0.000***
|
Other/don't know (5.34)
|
17
|
9
|
|
|
|
There are key moments when you need to wash your hands to prevent germs. What are these key moments?
|
Knows key moments of handwashing (62.55)
|
275
|
34
|
0.41
|
1
|
0.52
|
Do not know key moments of handwashing (37.45)
|
168
|
17
|
|
|
|
What are the signs of undernutrition?
|
Knows signs of undernutrition (30.95)
|
138
|
18
|
0.5
|
1
|
0.48
|
Do not know signs of undernutrition (69.05)
|
315
|
33
|
|
|
|
What are the reasons why people are undernourished?
|
Knows causes of undernutrition (12.97)
|
50
|
12
|
6.84
|
1
|
0.009**
|
Do not know causes of undernutrition (87.03)
|
380
|
36
|
|
|
|
What are the causes of undernutrition in children?
|
Knows causes of low weight in children (44.56)
|
184
|
25
|
1.98
|
1
|
0.16
|
Do not know causes of low weight in children (55.44)
|
239
|
21
|
|
|
|
What should you do to prevent undernutrition among children 0-6months?
|
Knows how to prevent undernutrition (95.02)
|
408
|
24
|
2.92
|
1
|
0.087*
|
Do not know how to prevent undernutrition (4.98)
|
50
|
0
|
|
|
|
What should you do to prevent undernutrition among children 6-23months?
|
Knows how to prevent undernutrition (22.66)
|
103
|
6
|
3.62
|
1
|
0.057*
|
Do not know how to prevent undernutrition (77.34)
|
328
|
44
|
|
|
|
When cooking food, what signs shows that the food is cooked and ready to be served?
|
Knows signs of cooked food (78.44)
|
352
|
41
|
0.13
|
1
|
0.72
|
Do not know the signs of cooked food (21.56)
|
98
|
10
|
|
|
|
Attitude Variables
|
How likely do you think you or other members of your household to become sick, such as having diarrhea and stomach ache from not washing your hands?
|
Likely (90.62)
|
448
|
6
|
23.86
|
1
|
0.000***
|
Not likely (9.38)
|
41
|
6
|
|
|
|
How likely do you think you or any member of your household are to get diarrhea from using unsafe water?
|
Likely (88.31)
|
432
|
6
|
17.48
|
1
|
0.000***
|
Not likely (11.69)
|
52
|
6
|
|
|
|
How likely do you think your child is undernourished, that is they stop growing or lose weight?
|
Likely ( 98.36)
|
431
|
50
|
0.04
|
1
|
0.85
|
Not likely (1.64)
|
7
|
1
|
|
|
|
How serious do you think undernutrition is for a child's health?
|
|
|
|
Serious (83.20)
|
368
|
38
|
3.07
|
1
|
0.08*
|
Not serious (16.80)
|
69
|
13
|
|
|
|
Practice variable
|
Could you please describe step by step how you wash your hands?
|
|
|
|
Knows steps in handwashing (38.4)
|
187
|
5
|
0.06
|
1
|
0.81
|
Do not know handwashing steps (61.6)
|
301
|
7
|
|
|
|
What is the main source of water used by household for drinking, cooking and handwashing?
|
Protected water sources (69.64)
|
318
|
33
|
0.65
|
1
|
0.42
|
Unprotected water sources (30.36)
|
135
|
18
|
|
|
|
*, **, ***- significant at 10%, 5%, 1% respectively
Association of the Mean KAP of women and access to nutrition information
The results in Table 4 show the association between mean KAP of women and access to nutrition information. Overall, 53.6% of the women scored above the mean ± SD score on knowledge (6.3±1.6). Women scored 6 and above out of 10 knowledge questions which indicated that women had substantial knowledge of nutrition and nutrition related issues. However, the association between access to nutrition information and nutrition knowledge was not significant (P=0.84). Regarding attitude, the results show that the majority (75.8%) of the women had a good attitude towards nutrition and nutrition related issues and the association between access to nutrition information and nutrition attitudes was significant (P=0.01).Women scored above the mean attitude score of (3.6± 0.7) The results also showed that women generally had good practices toward nutrition issues and there was significant association between access to nutrition information and nutrition practices with majority (96.8%) of women scoring above the mean practice score (1.1±+0.7) out of four practice questions.
Table 4 Association of mean KAP of women and access to nutrition information
KAP (%)
|
Access to nutrition information
|
Chi2
|
Df
|
Pvalue
|
|
Have access
|
No access
|
|
|
|
Have good knowledge on nutrition related issues (53.57)
|
242
|
31
|
0.04
|
1
|
0.841
|
Do not have good knowledge on nutrition related issues (46.43)
|
102
|
23
|
|
|
|
Have good attitude towards nutrition related issues(75.79)
|
351
|
31
|
6.97
|
1
|
0.008**
|
Do not have good attitude towards nutrition related issues (24.21)
|
102
|
20
|
|
|
|
Good practices on nutrition related issues (96.83)
|
443
|
45
|
13.62
|
1
|
0.000***
|
Do not have good practices on nutrition related issues (3.17)
|
10
|
6
|
|
|
|
Association of access to nutrition information and women nutritional status
Table 5 shows the association between access to nutrition information and women’s nutritional status. The results showed that there was no association (Chi-square =2.75; P=0.25) between access to nutrition information and women nutritional status. Furthermore, there was no association (Chi-square=3.14; P=0.21) between mean household dietary score (HDDS) and women’s nutritional status (see Table 5).
Table 5: Association between access to nutrition information and women nutritional status
Access to nutrition information
|
Nutritional status of woman
|
Normal
|
Underweight
|
Overweight
|
Total
|
Do not have access
|
38
|
3
|
10
|
51
|
Have access
|
345
|
50
|
58
|
453
|
Total
|
383
|
53
|
68
|
504
|
Pearson chi2(2)=2.75
Pvalue =0.25
|
HDDS
|
Below mean HDDS
|
17
|
2
|
0
|
19
|
Equal to/above mean HDDS
|
366
|
51
|
68
|
485
|
Total
|
383
|
53
|
68
|
504
|
Pearson chi2=3.14
Pvalue=0.21
|
|
|
|
|
|
|
|
|
|
*, **, ***- significant at 10%, 5%, 1% respectively.