Key points are not available for this paper at this time.
The inadequate dietary diversity of pregnant women in low- and middle-income countries, including Rwanda, is rising and leading to macro and micronutrient deficiencies. The extent of dietary diversity and the factors contributing to it are unknown in Rwanda. This cross-sectional study, with 612 women who attended antenatal care services in Rwanda's Southern Province, identified determinants of dietary diversity among pregnant women. A multistage sampling scheme was used in which four districts were sampled, thereafter one urban and one rural health centre was sampled in each district and finally, a systematic sample of pregnant women was selected in each sampled health centre. Dietary diversity was measured using Minimum Dietary Diversity for Women (MDD-W), and multiple logistic regression models were fitted to identify factors associated with dietary diversity. Only 44.1% (95% confidence interval (CI) of 40.1%, 48.0%) of participants had adequate dietary diversity. Approximately 95.4% of participants consumed grains, white roots, and tubers. The food groups that were the least consumed consisted of eggs (n = 99, 16.4%), as well as those consisting of milk and milk products (n = 112, 18.5%). The factors which were positively associated with dietary diversity were owning a radio (adjusted odds ratio aOR = 1.90 95% CI 1.27, 2.85), maternal education (aOR = 1.85 95% CI 1.28, 2.65), having a kitchen garden (aOR = 1.69 95% CI 1.11, 2.57) and nutrition knowledge score (aOR = 1.45 95% CI 1.21, 1.74) for a five-point increase in nutrition knowledge score. The factors negatively associated with dietary diversity include food insecurity, which reduced the odds of dietary diversity (aOR = 0.19 0.07, 0.50) per five-unit increase in food insecurity. Furthermore, the odds of adequate dietary diversity were lower among urban residents than rural residents (aOR = 0.69 0.47, 1.03). The household size was associated with dietary diversity with the odds of dietary diversity decreasing by 12% for a five-unit increase in household size (aOR = 0.88 0.79; 0.99). 23% had poor nutritional status, indicated by their mid-upper arm circumference (MUAC; < 23 cm). Enhanced nutritional education is needed to improve the nutritional knowledge of this population with particular emphasis on the consumption of animal-source foods. Sensitisation activities promoting ownership of kitchen gardens and radios could improve dietary diversity among Rwanda's pregnant women.
Uwase et al. (Fri,) studied this question.