Determinants of health and nutritional status of rural Nigerian women.

ABSTRACT

This study was undertaken to determine the effects of socioeconomic and cultural factors on the health and nutritional status of 300 women of childbearing age in two rural farming communities in Enugu State, Nigeria. The women were engaged in farming, trading, and teaching. A cross-sectional survey was conducted using both qualitative and quantitative data-collection methods. The study involved focus-group discussions (FGDs), interviews using a questionnaire, measurement of food/nutrient intake, assessment of activity patterns, anthropometry, and observations of clinical signs of malnutrition. The better-educated women had higher incomes than those with little or no education. Poor education was mainly attributed to lack of monetary support by parents (34%), marriage while in school (27%), and sex discrimination (21%). The teachers had significantly (p < 0.05) better health status, health and nutrition knowledge, food habits, nutrient intake, and self-concept, and adhered less to detrimental cultural practices. However, none of the women met their iron, riboflavin and niacin requirements. More cases of chronic energy deficiency were observed among the farmers (16%) and traders (13%) than among the teachers (5%). Generally, the women worked long hours with reported working hours (6-7 hours) being lower than the observed working hours (11 hours) for the traders and teachers. Income had a significant (p < 0.05) positive correlation with all nutritional variables, except vitamin C, age-at-marriage (r = 0.719), and nutrition knowledge (r = 0.601). Age-at-marriage had a positive correlation with body mass index (BMI) and all nutritional variables but was significant (p < 0.05) for protein (r = 0.362), calcium (r = 0.358), iron (r = 0.362), riboflavin (r = 0.364), and vitamin C (r = 0.476). Workload was negatively correlated with protein intake (r = 0.346; p < 0.05). Meal frequencies for more than 70% of the farmers and petty traders and 42% of the teachers were dependent on the availability of food in the household. Food taboos had no effect on their nutrient intake, since only 5-11% of women adhered to taboos. Although most women gave their children and husbands preference in food distribution, not much difference was found in the amount of food consumed by these women. The ratio of wife's portion to husband's was 11.4 for the farmers, 11.3 for the traders, and 11.2 for the teachers. FGDs revealed that sex discrimination in education prevailed where resources were limited. The results of the study suggest that the basic determinants of health and nutritional status of women are socioeconomic and cultural, education having a mediating or modifying influence on cultural practices.