A cross-sectional descriptive study assessing minimum dietary diversity among women desiring pregnancy in tribal and non-tribal blocks in rural area of a north Maharashtra district, India
DOI:
https://doi.org/10.47203/IJCH.2025.v37i03.005Keywords:
Preconception, Tribal, Dietary Diversity Score, Minimum Dietary Diversity, Food GroupsAbstract
Introduction: Minimum Dietary Diversity reflects the consumption of micronutrients and is measured by assessing consumption items from various food groups. The preconception phase is crucial in women’s reproductive cycle. Objectives: to estimate the proportion of women having minimum dietary diversity in desiring to conceive within one year in tribal and non-trial blocks, to compare the proportion in tribal and non-tribal blocks, and to identify associated risk factors. Methods: A cross-sectional descriptive study of two tribal and two non-tribal blocks in the Nashik district of Maharashtra. All women desiring pregnancy in a year were enrolled. The consumed items in 24 hours were grouped into ten. The study gave one score for each consumed group. The study considered accomplished minimum dietary diversity when the woman scored five or more. Results: The study enrolled 7,794 women. The mean age of the women was 23.19 years (SD=3.72). The mean dietary diversity score of the women was 4.73 (SD=0.7), 68.8% had minimum dietary diversity, and there was no difference between tribal and non-tribal blocks. Starchy food consumption was 100%, and fruit and vegetable consumption were minimal. Lower parity had a positive effect (AOR =0.90; CI 95%= 0.81-0.99). Unemployed women (AOR =1.12; CI 95% =1.01-1.24), consumption of tobacco in any form (AOR=1.38; CI 95% =1.11-1.70), and substantially less protein intake (AOR=2.49; CI 95%=1.61-3.84) had a negative effect. Conclusions: About two-thirds of women had minimum dietary diversity. Residence in tribal areas did not affect, but socio-demographic factors, tobacco, and less protein consumption affected minimum dietary diversity.
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References
World Health Organization. Infant and young child feeding Model Chapter for textbooks for medical students and allied health professionals. 2009.
Food and Agriculture Organization of the United States. Minimum Dietary Diversity for Women- A Guide to Measurement [Internet]. 2016 [cited 2025 Mar 2]. Available from: www.fao.org/publications
Food and Agricultur Organization of the United Nations. Minimum dietary diversity for women: An updated guide for measurement - from collection to action [Internet]. 2021 [cited 2025 Mar 2]. Available from: https://doi.org/10.4060/cb3434en
Press Information Bureau National Health Mission India. Anaemia Mukt Bharat [Internet]. Vol. 5. 2022. p. 1–8. Available from: https://anemiamuktbharat.info/programme/interventions
Khura B, Ahmed KY, Mohanty P, Kumar CP, Thapa S. Minimum dietary diversity is associated with lower risk of childhood underweight: Evidence from the 2019/2021 National Family Health Survey of India. Nutr Res. 2024 Oct 1;130:11–21.
Saaka M, Wemah K, Kizito F, Hoeschle-Zeledon I. Effect of nutrition behaviour change communication delivered through radio on mothers’ nutritional knowledge, child feeding practices and growth. J Nutr Sci. 2021;10:1–9.
Gelli A, Margolies A, Santacroce M, Roschnik N, Twalibu A, Katundu M, et al. Using a Community-Based Early Childhood Development Center as a Platform to Promote Production and Consumption Diversity Increases Children’s Dietary Intake and Reduces Stunting in Malawi: A Cluster-Randomized Trial. J Nutr. 2018 Oct 1;148(10):1587–97.
Uwase A, Nsereko E, Pillay N, Levin J. Dietary diversity and associated factors among pregnant women in the Southern Province of Rwanda: A facility-based cross-sectional study. PLoS One [Internet]. 2024 Feb 1 [cited 2025 Mar 2];19(2):e0297112. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10889653/
Mesfin BA, Argaw AT, Getahun Negash F, Emiru DA, Aserese AD, Matebe GY. Minimum Dietary Diversity and Associated Factors Among Pregnant Women Living in Arba Minch Health and Demographic Surveillance Sites, Southern Ethiopia, 2022. Heal Serv Res Manag Epidemiol. 2023;10:1–9.
Geremew H, Abdisa S, Zerihun E, Gizaw YK, Kassa Y, Gashu C, et al. Dietary diversity practice and its associated factors among pregnant women in Eastern Ethiopia: A community-based cross-sectional study. Food Sci Nutr [Internet]. 2024 Mar 1 [cited 2025 Mar 2];12(3):1965–72.
Agrawal S. Health and Nutritional Disadvantage among Tribal Women and Children of Orissa: An Enquiry. Popul Reprod Child Heal. 2013;(Basu 2000):317–36.
Rokade S, Mog M, Mondal NA. Nutritional status among tribal women in Maharashtra, India: Spatial variations and determinants. Clin Epidemiol Glob Heal [Internet]. 2020;8(4):1360–5. Available from: https://doi.org/10.1016/j.cegh.2020.05.012
Nongrum MS, Pawera L, Mawroh B. Dietary diversity and its determinants among Khasi and Garo indigenous women (15 to 49 years) in Meghalaya, northeast India. Nutr Health. 2022;28(2):249–56.
Kapoor R, Sabharwal M, Ghosh-Jerath S. Diet Quality, Nutritional Adequacy and Anthropometric Status among Indigenous Women of Reproductive Age Group (15–49 Years) in India: A Narrative Review. Dietetics. 2022;2(1):1–22.
Ghosh-Jerath S, Kapoor R, Singh A, Nilima, Downs S, Goldberg G, et al. Agroforestry diversity, indigenous food consumption and nutritional outcomes in Sauria Paharia tribal women of Jharkhand, India. Matern Child Nutr. 2021;17(1):1–17.
World Health Organization. Preconception care: Maximizing the gains for maternal and child health. p. 1–15.
Shumayla S, Irfan EM, Kathuria N, Rathi SK, Srivastava S, Mehra S. Minimum dietary diversity and associated factors among lactating mothers in Haryana, India: a community based cross-sectional study. BMC Pediatr [Internet]. 2022 Dec 1 [cited 2025 Feb 24];22(1):1–9.
Martin-Prevel Y, Arimond M, Allemand P, Wiesmann D, Ballard TJ, Deitchler M, et al. Development of a dichotomous indicator for population-level assessment of dietary diversity in women of reproductive age. Curr Dev Nutr. 2017 Nov 2;1(12).
Talegawkar SA, Jin Y, Sedlander E, Ganjoo R, Behera S, Dipietro L, et al. A Social Norms-Based Intervention Improves Dietary Diversity among Women in Rural India: The Reduction in Anemia through Normative Innovations (RANI) Project. Nutrients [Internet]. 2021 Aug 1 [cited 2025 Feb 24];13(8).
Singh S, Jones AD, DeFries RS, Jain M. The association between crop and income diversity and farmer intra-household dietary diversity in India. Food Secur [Internet]. 2020 Apr 1 [cited 2025 Mar 25];12(2):369–90.
Adubra L, Savy M, Fortin S, Kameli Y, Kodjo NE, Fainke K, et al. The minimum dietary diversity for women of reproductive age (MDD-W) indicator is related to household food insecurity and farm production diversity: Evidence from rural Mali. Curr Dev Nutr. 2019;3(3):1–9.
Alamirew SK, Lemke S, Stadlmayr B, Freyer B. Dietary Behaviour and Sociocultural Determinants of Dietary Diversity among Rural Women of Reproductive Age: A Case of Amhara Region, Ethiopia. Nutrients. 2023;15(15).
Nyhus Dhillon C, Vossenaar M, Weiligmann B, Sanwal N, Djimeu EW, Kneepkens M, et al. A Nutrition Behavior Change Program Moderately Improves Minimum Diet Diversity and Handwashing Behaviors Among Tea Workers in Assam and Tamil Nadu, India. Food Nutr Bull. 2022 Jun 1;43(2):159–70.
Diop L, Becquey E, Turowska Z, Huybregts L, Ruel MT, Gelli A. Standard Minimum Dietary Diversity Indicators for Women or Infants and Young Children Are Good Predictors of Adequate Micronutrient Intakes in 24-59-Month-Old Children and Their Nonpregnant Nonbreastfeeding Mothers in Rural Burkina Faso. J Nutr [Internet]. 2021;151(2):412–22.
Alexandra L. Bellows CRC, Blakstad MM, Dominic Mosha RANPW, Kinabo J, Masanja H, Fawzi WW. The Relationship Between Dietary Diversity Among Women of Reproductive Age and Agricultural Diversity in Rural Tanzania Alexandra. Food Nutr Bull. 2020;41(1):50–60.
Sinharoy SS, Waid JL, Haardörfer R, Wendt A, Gabrysch S, Yount KM. Women’s dietary diversity in rural Bangladesh: Pathways through women’s empowerment. Matern Child Nutr [Internet]. 2018 [cited 2025 Feb 28]; Available from: https://doi.org/10.1111/mcn.12489
Baxter JAB, Wasan Y, Islam M, Cousens S, Soofi SB, Ahmed I, et al. Dietary diversity and social determinants of nutrition among late adolescent girls in rural Pakistan. Matern Child Nutr. 2022;18(1):1–11.
Ramaswamy J, Natarajan T, Haridas S, Palanisamy K, Nedungadi P. Community-Based Approach to Combat Micronutrient Deficiencies Among Irular Tribal women: An Education Intervention. Indian J Public Health. 2022;66(4):516–9.
Acham H, Oldewage-Theron WH, Egal AA. Dietary diversity, micronutrient intake and their variation among black women in informal settlements in South Africa: A cross-sectional study. Int J Nutr Metab [Internet]. 2012 [cited 2025 Mar 2];4(2):24–39. Available from: http://www.academicjournals.org/IJNAM
Dusingizimana T, Gilbert N, Kjelqvist T. Women’s dietary diversity is associated with homestead production and market access: A cross-sectional study in rural Rwanda. Matern Child Nutr [Internet]. 2025 [cited 2025 Feb 24]; Available from: https://doi.org/10.1111/mcn.13755
Vijay J, Kumar Patel K. Recommendations to scale up dietary diversity data at household and individual level in India. Diabetes Metab Syndr Clin Res Rev [Internet]. 2021;15(6):102310.
Shashikantha S, Sheethal M, Vishma B. Dietary diversity among women in the reproductive age group in a rural field practice area of a medical college in Mandya district, Karnataka, India. Int J Community Med Public Heal. 2016;3(3):746–9.
Ukegbu O, Patricia, Ekebisi C. Food Science and Nutrition Technology Assessing Dietary Diversity Score and Nutritional Status of Rural Adult Women in Abia State, Nigeria. FoodScience Nutr Technol. 2016;1(1):1–11.
Gupta S, Sunder N, Pingali PL. Market Access, Production Diversity, and Diet Diversity: Evidence From India. Food Nutr Bull. 2020;41(2):167–85.
Ghosh-Jerath S, Kapoor R, Bandhu A, Singh A, Downs S, Fanzo J. Indigenous Foods to Address Malnutrition: An Inquiry into the Diets and Nutritional Status of Women in the Indigenous Community of Munda Tribes of Jharkhand, India. Curr Dev Nutr. 2022;6(9):1–18.
Raghuwanshi D, Mogra R. Assessment of dietary diversity of rural women of reproductive age. Asian J Home Sci. 2020;15(1):110–3.
Gupta S, Sunder N, Pingali PL. Are Women in Rural India Really Consuming a Less Diverse Diet? Food Nutr Bull [Internet]. 2020 Sep 1 [cited 2025 Mar 25];41(3):318–31.
Nyhus Dhillon C, Vossenaar M, Weiligmann B, Sanwal N, Djimeu EW, Kneepkens M, et al. A Nutrition Behavior Change Program Moderately Improves Minimum Diet Diversity and Handwashing Behaviors Among Tea Workers in Assam and Tamil Nadu, India. Food Nutr Bull [Internet]. 2022 Jun 1 [cited 2025 Mar 2];43(2):159.
Davis U. Minimum Dietary Diversity for Women- A Guide to Measurement [Internet]. 2016 [cited 2025 Mar 2]. Available from: www.fao.org/publications
Unisa S, Saraswat A, Bhanot A, Jaleel A, Parhi RN, Bhattacharjee S, et al. Predictors of the diets consumed by adolescent girls, pregnant women and mothers with children under age two years in rural eastern India. J Biosoc Scinece [Internet]. 2020 [cited 2025 Mar 25];1–20.
Rastogi P, Choudhary S, Mehra S, Sharma S. Improving dietary diversity among women of reproductive age group (15-49 years) through community-based activities across four districts of India. Int J Community Med Public Heal [Internet]. 2023 Sep 30 [cited 2025 Feb 24];10(10):3721–7.
Mukuria-Ashe A, Alayon S, Williams T, Sydykova G, Ali D, Milner E, et al. Determinants of Maternal Diet Quality in Winter in the Kyrgyz Republic. 2022 [cited 2025 Mar 2]; Available from: www.ghspjournal.org
Ekesa B, Ariong RM, Kennedy G, Baganizi M, Dolan I. Relationships between land tenure insecurity, agrobiodiversity, and dietary diversity of women of reproductive age: Evidence from Acholi and Teso subregions of Uganda. Matern Child Nutr. 2020 Dec 1;16(S3).
Jin Y, Talegawkar SA, Sedlander E, DiPietro L, Parida M, Ganjoo R, et al. Dietary Diversity and Its Associations with Anemia among Women of Reproductive Age in Rural Odisha, India. Vol. 61, Ecology of Food and Nutrition. 2022. p. 304–18.
Sharma A, Chanda S, Porwal A, Wadhwa N, Santhanam D, Ranjan R, et al. Effect of social and behavioral change interventions on minimum dietary diversity among pregnant women and associated socio-economic inequality in Rajasthan, India. BMC Nutr. 2024;10(1):1–12
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