Kinshella Mai-Lei Woo, Dama Shilla, Wanje Onesmus, Pires Rosa, Boene Helena, Jagne Papa, Jah Hawanatu, Koech Angela, Mwashigadi Grace, Naanyu Violet, Idris Yahaya, Kongira Fatoumata, Diallo Brahima A, Ceesay Omar, Volvert Marie-Laure, Mistry Hiten D, Temmerman Marleen, Sevene Esperança, Roca Anna, D'Alessandro Umberto, Vidler Marianne, Magee Laura A, von Dadelszen Peter, Moore Sophie E, Elango Rajavel
Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada.
Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya.
PLOS Glob Public Health. 2025 Apr 2;5(4):e0004411. doi: 10.1371/journal.pgph.0004411. eCollection 2025.
Pregnant and lactating women in sub-Saharan Africa are vulnerable to micronutrient inadequacies, with risk of adverse pregnancy outcomes. Adequate intakes of diverse foods are associated with better micronutrient status and recommended by the World Health Organization as part of healthy eating counselling during antenatal care. However, our understanding of community knowledge of dietary diversity within the context of maternal diets is limited. We used a descriptive qualitative approach to explore community perceptions of dietary diversity during pregnancy and lactation, as well as influencing factors in sub-Saharan Africa. A total of 47 in-depth interviews were conducted between May and October 2022 in Kenya, Mozambique and The Gambia with a purposively drawn sample of pregnant women and mothers who had delivered within two years preceding the data collection, their male and female relatives, and community opinion leaders. Other methods included participant observation and photovoice. Data were analyzed using a thematic approach on NVivo software. Dietary diversity was found to be well aligned with local perceptions of healthy meals. All participants were able to differentiate between starchy staple grains and additional foods to provide nutrients. While diverse meals were valued for pregnant and lactating mothers, participants across the three countries shared that maternal diets were not more diverse compared to typical household meals. Furthermore, diverse diets were inaccessible for many in their communities, due to challenges in affordability, seasonality, gender norms, knowledge and preferences. Adequate nutrition knowledge, accessibility of foods, and support of household decision-makers, particularly husbands and partners, were all identified as critical to ensure women have adequate diverse maternal diets.
撒哈拉以南非洲地区的孕妇和哺乳期妇女易受微量营养素缺乏影响，存在不良妊娠结局风险。摄入充足的各类食物与更好的微量营养素状况相关，世界卫生组织建议将其作为产前护理期间健康饮食咨询的一部分。然而，我们对孕产妇饮食背景下社区对饮食多样性的了解有限。我们采用描述性定性方法，探讨撒哈拉以南非洲地区社区对孕期和哺乳期饮食多样性的看法以及影响因素。2022年5月至10月期间，在肯尼亚、莫桑比克和冈比亚共进行了47次深入访谈，对象是有目的地抽取的孕妇以及在数据收集前两年内分娩的母亲、她们的男性和女性亲属，还有社区意见领袖。其他方法包括参与观察和摄影之声。使用NVivo软件采用主题分析法对数据进行分析。发现饮食多样性与当地对健康膳食的看法高度一致。所有参与者都能区分富含淀粉的主食谷物和其他提供营养的食物。虽然多样化膳食对孕妇和哺乳期母亲很重要，但这三个国家的参与者都表示，与典型的家庭膳食相比，孕产妇饮食的多样性并没有更高。此外，由于可负担性、季节性、性别规范、知识和偏好等方面的挑战，社区中的许多人无法获得多样化的饮食。充足的营养知识、食物的可及性以及家庭决策者（尤其是丈夫和伴侣）的支持，都被认为是确保妇女获得充足多样的孕产妇饮食的关键。
