Author: Detty Siti Nurdiati
Background: Indonesian maternal mortality rate is still high. Poor nutritional status of women is considered one of the major factors which contribute to the existing high rates of maternal mortality. However, the nutritional issues of women themselves are rarely investigated.
OBJECTIVES: To estimate and characterise the nutritional status in non-pregnant women as reflected by anthropometry and to explore the possible associations between reproductive, demographic and socio-economic factors and nutritional status.
METHODS: A cross-sectional study was carried out to estimate nutritional status among non-pregnant women of reproductive age in the Community Health and Nutrition Research Laboratory (CHN-RL) surveillance area, in the Purworejo district, Central Java, Indonesia. A sample of approximately 13.000 households was selected using the probability proportional to estimated size. The data on socio-economic, demographic and reproductive factors were taken from surveillance data collected in August – October 1995. The collection of anthropometric data including weight, height, mid-upper arm circumference (MUAC) and triceps skinfold thickness on non-pregnant women took place between January – March 1996. The quality of data collection was monitored by a checking system.
RESULTS: Married women defined as being at risk of becoming pregnant were available for this study (n=8442) and 69.7% of these eligible women were included in the analyses (n=5817). The mean weight of the women in the study sample was 47.8 7.9 kg, mean height was 149.1 5.1 cm, mean MUAC was 25.8 2.9 cm, mean triceps skinfold thickness was 15.0 6.3 mm and mean body mass index (BMI) was 21.2 3.1. The BMI of the study sample was compared with the classification for chronic energy deficiency (CED) and obesity among adults (James et al., 1988; WHO, 1995). The total prevalence of CED was 17.0%. Further, CED grades III, II, I, normal, Obese I and Obese II were found among 1.2, 3.0, 12.8, 71.7, 10.0 and 1.4% of the women, respectively. Multivariate regression models that controlled for possible associated factors showed that occcupation was a significant factor which influenced the nutritional status of the women. The women working with agriculture or domestically were 40-48% more likely to be CED. Women with better economic status, as shown by the availability of drinking water, television and refrigerator ownership had better nutritional status. We found that status of using contraceptive methods was related to nutritional status. In multivariate analyses parity and family size were not significantly related with CED. However in univariate analyses these factors were significant; it could be that those are related to the background factors.
CONCLUSION: The results of this study suggest that 17% of non-pregnant women of reproductive age had CED, that 71.7% were normal and that 11.4% were obese. The major reasons for malnutrition, i.e., limited resources and poor socio-economic status of the population, need to be addressed to improve nutritional status of girls and women prior to and subsequent to pregnancy. Continuing research in the area of preconception nutrition is needed to ensure better health status and pregnancy outcomes. A more detailed understanding of the socio-economic determinants of malnutrition among women could help improve interventions.