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NEWPORT INTERNATIONAL JOURNAL OF
RESEARCH IN MEDICAL SCIENCES (NIJRMS)
Volume 3 Issue 1 2023
Page | 46
Assessment of Nutritional Status as it relates to
maternal health and mortality among women
attending antenatal clinic of Murtala Muhammed
specialist hospital, Kano State, Nigeria

1,2
Mikail Isyaku Umar, 3Aisha Suleiman Sa'ad, 3Maryam N. Aliyu,
3
Ibrahim Isyaku, 3Bello Bashir Aisha, 4Maryam Isa Shariff and
5
Emmanuel Ifeanyi Obeagu*

1Human Anatomy Department, Kampala International University, Uganda.

2Department of Human Anatomy, Federal University Dutse, Jigawa state, Nigeria.
3Department of Human Anatomy, Yusuf Maitama Sule University Kano, Kano State, Nigeria.
4Department of Human Anatomy, Bayero University, Kano, Kano State, Nigeria.
5Department of Medical Laboratory Science, Kampala International University, Uganda.

ABSTRACT
Nutrition is the fundamental human right and it plays a key role in health. Eradication of hunger ranks high
among international goals because good nutrition is essential for the health and capacity needed to achieve so
many of the other Millennium Development Goals. The aim of this study is to assess nutritional status as it
relates to maternal health and mortality among pregnant women attending antenatal clinic of Murtala
muhammed specialist hospital Kano. Three hundred and eighty-four (384) pregnant women were selected from
antenatal clinic of murtala Muhammad specialist hospital. The age range of the participants was between 18-45
years. Their BMI measurement, mid upper arm circumference and facial anthropometry was taken. Information
was obtained about their dietary intake using the Dietary diversity score (DDS). All data are summarized as and
expressed as Mean ± standard deviation. Data analyze using IBM and statistical package for social science
(SPSS). P value of <0.05. chi square result with p-values less than 0.05). A cross-sectional descriptive research
was performed to evaluate the anthropometric and bio-chemical measurements of pregnant women who visited
prenatal clinics. The result of the study shows that there is a relationship between the dietary diversity score
affecting the nutritional status as it relates to maternal health and mortality among pregnant women, it also
shows that there is no relationship between Mid upper arm circumference affecting nutritional status as it relates
to maternal health and mortality, also shows no relationship between socio demographic factors and economic
factors affecting nutritional status as it relates to maternal health and mortality among pregnant women
attending antenatal clinic of murtala muhammed specialist hospital, Kano state. In conclusion, this study it is
determined that the study population's intake of fruits and vegetables is poor. Anthropometry of pregnant
women reveals that the majority have a non-healthy dietary state. Anemic ladies made up around one-third of
the pregnant women. The analysis revealed that scientific and medical progress played a significant role in the
reduction of maternal mortality, beginning with the introduction of antisepsis techniques. The statistical
analysis revealed a significant positive association between level of education and nutritional status as it relates
to maternal health and mortality among women attending antenatal clinic of Murtala Muhammad Specialist
Hospital Kano.
Keywords: nutrition, maternal health, maternal mortality, malnutrition and maternal morbidity.

INTRODUCTION
Malnutrition is one of the major problems in which the physical function of an individual is impaired to the point
that it can no longer maintain adequate body processes such as growth, physical work, and resistance to any

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recovery from diseases. Malnutrition is associated with a low economic situation, and poor personal and
environmental hygiene. The world health Organization defines ‘malnutrition’ as “the cellular imbalance between
the supply of nutrients and energy and the body’s demand for them to ensure growth, maintenance and specific
functions”. Contrary to the common use, the term malnutrition refers not only to deficiency states but also to
excess and imbalance in the intake of calories, proteins and/or other nutrients [10].
A balanced amount of nutrients is necessary for the proper functioning of the body system. Nutrition is the
fundamental pillar of human life, health and development throughout the entire life span [1]. Proper food and
good nutrition are essential for survival, physical growth, mental development, performance and productivity, Page | 47
health and wellbeing. However, nutrition requirements vary with age, gender and during physiological changes
such as pregnancy. Pregnancy is such a critical phase in woman’s life when the expecting mother needs optimal
nutrients of superior quality to support the developing fetus [2].Malnutrition manifest itself as a function of
many and complex factors that affect the national child status [3]. It is directly linked to inadequacy in diet and
diseases under living condition factors that include crisis in household food supply, inappropriate childcare and
feeding practices, unhealthy place of residence and insufficient basic health services for those in poor
socioeconomic situations, cultural beliefs and lack of parents’ education, especially that of mothers [3].
Poor nutrition in pregnancy, in combination with infections, is a common cause of maternal mortality, low birth
weight and intrauterine growth retardation (IUGR). Malnutrition remains one of the world’s highest priority
health issues, not only because its affects are so widespread and long lasting but also because it can be eradicated
best at the preventive stage [4]. Maternal malnutrition is influenced not only by lack of adequate nutrition but
also influenced by social and psychological factors, nutritional knowledge of mothers, and biological changes
that influence perceptions of eating patterns during pregnancies [5]. Many women in Africa suffer from chronic
energy deficiency, inadequate weight gain during pregnancy and poor micronutrient status. Insufficient food
intake, high energy expenditure, micronutrient-deficient diets, infections, and the demands of pregnancy and
lactation contribute to maternal malnutrition [6]. The study was done to assess nutritional status as it relates
to maternal health and mortality among pregnant women attending antenatal clinic of Murtala Muhammad
specialist hospital, Kano state.
Materials and Methods
Study area
The assessment was carried out in Murtala Muhammad Specialist Hospital (MMSH), Kano State.
Study Design
This is a descriptive cross sectional study and analysis methods to investigate dietary patterns of individual
women in the previous 24 hours before the survey. The study population comprised pregnant women.
Study Population
Study population constitute 384 pregnant women attending antenatal clinic of Murtala Muhammed Specialist
Hospital.
Sample Size Determination
Sample size was determined using the formula developed by Cochran [7] as shown below;
Where n-desired sample size z= confidence level (how confident the actual mean falls within your confidence
interval) 1.96 at 95% p= prevalence/ proportion of standard deviation (how much variance is expected in the
response) =0.5 q= 1-p, d- degree of precision/ margin of error which is 5%, N=z-pq/d (1.96) ^2 0.5(1-0.5)/
(0.05) ^2= 384.
The minimum sample size needed for the study was 384.
Sampling Technique
Random selection technique was used to select the patients without unbiased, and the interview with the health
practitioners, i.e., the doctors and nurses was carried on those who are on duty.
Inclusion criteria
Pregnant women attending antenatal clinic of Murtala Muhammed Specialist hospital who are within their 2nd
trimester i.e. from 3rd month. Doctors, nurses and midwives on duty.
Exclusion criteria
Pregnant women who are within their 1st trimester. Non pregnant women. Doctors, nurses and midwives that
are not on duty.
Ethical Approval
Introductory letter was obtained from the head of Anatomy Department of Yusuf Maitama Sule University.
Ethical approval was obtained from the ministry of health. Consent was obtained from the management of
Murtala Muhammed Specialist Hospital Kano, as well as from the in charge of the antenatal clinic of the hospital
before the commencement of the research work.
Statistical Analysis
All data are summarized as and expressed as Mean ± standard deviation. Data analyze using IBM and
statistical package for social science (SPSS). P value of <0.05.

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RESULTS
Table 1: Socio-demographic factors and economic characteristics of respondents
Items Frequency Percentage (%)
Educational Qualification:
Primary 201 56.0
Secondary 90 25.0
Tertiary 69 19.0
Page | 48
Husband Educational Qualification:
Primary 72 20.0
Secondary 191 53.0
Tertiary 59 16.5
Above tertiary 38 10.5
Age:
18-23 yrs. 281 78.0
24-29 yrs. 43 12.0
30-35 yrs. 22 6.0
36 & above yrs. 14 4.0
Height:
less than 1.4m 50 14.5
equal to 1.4m 50 14.5
greater than 1.4m 260 71.0
Weight:
less than 50kg 14 4.0
equal to 50kg 317 88.0
higher than 50kg 29 8.0
BMI:
Normal weight 209 58.0
Neutral 50 14.5
Underweight 50 14.5
Ethnicity:
Hausa 325 90.3
Igbo 15 4.2
Yoruba 20 5.5
Occupation:
Civil servants 7 2.0
Business woman 72 20.0
Housewife 281 78.0
Income:
Less than 35,000 43 12.0
35,001-50,000 237 65.8
50,001 & above 80 22.2
Family type:
Polygamy 263 73.0
Monogamy 97 27.0
Table 1 shows the Socio-demographic factors and economic characteristics of respondents, in terms of required
educational qualification. The vast majority of responders (19%) had at least some tertiary experience, while
only 55% had only completed elementary school. The husbands of 53% of respondents had at least a bachelor's
degree, while only 2% had only elementary school certificate. The vast majority of responders (78%) fell into
the 18-23-year-old bracket, while only 4% were 36 and older. (71%) were taller than 1.4 meters, (88%) weighed
less than fifty kilograms, and (71%) had a body mass index (BMI) of twenty-five or less. Roughly the same
percentage (85.6%) were Hausa, (10.2%) were Igbo, and 4.2% were Yoruba. Almost 1 in 8 (12.0%) of respondents
had monthly incomes of less than N35,000, (65.8%) had monthly incomes of N35,001-N50,000 while (22.2%)
had a monthly income of N50,001-above. (30.6%) were in monogamous couples, whereas only (69.4%) were
polygamous.

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Table 2: Descriptive Statistics of the Variables
Variables Mean Std. Dev. Minimum Maximum Obs.
Educational Qualification 2.8417 0.4600 1 3 360
Husband Educational Cert. 2.7722 0.6908 1 4 360
Age of the Respondents 1.3583 0.7662 1 4 360
Height of the Respondents 2.5833 0.7227 1 3 360
Page | 49
Weight of the Respondents 2.0417 0.3436 1 3 360
Body Mass Index (BMI) 1.4167 0.7227 1 3 360
Ethnicity of the Respondents 1.2000 0.5214 1 3 360
Occupation of the Respondents 1.1389 0.3987 1 3 360
Income of the Respondents 2.8806 0.3248 2 3 360
Family Type of the Respondents 1.9806 0.1383 1 2 360
Source: Computed using SPSS
Table 3: Recall of Dietary Practice of the respondents within 24 Hours
Items Frequency Percentage (%)
Do You Skip Meal:
Yes 131 36.3
No 229 63.7
If Yes, What is the Reason for Skipping Meal:
Loss of appetite 45 12.3
Unavailable food 7 2
Not the type of food I like 79 22
Don’t have reason to skip food 229 63.7

Types or Collection of Food Consumed:

Beans, nuts and seeds 72 20.0
Starchy foods 86 24
green leafy vegetables 68 19
Meat and fish 59 16.5
Other vitamin and rich fruits 40 11
Milk and milk products 13 3.5
Fat and oil 22 6.0

Table 3 shows the Recall of Dietary Practice of the respondents within 24 Hours. One third or more of the group
skip their meal (36.3%). Fewer people cited food inaccessibility as a reason for skipping meals (2%), while the
vast majority didn't provide a reason (since they didn't skip meals). Starchy food (24%), including rice and maize,
were the most often eaten food group, milk and milk products (3.5%) was the least.

Table 4: Descriptive Statistics of the Variables

Mean Std. Dev. Minimum Maximum Obs.
Do You Skip Meal 1.636111 0.4818 1 2 360
Reason for Skipping Meal 2.730556 0.6694 1 3 360
Types of Food Consumed 4.169444 1.6256 1 7 360

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Table 5: Frequency of Malnutrition and Anaemia
Items Frequency Percentage (%)
Mid Upper Arm Circumference of Respondents:
Normal (≥ 23 cm) 272 75.6
Malnourished (< 23 cm) 88 24.4
Anemic Status of the Respondents:
Not anemic 245 68
Anemic 115 32
Page | 50
Severity of Anaemia Among Respondents:
Severe 68 19
Modest 47 13
Slight 245 68
Source: Field Survey, 2023
Table 5 shows the frequency of malnutrition and anaemia of the respondents. About a quarter of the pregnant
women (24.4%; MUAC 23 cm) were undernourished, whereas the remaining majority (75.6%; MUAC 23 cm;
mean = 1.2444 cm) were healthy. Also, 32% of the pregnant women were anaemia, whereas 68% were not. They
ranged from mild anaemia (68%), to moderate anemia (13%), to severe anemia (19%). Overall, the hemoglobin
level was 1.3194 2.4917 g/dl.
Table 6: Descriptive Statistics of the Variables
Mean Std. Dev. Minimum Maximum Obs.
MUAC 1.2444 0.4304 1 2 360
Anemic Status 1.3194 0.4670 1 2 360
Severity of Anaemia 2.4917 0.7934 1 3 360
DISCUSSION
The principal concern of this study is to assess the nutritional status of pregnant women as it relates to maternal
health and mortality among women attending antenatal clinic of Murtala Muhammad specialist hospital, Kano
state. There is no relationship between Socio-demographic factors and economic characteristics affecting
maternal health and mortality among pregnant women attending antenatal clinic of Murtala Muhammad
Specialist Hospital Kano. It shows that these factors have no impact on the mortality among the pregnant women
[8-9].There is a relationship between Dietary Diversity Score (DDS) affecting maternal health and mortality
among women attending antenatal clinic of Murtala Muhammad Specialist Hospital Kano.There is no
relationship between facial anthropometry and mid arm circumference affecting nutritional status as it relates
to maternal health and mortality among women attending antenatal clinic of Murtala Muhammad Specialist
Hospital Kano. The analysis revealed that scientific and medical progress played a significant role in the
reduction of maternal mortality, beginning with the introduction of antisepsis techniques.
CONCLUSION
Anthropometry of pregnant women reveals that the majority have a non-healthy dietary state. Anemic ladies
made up around one-third of the pregnant women. The analysis revealed that scientific and medical progress
played a significant role in the reduction of maternal mortality, beginning with the introduction of antisepsis
techniques. The statistical analysis revealed a significant positive association between level of education and
nutritional status as it relates to maternal health and mortality among women attending antenatal clinic of
Murtala Muhammad Specialist Hospital Kano.
REFERENCES
1. World Bank. Repositioning nutrition as central to development: A strategy for large scale action.
Washington, DC: World Bank. 2006.
2. Yifru B, Asres B. Commentary: actions in the pipeline and the way forward to reduce maternal and perinatal
mortality in Ethiopia. Ethiop J Health Sci. 2014; 24(0 Suppl):149-168.
3. Ronsmans C, Graham WJ. Maternal mortality: who, when, where, and why. The Lancet. 2014; 368(9542)
4. Daba G, Beyene F, Fekadu H, Garoma W. Assessment of Knowledge of Pregnant Mothers on Maternal
Nutrition and Associated Factors in Guto Gida Woreda, East Wollega Zone, Ethiopia. J Nutr Food Sci.
2013;3(6):235.
5. Temesgen DH, Dessalegn W, Habtamu FG, Dunkana NK. Nutritional Status and Associated Factors
Among Lactating Mothers in Nekemte Referral Hospital and Health Centers, Ethiopia. International
Journal of Nutrition and Food Sciences. 2015; 4(2):216-222.
6. Idowu OA, Mafiana CF, Dapo S. Anaemia in pregnancy: a survey of pregnant women in Abeokuta, Nigeria.
Afr Health Sci. 2005; 5(4):295-259.
7. Cochran WG. Sampling techniques. 3rd Ed. New York: John Wiley & sons 1977..

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8. Ibekwe AM, Obeagu EI, Ibekwe CE, Onyekwuo C, Ibekwe CV, Okoro AD, Ifezue CB. Challenges of
Exclusive Breastfeeding among Working Class Women in a Teaching Hospital South East, Nigeria.
Journal of Pharmaceutical Research International. 2022 Jul 27;34(46A):1-0.
9. Fasina F, Oni G, Azuh D, Oduaran A. Impact of mothers’ socio-demographic factors and antenatal
clinic attendance on neonatal mortality in Nigeria. Cogent Social Sciences. 2020 Jan 1;6(1):1747328.

Mikail Isyaku Umar, Aisha Suleiman Sa'ad, Maryam N. Aliyu, Ibrahim Isyaku, Bello Bashir Aisha, Maryam Isa
Shariff and Emmanuel Ifeanyi Obeagu (2023). Assessment of Nutritional Status as it relates to maternal health Page | 51
and mortality among women attending antenatal clinic of Murtala Muhammed specialist hospital, Kano State,
Nigeria. NEWPORT INTERNATIONAL JOURNAL OF RESEARCH IN MEDICAL SCIENCES (NIJRMS)
3(1): 46-51

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