Undernutrition and its associated factors among pregnant women attending antenatal care at public health facilities in pastoral communities of Afar Regional State, northeast Ethiopia

Abstract Background Maternal malnutrition during pregnancy increases the risk of miscarriages and foetal deaths, pre-term delivery, and maternal mortality. However, limited studies have been conducted in Ethiopia that may not represent the problem among pregnant women in pastoral communities like the Afar region. Therefore, this study assessed the prevalence and associated factors of undernutrition among pregnant women attending antenatal care at public health facilities in pastoral communities of the Afar region, northeast Ethiopia. A facility-based cross-sectional study design was employed from 20 September to 5 October 2020. A sample of 387 pregnant women attending antenatal care clinics in randomly selected public health facilities was included. The collected data were checked, cleaned, and entered using Epi-data version 3.1 and exported into Stata version 14.0 for further analysis. Binary logistic regression analysis was used to measure the association between undernutrition and its predictors among pregnant women. Finally, the statistical significance level was declared using an adjusted odds ratio with its corresponding 95% confidence interval. The overall prevalence of undernutrition among pregnant women was found to be 30.9% [95% CI 26.5%, 35.8%]. Being illiterate, living in rural, women’s substance usage during pregnancy, not receiving counselling on a balanced diet, having chronic medical problems, not taking extra meals within 24 h, having food restrictions during this pregnancy, and being HIV-positive were the independent predictors of undernutrition. Conclusion This study indicated that nearly a third of pregnant women were undernourished. The regional and national governments should give due attention to women residing in rural areas to get access to education for women in pastoral communities. The health care providers should strengthen the screening of women with medical problems and interventions that improve maternal health during pregnancy. Besides the provision of prenatal dietary counselling on a balanced diet, avoiding food restrictions and encouraging them to take extra meal during pregnancy are recommended to avoid undernutrition among pregnant women in pastoral communities.