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Effect of Antenatal Nutrition Education on Dietary Practices among Pregnant Women in Nigeria

Abstract

Adequate maternal nutrition during pregnancy is essential for maintaining maternal health, supporting fetal growth and development, and reducing the risk of adverse pregnancy outcomes. Pregnancy increases the body's requirements for energy, protein, vitamins, minerals, and other essential nutrients, making appropriate dietary practices particularly important. Dietary practices among pregnant women include dietary diversity, meal frequency, consumption of fruits and vegetables, intake of protein-rich and micronutrient-rich foods, adherence to recommended micronutrient supplementation, appropriate food preparation, and avoidance of potentially harmful foods and substances. Antenatal nutrition education is an important component of maternal healthcare that provides pregnant women with information and practical guidance on balanced diets, nutrient requirements, dietary diversity, healthy food choices, food safety, micronutrient supplementation, and management of common pregnancy-related nutritional challenges. In Nigeria, pregnant women may experience barriers to healthy dietary practices, including inadequate nutrition knowledge, household food insecurity, poverty, high food prices, cultural beliefs, food taboos, limited access to nutritious foods, and inadequate nutrition counselling during antenatal care. Effective antenatal nutrition education may improve women's knowledge and decision-making regarding food choices and encourage healthier dietary practices during pregnancy. Against this background, this study investigates the effect of antenatal nutrition education on dietary practices among pregnant women in Nigeria. The study is anchored on the Health Belief Model (HBM), Social Cognitive Theory (SCT), and Knowledge-Attitude-Practice (KAP) framework. The Health Belief Model explains health-related behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding pregnant women's decisions regarding appropriate dietary practices. Social Cognitive Theory emphasizes the interaction between knowledge, behavioural capabilities, self-efficacy, social influences, and environmental conditions in shaping dietary behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how improved nutrition knowledge and attitudes resulting from antenatal nutrition education may influence dietary practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how antenatal nutrition education may influence dietary practices among pregnant women in Nigeria. The study adopts a quantitative quasi-experimental research design. Primary data will be collected from pregnant women attending selected public and private antenatal care facilities in Nigeria using a structured interviewer-administered questionnaire and an appropriate dietary assessment instrument. A multistage sampling technique will be employed to select states, local government areas, healthcare facilities, antenatal clinics, and eligible participants. Where feasible, selected facilities or participants will be assigned to intervention and comparison groups. Pregnant women in the intervention group will receive structured antenatal nutrition education covering balanced diets, dietary diversity, meal frequency, consumption of fruits and vegetables, protein-rich foods, iron- and folate-rich foods, recommended micronutrient supplementation, food safety, healthy weight gain, and practical strategies for making nutritious food choices within available household resources. Dietary practices will be assessed using indicators such as dietary diversity, frequency of consumption of major food groups, meal frequency, intake of nutrient-dense foods, adherence to recommended micronutrient supplementation, food safety practices, and avoidance of harmful dietary practices. Dietary information may be assessed using a validated dietary recall or food-frequency instrument appropriate to the study setting. Descriptive statistics will be used to summarize participants' sociodemographic and obstetric characteristics, exposure to antenatal nutrition education, and dietary practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be employed to determine the effect of antenatal nutrition education on dietary practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, and the robustness of the findings. The study anticipates that antenatal nutrition education will have a significant positive effect on dietary practices among pregnant women in Nigeria. Pregnant women exposed to structured nutrition education are expected to demonstrate improved knowledge of pregnancy-related nutritional requirements and greater adoption of healthy dietary practices. Antenatal nutrition education may encourage increased dietary diversity, appropriate meal frequency, greater consumption of nutrient-rich foods, improved food safety practices, and adherence to recommended micronutrient supplementation. However, nutrition education alone may not guarantee sustained improvement in dietary practices because pregnant women may continue to face barriers such as household food insecurity, poverty, high food prices, cultural food taboos, limited availability of nutritious foods, and household decision-making constraints. Consequently, antenatal nutrition education is expected to be more effective when integrated with affordable and accessible nutritious foods, micronutrient supplementation, food-security interventions, practical nutrition counselling, and supportive household and community environments. This study is expected to contribute to the literature on maternal nutrition, antenatal care, nutrition education, dietary practices, maternal health, and public health in Nigeria by providing empirical evidence on the effect of antenatal nutrition education on dietary practices among pregnant women. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, hospitals, primary healthcare facilities, midwives, nurses, nutrition professionals, community health workers, maternal and child health programmes, development partners, and policymakers regarding strategies for improving maternal nutrition. The study will also provide evidence-based recommendations for strengthening nutrition education during antenatal care, standardizing antenatal nutrition counselling, promoting dietary diversity, addressing harmful food taboos, strengthening micronutrient supplementation, improving nutrition education materials, and integrating practical nutrition interventions into routine antenatal care services across Nigeria.

Keywords: Antenatal nutrition education, dietary practices, pregnant women, maternal nutrition, antenatal care, dietary diversity, nutrition counselling, micronutrient supplementation, maternal health, public health, Nigeria.