Malnutrition and Micronutrient Deficiency among Pregnant Women under Pradhan Mantri Surakshit Matritva Abhiyan in Jharkhand, India: A Cross-sectional Study

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Abstract Objective Malnutrition and micronutrient deficiency are significant public health problems affecting the well-being of both the mother and her offspring. It is important to first quantify their burden in underserved communities and then to tackle this problem. The objective of this study was to assess the nutritional status, micronutrient deficiency profile, and associated determinants among pregnant women attending antenatal care clinics under PMSMA in selected government health facilities across three districts of Jharkhand, India. Design The study employed a cross-sectional study design to assess the burden of malnutrition and micronutrient deficiency among pregnant women. Setting The study was conducted in 4 health facilities in 3 districts of Jharkhand. The selected facilities were Rajendra Institute of Medical Sciences (RIMS), Ranchi; District Hospital (Sadar), Ranchi; District Hospital (Sadar), Godda; and Community Health Centre (Gamharia, Saraikela) under RHTC, Department of Community Medicine, Manipal Tata Medical College, Jamshedpur. The study was conducted during the period of September to December, 2022. Participant Eligible pregnant women attending ANC clinics under PMSMA in the selected health facilities were enrolled until the required sample size of 977 was achieved. Pregnant women who were critically ill or those who presented with some emergency conditions were excluded from the study. Result Based on BMI assessment, 38.6% of participants were malnourished, with 17.7% being underweight and 20.9% overweight or obese. Anaemia affected 69.3% of women, while clinical features suggestive of iron deficiency were observed among 21.1% of the participants. Vitamin A deficiency, iodine deficiency, and fluoride excess were also identified among a smaller proportion of women. Conclusion The present study highlights a substantial burden of both malnutrition and micronutrient deficiency among pregnant women in Jharkhand and justifies the need for integrated maternal nutrition strategies during antenatal care. Key Points What is already known on this topic Malnutrition and micronutrient deficiency in pregnant women is a global cause of concern as it adversely affects both the mother and her child. Global and national prevalence estimates among women of reproductive ages are reported regularly, but that for pregnant women is lacking. What this study adds This study provides localized context-specific burden of malnutrition and micronutrient deficiency and its determinants among pregnant women in a backward state of India. How this study might affect research, practice or policy The findings of this study can help the government to deploy adequate and effective context- tailored interventions to reduce the burden of malnutrition and micronutrient deficiency in pregnant women.

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