Prevailing food taboos among pregnant women in urban slums ofBengaluru- a cross sectional study.

1 2 3Narasimha BC , Ravish KS and Ranganath TS

1 - Post graduate student 2- Assistant Professor 3- Professor and Head, Department of Community Medicine Bangalore Medical College & Research Institute, Bengaluru.

ORIGINALARTICLE

ABSTRACT

INTRODUCTION: Poor maternal nutrition especially in urban slums, adversely affects pregnancy and birth outcomes. In many local communities, pregnant women have food taboos which consequently results in depletion of vital nutrients. Hence this study is aimed at describing women who are likely to have certain taboos or misconceptions during pregnancy.

METHODS: A cross sectional study was conducted in few urban slums of Bengaluru. 160 Pregnant women were selected by simple random sampling method. Pre–tested questionnaire was used to collect information. All the Pregnant women above 18 years of age were interviewed.

RESULTS: Out of 160 pregnant women interviewed, 41.25% were in the age group of 18-22 years. Majority of the women (88.1%) were literates and 61.8% were housewives. Most of them (53.75%) belong to upper-lower class. About 75% women had some kind of food taboos associated with pregnancy. The common food taboos seen were avoidance of some food/fruits during the pregnancy. Most common foods avoided were Papaya (55%), Jack fruit (37.5%) and Ground nut (36.25%). Reasons given for not consuming these foods were many and about 56.25% of pregnant women perceived that eating papaya will cause abortion. 43.75% & 36.25% said it may cause harm to the mother and baby respectively

KEY WORDS: food taboos, pregnant, nutrition, urban slums, misconceptions.

Corresponding Author: Narasimha B.C., Postgraduate Student,Department of Community MedicineBangalore Medical College & Research Institute, Fort, K.R. Road, Bengaluru.Email: narasimhabc@gmail.com

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Introduction

Among all communities, whether rural or urban, people have their own beliefs and practices. Some are based on centuries of trial and error and have positive values while others may be useless or harmful. This is true for food also. Some food items are considered good and some are bad at different stages of life. Food taboos are known from virtually in all human societies. Probably food taboos exist in one form or another in every society on Earth, for it is a fact that perhaps nowhere in the world, a person, a tribe, or an ethnic group makes use of the full potential of edible items in its surroundings. It is the regular avoidance of a food that turns into a tradition which ends up eventually as a food taboo (1). Food taboos and misconceptions during pregnancy have been part of Indian cultures since centuries. The avoidance of certain food items and incorrect knowledge regarding its benefits can deprive

women from adequate nutrition (2). Therefore a balanced and adequate diet is most important during pregnancy and lactation to meet the increased needs of the mother and to prevent “nutritional stress” (1). Food taboos have been identified as one of the factors contributing to maternal under nutrition in pregnancy (3). In various studies it was seen that pregnant women in various parts of the world are forced to abstain from nutritious foods as a part of their traditional food habits (4, 5, 6).

In Indian custom, food taboos and beliefs are more common. So food taboos in urban slums will affect the pregnancy outcome because majority of slums having compromised environmental condition, poor health care services, illiteracy and ignorance. Many studies have been conducted on food taboos, but there is a

gap of research literature related to food taboos among pregnant in Indian urban slum setting. Hence this study was done to explore prevailing food taboos among pregnant mothers in urban slums.

Objective

- To determine pre-existing knowledge and attitude of pregnant mothers regarding food taboos.

Materials and methods:

A cross sectional study was conducted in the urban slums of urban field practice area of Bangalore medical College & Research Institute (BMCRI), Bengaluru. After conduction of door to door survey, totally 160 antenatal women were selected by simple random sampling method. After explaining purpose of the study, informed oral consent was taken among these women. Data was collected by interview using a pre-tested and semi-structured questionnaire. Apart from socio-demographic details, women were asked about the different kinds of taboos and misbelieves they followed during pregnancy. Modified Kuppuswamy classification was used to grade the socio-economic status. This survey was conducted over a period of 3 months (July to September 2014). The houses with doors locked and those who were not willing to give consent were excluded from the study. Data was analysed using Epi info version 7 and Microsoft Excel version 2007.

Results and Discussion:

Totally 160 pregnant women were interviewed in the slums of urban field practice area of BMCRI, Bengaluru. In that most of the women (41.25%) were between 18-22 years age group followed by 23 - 27 years (40%). (Table 1).

Regarding literacy status 88.1% (148) women were literates and 11.9% were illiterates (Graph 1). In a similar study conducted by

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Table 1: Age wise distribution of pregnant women.

Age in range (years) Frequency Percentage

18 – 22

23 – 27

28 – 38

66

64

30

41.25%

40%

18.75%

Graph 1; Distribution of Pregnant Women according to Literacy States

Taboos Illiterate (n=12) Literate (n=148)

Frequency % Frequency %

Yes 8 66.66 116 79.5

No 4 33.33 30 20.5

(X2 = 0.873, df=1 p=0.35)

Pork 120 75

Papaya 88 55

Jack fruit 60 37.5

Ground nut 58 36.25

Brinjal 58 36.2

Jaggery 44 27.5

Capsicum 42 26.25

Green leafy Vegetable 6 3.75

Table 3: Different food taboos present in the study population

Table 2: Association between presence of taboos and literacy status of women

Food avoided Frequency (n=160) Percentage (%)

Prevailing food taboos among pregnant women in urban slums of Bengaluru - a cross sectional study. Narasimha et al

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Patil R et al majority of them were illiterates (91.3%) (7).

In our study, majority of women (61.8%) were home maker and remaining were working women (Graph 2)

This study shows that about 53.75% pregnant women belong to upper lower socio-economic status, 25% and 21.25% to lower middle and upper middle respectively, according to Modified Kuppuswamy socio-economic status scale (Graph 3).

Literacy is an important determinant for health and disease so literacy status was compared with presence or absence of taboos and their reasons between literates and illiterates. There was no significant association found between the literacy status with presence of taboos as shown in the table 2.

Our study showed that, about 75% pregnant women had some kind of food taboos. Similarly a study conducted by Patil R et al in Pondicherry, shows that about 63.7% of women told that they

avoided certain foods during pregnancy (7).We can see from the above lines that the prevalence of food taboos are more prevailing in our study population. Most common foods avoided were pork (75%), papaya (55%), Jack fruit (37.5%), groundnut (36.25%) etc. as shown in table 3.

A study among 1200 women from all districts of Tamil Nadu showed that 82 % of women avoided papaya during pregnancy (8).

The most common reason given by the pregnant women for not consuming such foods were that they believe these foods causes abortion (56.25%), harm to the mother (43.75%) & harm to the foetus (36.25%). In our study 55% of pregnant women believe that consuming papaya during pregnancy could cause abortion. Similarly in a study done by Puri S et al, it was reported that only

16.5 % women believed that papaya could cause abortion (9).

Conclusion

In our study, we found high prevailing food taboos during pregnancy irrespective of literacy status. Since maternal nutrition in pregnancy is pivotal to pregnancy outcomes, there is a need for nutrition education and awareness generation among women. The Urban Health & Nutrition day conducted every month may be used as a platform to provide education on nutrition & safe pregnancy (10).

The health education programs should take cognizance of the popular beliefs regarding food habits during pregnancy in urban,

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urban slums & rural area and use innovative means to minimize their negative and maximize their positive nutritional effects.

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Prevailing food taboos among pregnant women in urban slums of Bengaluru - a cross sectional study. Narasimha et al