Dietary Diversity Practices of Pregnant Women and Associated Factors among Women Attending Public Hospitals in Gambella Town, Southwest Ethiopia

Inadequate dietary diversity among pregnant women in Ethiopia remains a major public health concern, with approximately half of the women affected. Understanding context-specific dietary practices and associated factors is essential for effective intervention. This study assessed dietary diversity practices of pregnant women and their determinants among women attending public hospitals in Gambella Town, Southwest Ethiopia. An institution-based prospective cohort design was employed from July 25, 2024, to September 10, 2024, using a single-stage cluster sampling approach. Data were collected using an interviewer-administered questionnaire with KoboCollect software and analyzed in SPSS version 25. Dietary diversity was assessed twice using a 24-hour dietary recall. A modified Poisson regression model was applied, and statistical significance was declared at p < 0.05. All 254 participants completed the first follow-up, yielding a 100% response rate. The prevalence of inadequate dietary diversity practice was 76.4%. Factors significantly associated with being exposed included having at least one child under five years (ARR = 1.27; 95% CI: 1.03–1.57), lack of television in household (ARR = 1.19; 95% CI: 1.02–1.40), lack of antenatal care (ARR = 1.25; 95% CI: 1.02–1.53), gastritis (ARR = 1.29; 95% CI: 1.13–1.47), and meals or snacks frequency of only 1–4 times per day (ARR = 1.41; 95% CI: 1.17–1.69). The prevalence of inadequate dietary diversity practice was high. Strengthening nutrition education through mass media, improving antenatal nutrition counseling on meal frequency and diversity, and enhancing the screening and management of gastritis with smaller, more frequent meals were recommended.