Prevalence of Micronutrient Deficiencies and their Association with Sociodemographic Factors, Dietary Practices and Micronutrient Supplementation amongst Lactating Women: Findings from the Palestinian Micronutrients Survey
Breastfeeding women in Palestine suffer from various nutritional problems as a result of multiple reasons. The most important are poverty, lack of health awareness, community traditions, and the blockade imposed by the Israeli occupation on the Gaza Strip. Such situation has created a shortage of minerals and vitamins in the lactating women and their infants; such as vitamin D, vitamin A, calcium, iron, and B12. Therefore, this study aimed to determine the nutritional status and comorbidities of micronutrients deficiencies amongst lactating mothers in the Palestinian population. The study was based on the survey (PMS) made by the Palestinian Ministry of health. This, survey has been prepared to provide an evidence-based source of information on the presented aspects of the nutrition situation in the State of Palestine, for increased donor funding in nutritional aspects, towards informed discussions among policy makers, development partners and other stakeholders. Also, this survey provides an extensive evaluation and documentation of important aspects of the nutrition and health status in Palestine. A representative cross-sectional study on micronutrient status (Micronutrient Profile), prevalence and causes of anaemia, coverage and use of micronutrient supplements, flour fortification and salt iodization, and salt intake was carried out among lactating mothers (18-48 years). The percentage of women who suffer from anaemia was 20.2% in the West bank and 35.3% in Gaza. This study showed that there was significant association (P < 0.05) between micronutrient deficiency and the type of community, there the values for Zinc (P= 0.04), Iron (P=0.0001), Vit A(P=0.0001) and D (P 0.0001). Percentage of lactating women suffering from zinc deficiency, 88.8% in the West Bank and 92.7% in Gaza. While the percentage of lactating women suffering from vitamin A deficiency was 33% in the West Bank and 92.7% in Gaza. The percentage of lactating women suffering from iron deficiency in the West Bank was 2.7% and in Gaza was 19.5%. Finally, Vitamin D deficiency was 36% in West bank and 24% in Gaza. The results have shown that age was significantly associated with Vitamin A deficiency (P = 0.002), but no significant association was found with Zinc, Iron and Vit D (P > 0.05). Nutritional status has not shown a relationship with micronutrients deficiency in iron, zinc, vitamin A and D, however, there was a significant relationship between chocolate intake and zinc (P = .035) and intake of red meats and iron (P = .032). The current study has concluded that although many factors may play a role in anaemia and other comorbidities, there were few factors clearly associated with such conditions. Vitamin A and Zn were the most associated with prevalence of iron deficiency. With high level of deficiency of both micronutrients, proper policies and regulations should be warranted. This study recommends improving the antenatal care (ANC) services, promoting awareness about healthy diet by increasing the consumption of vitamin A and C rich fruits and vegetables. Moreover, it is highly recommended to adopt the traditional household practices such as fresh cooking, legume soaking, dairy fermenting and cereal sprouting to reduce the phytate content of the cereals and legumes consumed by the majority of the study participants.