Seasonal variation in nutritional status and anemia among lactating mothers in two agro-ecological zones of rural Ethiopia: A longitudinal study

• There is a high prevalence of undernutrition and anemia in lactating mothers in rural Ethiopia.
• Variations exist in undernutrition and anemia in lactating mothers both pre- and postharvest.
• Undernutrition and anemia are more prevalent in lowland agro-ecological zones.
• Poor dietary diversity exists in both mid- and lowland agro-ecological zones in Ethiopia.

ObjectiveThe aim of this study was to determine seasonal and agro-ecological variations in nutritional status, anemia, and associated factors among lactating women in rural Ethiopia.MethodsWe conducted a longitudinal study with 216 mothers in pre- and postharvest seasons in two agro-ecological zones of rural Ethiopia. We conducted interviews using a structured questionnaire, anthropometric measurements, and blood tests for anemia. We used multivariable linear regression models to identify independent predictors.ResultsThe prevalence of anemia increased from postharvest (21.8%) to preharvest seasons (40.9%). Increases were from 8.6% to 34.4% in midland and from 34.2% to 46.3% in lowland agro-ecological zones. Of the mothers, 15% were anemic during both seasons. The prevalence of undernutrition, assessed using body mass index (BMI) < 18.5 kg/m2, increased from 41.7% to 54.7% between the two seasons. Prevalence of maternal mid upper arm circumferences <22 cm also increased from 43.1% to 55.2% during the preharvest season. The seasonal effect was generally more pronounced in the midland community for all forms of malnutrition. Predictors of anemia were high parity of mother and low dietary diversity. Parity, number of children under the age of 5 y, and regional variation were predictors of low BMI among lactating mothers.ConclusionThe magnitude of malnutrition and anemia was significantly influenced by variations in season and agro-ecological zones. Interventions focused on agro-ecology and seasonal variation should be considered in addition to current strategies to alleviate malnutrition in lactating mothers.