Specific micronutrient practices drive dietary quality in Ethiopia's industrial urban communities

This study assessed the relationship between HFCS and knowledge, attitudes, and practices of vitamin A, iron, and iodine among nutritionally vulnerable households within Ethiopia's industrial area.

A community-based, cross-sectional study was conducted using structured interviews and food frequency questions. The association between KAP variables and HFCS was assessed by ordered logit regression, controlling demographic and socio-economic factors. The study took place in three of the most densely populated and industrially active districts of Akaki-Kaliti Sub-City, Addis Ababa, Ethiopia.

In all, 504 nutritionally vulnerable households containing at least one under-five child, pregnant, or lactating woman were interviewed, of which the majority were male-headed and married. Only 23.5% of households had an acceptable HFCS, mainly cereal- and tuber-based diets with very low fruit and vegetable consumption. Mean household wealth index was low at 0.33, with one-quarter of household heads and mothers being unemployed. Overall KAP scores were not significantly related to HFCS, but certain micronutrient practices were strongly positively related to vitamin A and iron intakes. Vitamin A knowledge and attitude also showed a significant positive association with higher HFCS, while iodine-related attitude was negatively associated. Higher education level and household wealth were positively associated with acceptable HFCS. Older maternal age was inversely associated, while household size showed mixed effects, being negative in the overall model and positively associated with acceptable HFCS in the nutrient-specific models for iron and vitamin A. Households having a pregnant woman and those from highly urbanized districts had higher odds of having acceptable HFCS. Although there was a widespread use of iodized salt, knowledge on the three micronutrients remained poor, with only 2.2% of the households showing good knowledge in all categories.

Dietary quality among households was generally low and closely associated with socioeconomic status and specific micronutrient practices. Improving education and household economic capacity could enhance nutritional outcomes, particularly among larger households and older mothers. Nutrition programs should prioritize promoting micronutrient-related behaviors and addressing socioeconomic and spatial disparities across urban districts.