Sources of nutrition information for Indonesian women during pregnancy: how is information sought and provided?

Indonesia is a large country with a severe Double Burden of Malnutrition (DBM)⁽¹⁾. While the prevalence of stunting of children under 5 years of age in Indonesia is high (30·8 %), the prevalence of maternal overweight and obesity is also high (44·4 %)⁽²⁾. The development of household Double Burden of Malnutrition (childhood stunting and overweight or obese mothers) begins during pregnancy^(3,4). Poor nutrition during pregnancy⁽³⁾ leading to low gestational weight gain (GWG) and low birth weight⁽⁵⁾ has been found to contribute to the development of childhood stunting in Indonesia⁽⁶⁾. Medium- and long-term effects of low birth weight include childhood stunting⁽⁶⁾, adverse neurodevelopmental and physical health outcomes⁽⁷⁾, suboptimal health status, educational achievement and productivity later in life⁽⁸⁾. In contrast, excessive GWG was associated with large birth weight and caesarean delivery⁽⁹⁾. Excessive GWG also negatively impact on post-partum weight retention⁽⁴⁾ and maternal and childhood obesity⁽¹⁰⁾. Therefore, addressing nutrition intervention during pregnancy is essential to prevent DBM in Indonesia.

Previous work in Indonesia has shown that low nutrition literacy is an important cause of childhood stunting and maternal overweight within households⁽¹¹⁾. A mother’s lack of knowledge of nutrition during pregnancy was associated with suboptimal GWG⁽¹²⁾ and anaemia during pregnancy⁽¹³⁾. Nutrition education is required to improve the nutrition and health status of mother and child^(14–18). Further studies have reported that nutrition education interventions have the capacity to increase knowledge and practice towards prevention of low birth weight⁽¹⁴⁾, anaemia during pregnancy and lactation⁽¹⁵⁾, limit excessive GWG⁽¹⁷⁾, optimise post-partum weight loss⁽¹⁸⁾ and improve complementary feeding practices⁽¹⁶⁾.

Women’s nutrition information-seeking behaviour, including actively seeking and/or passively obtaining nutrition information⁽¹⁹⁾, is an important determinant for improving their nutrition awareness during pregnancy⁽²⁰⁾. Women who receive more nutrition information may filter the information they receive and then translate it into healthy eating behaviour⁽²¹⁾. A review of literature which included twenty-nine studies from twelve predominantly high-income countries showed, overall, a positive association between nutritional knowledge and dietary intake⁽²²⁾. Consequently, further work is needed in low middle-income countries as providing reliable nutrition...