A Predictive Modelling Approach on Socioeconomic and Cultural Determinants of Dietary Practices among Pregnant Women in Sierra Leone
Marion Malia Jigba
Department of Vocational and Technical Education, EBKUST University, Magbruka, Sierra Leone and Institute of Food Technology, Nutrition and Consumer Studies, Njala University, Mokonde, Sierra Leone.
Tamba S. Sonda *
Department of Vocational and Technical Education, EBKUST University, Magbruka, Sierra Leone and Institute of Food Technology, Nutrition and Consumer Studies, Njala University, Mokonde, Sierra Leone.
Sheku Alfred Kanu
Department of Biological Sciences, Fourah Bay College, Freetown, University of Sierra Leone, Sierra Leone.
Abdulai Sillah
Department of Agribusiness Management, Njala University, Mokonde, Sierra Leone.
Finda Miriam M. Barrie
Department of Home Science, Milton Margi Technical University, Freetown, Sierra Leone.
*Author to whom correspondence should be addressed.
Abstract
Aim: This study aimed to identify the socioeconomic and cultural determinants of dietary practices among pregnant women attending antenatal care (ANC) in Sierra Leone and to develop and validate a predictive model of dietary practices.
Methods: The study employed a descriptive cross-sectional survey using structured, interviewer-administered questionnaires. Dietary diversity was assessed using the Minimum Dietary Diversity for Women (MDD-W) indicator. Multiple linear regression analysis was used to model the predictors of dietary practices, and socioeconomic gradients were examined using Kruskal-Wallis tests with Dunn’s post-hoc comparisons. A total of 470 pregnant women attending government ANC clinics in the Port Loko and Moyamba districts of Sierra Leone were recruited between September and December 2025.
Results: Household income had a large effect on dietary diversity (Kruskal-Wallis H = 47.32, p < 0.001; η² = 0.18), with mean dietary diversity scores ranging from 3.4 in the low-income group to 5.6 in the high-income group. Educational attainment was significantly associated with dietary practices across all levels (H = 68.45, p < 0.001). Cultural food taboos were reported by 38% of participants and were associated with significantly lower dietary diversity scores (U = 19,234, p < 0.001; mean DDS: 3.6 versus 4.6). The multiple regression model was statistically significant (F (7, 463) = 58.42, p < 0.001; R² = 0.468) and explained 46.8% of the variance in dietary practices. Nutritional knowledge was the strongest predictor (β = 0.38), followed by income (β = 0.24), food avoidance (β = −0.18), education (β = 0.16), and receipt of nutrition education (β = 0.11).
Conclusion: Dietary practices among pregnant women in Sierra Leone were associated with nutritional knowledge, income, education, and cultural food taboos. Effective interventions may require a multilevel approach combining nutrition education, social protection measures, community engagement, and culturally sensitive counselling to address structural barriers to adequate maternal nutrition.
Keywords: Maternal nutrition, dietary practices, socioeconomic determinants, food taboos, dietary diversity, pregnancy, predictive modelling, antenatal care