Final report : work patterns, prenatal care, and nutritional status of pregnant subsistence farmers in Southern Malawi

In Malawi, as in most other African countries, rural women may need a considerably large increase in calories, due to their heavy workload in both the fields and the household. Although figures on adult nutrition in Malawi are not available, high malnutrition rates among children (27%) suggest that rural Malawian women may also be of a low nutritional status. This study follows about 70 Malawian women through their third trimester of pregnancy in order to document their anthropometric status, dietary intakes, socioeconomic situations, and interrelationships between these variables. Only descriptive results are presented herein, since quantitative analysis is still in progress. The women appeared to be facing food shortages while expending a large amount of energy in agricultural and other work. Average levels of intake and output do not appear to change during the progression of pregnancy, but there is some evidence that intake may increase slightly during lactation. This appears to put the women at serious nutritional risk, as evidenced by low anthropometric measures and poor birth outcome. Seasonality seems to be an important factor, with periods of maximal stress occurring during the rainy season, from November or December through February. The severity of the problem seems to warrant some form of nutritional supplementation program during the highest risk months of the year.