Assessment of Adolescent Girl Nutrition, Dietary Practices and Roles in Zimbabwe

Adolescence is a period of heightened nutritional need, which can be compounded by pregnancy. There is a gap in knowledge to help guide programming priorities for adolescent nutrition, including in programme areas where International Medical Corps operates in Zimbabwe. Research has shown that menarche (or puberty) may be an opportunity for catch-up growth. International Medical Corps conducted a mixed methods study to examine adolescent girl nutrition, dietary practices and roles in four districts of Zimbabwe. Pregnancy was common (27%) and mostly outside marriage (89%) amongst 692 adolescent girls surveyed (13-19 years of age). Average age at first marriage was 16.6 years. Only 36% of the sample was attending school. The overall women’s dietary diversity score was 3.2. Nearly half (47%) of those surveyed were food-insecure and 66% had poor dietary diversity, which significantly correlated. However, rates of stunting and thinness were under 10%. Correlation between menarche and stunting (17.7% pre-menarche, 2.3% post-menarche) was significant (p<.001), although the sample size was small. Key influencers were aunts (pregnancy and contraception), mothers (food preparation and purchase, health-seeking) and parents (schooling). Nutrition and hygiene knowledge was low. Recommendations include integrated behaviour change at key contact points, interventions to retain girls in schooling, and adolescent-sensitive food security programming to address dietary diversity. Much further research is needed, including how to engage men and adolescent boys in avoiding early pregnancy, mid-upper arm circumference (MUAC) cut-offs, and adolescent reference populations for nutritional status assessment.