Respondents socio-demographic characteristics

Table 3 presents the socio-demographic characteristics of the surveyed respondents. Male and female respondents account for 59.5% and 40.5% of the total (311) surveyed respondents, respectively. The study focused on men and women to get their opinion as well as gauge their nutrition knowledge, attitude, and practices. The same knowledge would facilitate an in-depth understanding of how men and women get involved and participate in decisions pertaining to the household. The overall average age of sampled respondents was 38 years old. The mean age of male and female respondents was 39.3 and 35.1, respectively. As a result of the T-test, the mean difference between males and females was statistically significant at 1% (p = 0.001). This indicates that, male respondents become more aware of malnutrition as their age increases, contrary to female respondents. This implied that higher level of understanding and deeper experience in household nutritional issues come with age.

Table 3 Socio-demographic characteristics of the respondent in the household

The household heads with longer farming experience are supposed to have better understanding of malnutrition of the household than the household heads with shorter farming experience. The mean year of farming experience of male and female respondents was 22.448 and 18.539, respectively. As a result of T-test, the mean difference between males and females was statistically significant at 1% (p = 0.001). This indicates that, male respondents become more aware of malnutrition as their year of farming increases, contrary to female respondents. This implied that, household head with longer farming experience were to be more knowledgeable and practicable regarding household malnutrition.

More than half of the respondents (54%) had only primary level education. The importance of the level of education in gender equality is also underscored by the World Bank, which notes that the low levels of education, especially among women, represent a very serious constraint on development in most of the sub-Sahara African countries, Ethiopia not being exceptional. At the individual level, for example, education is perceived to be the ultimate liberator, which empowers a person to make personal and social choices [21]. The World Bank argues that education is also perceived to be the ultimate equalizer, particularly in promoting greater gender equity for women. Education is very important for farmers to understand malnutrition. Farmers who have high formal education are expected to be aware of malnutrition earlier than uneducated; because farmers with higher education levels were able to get information from different sources. The study results also revealed that the education level of the household head has a positive relationship and is statistically significant (chi2 = 32.431, p = 0.000) at 1% of level (Table 3).

Nearly all (92%) respondents were married and the total average household size was 7, which is higher than the national average of 5. The mean household size for male and female-headed households was 7.2 and 7.0 respectively. The statistical analysis also, revealed that there is no significant difference (0.652) in the mean household size between male and female household head.

Knowledge and attitude towards malnutritionKnowledge about malnutrition

The results of the study on Table 4 show that, the majority of male (96%) and female (92%) can recognize if someone in their household is malnourished. The results of chi-square analysis indicate that recognition of malnutrition in the household has positive relationship but statistically not significant (x2 = 2.5013; p = 0.114) (Table 4). About 85% of respondents know that lack of energy or weakness, are the main symptoms of being malnourished, while 58% and 84% of respondents know that weakness of the body's immune system and loss of weight/thinness, respectively, are the main symptoms of being malnourished in their respective households. FGD and KII participants also stated that, weakness, less immunity, chest pain, and headache were the most common symptoms of malnutrition at household and community level in the study area.

Table 4 Knowledge and attitude towards malnutrition

It was found that 87% of study participants had insufficient money to buy food, and 71% were unable to access multiple food groups. A majority of respondents (72%) suggested that eating foods enriched with micronutrients such as iron and vitamin "A" would prevent malnutrition problems in their household. Around 77% of respondents said that raising awareness among household members about making healthy food choices would help prevent malnutrition, while 75% and 49% said that increasing household income to afford nutritious food in the market and distributing food fairly among family members in the household would help prevent malnutrition (Table 4).

Attitude towards malnutrition

A Likert scale was used to establish the respondent’s attitude towards malnutrition. Nearly three-quarters (74%) of the total respondents were not likely to think that their household may have malnourished members, while 22% of the respondents were likely to think that there would be malnourished members in their household. The results of chi-square test indicate that attitude towards malnutrition in the household has positive relationship but statistically not significant (x2 = 3.1058; p = 0.376). More than half of the respondents (57%) did not think malnutrition was a serious problem for household members' health and only 11% of respondents thought malnutrition was a very serious issue in their household. According to the results of the chi-square test, attitudes towards malnutrition in the household have a positive relationship, but the relationship is not statistically significant (× 2 = 3.1058; p = 0.376) (Table 4).

Consumption of iron-rich foods and iron -deficiency”Knowledge about iron-rich foods and iron deficiency

Table 5 presents respondent knowledge, attitude, and practice about iron-rich foods in the household. Regarding the sources of iron-rich foods, 78% of the respondents chose red meat as their major source of iron-rich foods, while 66%, 59%, and 34% chose teff (injera- a flat spongy Ethiopian bread mostly made of fermented teff flour), butter, and pumpkin, respectively. 9% of the respondents had no knowledge about the sources of iron-rich food. A majority of the respondents (93%) knew about the benefits of eating iron-rich foods.

Table 5 Consumption of iron rich foods in the household

Body weakness, paleness, and headache were the most common symptoms of inadequate intake of iron-rich foods reported by the respondents. The majority of the respondents (88%) reported that they had heard about iron-deficiency anemia. Moreover, FGD and KII participants reported that there are incidences of anemia in the community.

Attitude towards consumption of iron-rich foods and iron-deficiency

More than half of the respondents (60%) think that it is a serious problem when their household members do not eat iron-rich foods. Nearly 7 out of 10 respondents (68%) think it is good to prepare meals with iron-rich foods such as red meat, chicken, liver, and dark green vegetables. Approximately 34% of respondents said it is extremely difficult for their households to prepare meals rich in iron, while less than 18% said it is not difficult. Almost three-quarters (73%) of the respondents are not confident in preparing meals with iron-rich foods, indicating a perceived ability to prepare iron-rich foods is a major barrier, yet most of them (88%) like the taste of iron-rich foods such as red meat, liver, injera, and chicken.

About 4 out of every 10 respondents (40%) think that it is not likely to have iron-deficient household members. Those with less than 10% think it would be most likely to have a household member who is iron deficient.

Consumption practices of iron-rich foods

About half (53%) of survey respondents consumed iron-rich foods in the last 24 h prior to the survey. The most commonly consumed iron-rich foods reported by the surveyed respondents were Teff (injera), legumes (mixed beans, baked beans, lentils, chickpeas), and dark leafy green vegetables.

Consumption of vitamin “A” rich foodsKnowledge about vitamin A-rich foods

Table 6 presents respondents’ knowledge, attitude, and practice regarding vitamin A-rich food consumption in the household. Most surveyed respondents (89%) had heard about human health problems such as night blindness or inability to see in dim light in their community. About 83% had heard about Vitamin "A" deficiency or diseases caused by not consuming vitamin A-rich foods such as eggs, carrots, cheese, orange-fleshed sweet potatoes (OFSP), milk, or yoghurt (full cream dairy). In open-ended questions, respondents were asked to list vitamin "A" rich foods they are consuming in their households. Their responses were summarized as butter, milk, carrot, OFSP, and don't know for the purpose of presentation. Accordingly, most of the respondents (88%) reported carrots as a major source of vitamin "A", while 75%, 58%, and 39% noted milk, butter, and OFSP, respectively, as the major sources of vitamin "A". About 6% of the respondents were not aware of the major sources of vitamin "A" rich foods. Respondents were also asked about their knowledge about the benefits of eating vitamin "A" rich foods such as biofortified foods (e.g., orange-fleshed sweet potatoes) and fortified foods (e.g., fortified oil, wheat flour, and iodized salt). The majority of them, 90%, knew about the benefits of eating vitamin "A" rich foods.

Table 6 Consumption of Vitamin “A” rich foods in the householdsAttitude towards vitamin A-rich foods

The respondents were asked how likely they thought it was that any of their household members lacked vitamin "A". Thus, nearly half (46%) believe that it is likely Over half (52%) of respondents said vitamin A deficiency is serious. Seventy-one percent of respondents feel confident that they can prepare meals containing vitamin-A-rich foods. About 50% of respondents thought it was somewhat difficult to prepare foods rich in Vitamin A. About 54% of respondents were feel less confident in preparing meals with vitamin-A-rich foods in the household. The majority (95%) of the respondents like the taste of vitamin-A-rich foods (Table 6). These results indicate that respondents perceive a positive attitude towards eating vitamin A-rich foods.

Consumption practices of vitamin A-rich foods

A majority (83%) of the respondents consumed vitamin "A" rich foods in the past 24 h prior to this survey. More than half (57%) of the respondents stated that all family members have equal access to vitamin A-rich foods. About 58% of the respondent’s household uses biofortified and fortified foods, such as orange-fleshed sweet potatoes. Whereas, 79% of their households use fortified foods such as fortified edible oil or wheat flour (Table 6).

Consumption of iodized saltKnowledge about consumption of iodized salt

Survey results indicate that a majority of respondents (69%) had information about human health problems related to iodine deficiency, such as goiter, apathy, and muscle weakness (Table 7). All of the respondents stated that their household uses salt to cook meals.

Table 7 Consumption of iodine or iodized salt in the householdAttitude towards consumption of iodized salt

Results show that 32% of respondents think "it is likely" and 31% think "it is not likely" to lack iodized salt at home (Table 7). About (42%) think that the lack of iodized salt is a serious issue. About half (47%) were confident that they could prepare meals with iodized salt, and a slight majority (57%) stated that it was easy for their household to buy and use iodized salt. Only 14% said it was very difficult for their household to buy and use iodized salt.

Consumption practices of iodized salt

All surveyed respondents responded that they use salt to cook meals, with 39% using iodized salt and 45% using non-iodized salt (Table 7). All FGD and KII participants stated that the local community usually consumes non-iodized salt and on very rare occasions they consume packed and iodized salt. Some of the reasons given were lack of awareness about the existence of so-called iodized salt; they only knew about common or regular salt. Affordability (high price compared to the normal one) was also stated as a reason for not using iodized salt; even though they were aware of its existence, it was not available for purchase in local markets and shops. The results confirm that there is a knowledge and practice gap in the consumption of iodized salt in the study area.