Nutrition literacy in thai pregnancy: A qualitative exploration of progressive pathways and challenges across information, norms, and healthcare gaps
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Issued Date
2025-10-01
Resource Type
ISSN
02666138
Scopus ID
2-s2.0-105014174060
Journal Title
Midwifery
Volume
149
Rights Holder(s)
SCOPUS
Bibliographic Citation
Midwifery Vol.149 (2025)
Suggested Citation
Nuampa S., Rungamornrat S., Tangsuksan P., Kuesakul K., Sasiwongsaroj K. Nutrition literacy in thai pregnancy: A qualitative exploration of progressive pathways and challenges across information, norms, and healthcare gaps. Midwifery Vol.149 (2025). doi:10.1016/j.midw.2025.104580 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/111916
Title
Nutrition literacy in thai pregnancy: A qualitative exploration of progressive pathways and challenges across information, norms, and healthcare gaps
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
Problem: Conflicting cultural, digital, and clinical information may hinder Thai pregnant women's ability to make informed dietary choices, contributing to nutrition-related health risks. Background: Nutrition literacy, the capacity to access, understand, and apply food-related information, is crucial for maternal and fetal health. However, challenges in developing nutrition literacy during pregnancy remain understudied, particularly in Southeast Asia. Aim: To explore the progressive pathways through which Thai pregnant women engage with nutrition literacy across functional, interactive, and critical levels, using Nutbeam's model, and to understand key challenges affecting nutrition literacy among Thai pregnant women, with a focus on cultural norms, information sources, and healthcare systems. Method: A qualitative descriptive design was employed. Twenty-five focus group discussions were conducted with 200 pregnant women across four regions of Thailand. The semi-structured interview guides and thematic analysis were guided by Nutbeam's model of functional, interactive, and critical health literacy. The study adhered to Consolidated Criteria for Reporting Qualitative Research (COREQ) established reporting guidelines. Findings: Three themes emerged: (1) Functional literacy enabled women to follow basic advice when clearly explained, but misinformation from family traditions and social media sometimes disrupted their understanding; (2) Interactive literacy involved comparing and personalizing information from peers, healthcare providers, and digital platforms; (3) Critical literacy was less common but evident in participants who questioned traditional practices, evaluated online content, and expressed expectations for more accessible, trustworthy maternal health service system through effective health communication. Discussion: Women's nutrition literacy pathways are shaped by a mix of professional advice, cultural narratives, and digital content. While basic understanding is often achieved, gaps remain in critical engagement and system-level support. The absence of support system, nutrition counselling within antenatal care limits women's ability to make confident and informed dietary choices. Conclusion: Strengthening nutrition literacy during pregnancy requires more than accurate education. Antenatal services should adopt culturally responsive strategies that promote dialogue, support critical thinking, and address systemic gaps in communication and information access.