Health service delivery gaps and support systems for addressing central obesity in women beyond the postpartum period

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Abstract Background Central obesity is a critical public health issue linked to non- communicable diseases and long-term maternal health risks. Women beyond the postpartum period often face barriers to weight management, yet limited evidence exists on their specific challenges and the role of healthcare systems in addressing them. This study aimed to assess central obesity among women beyond postpartum period, focusing on the associated challenges and available health support systems. Methodology A cross-sectional design was employed whereby 120 women (1 to 5 years postpartum), aged 18 - 49 years, attending selected one private and two government health facilities in Morogoro Urban District participated. Face-to-face interviews using semi-structured questionnaires and anthropometric measurements of waist and hip circumference were conducted. Data were recorded using Kobo digital Toolbox. Key findings High prevalence of central obesity, with 68.3% of participants having a waist circumference above normal (≥80 cm) was observed. Although no socio-demographic factor assessed showed a statistically significant association with central obesity, trends indicated higher odds among older (OR=1.544; 95% CI, 0.084-28.557), married (OR= 1.730; 95% CI, 0.612-4.892) and higher income women (OR= 4.878; 95% CI, 0.367-64.818). Lifestyle behaviors such as low physical activity, poor dietary habits and lack of portion control were prevalent. 57.5% reported lacking information on weight and waist management. Despite attending health care facilities, 94.2% of the women had never received guidance from health providers regarding weight or central obesity management and 95% reported not receiving any form of support such as nutrition counseling or exercise recommendations. Conclusion The study concludes that central obesity is highly prevalent among women beyond postpartum period and is influenced by poor lifestyle behaviors and inadequate healthcare system support. It recommends integrating weight management strategies into routine postpartum care and strengthening healthcare systems to offer tailored guidance and support to women after childbirth.

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