Knowledge, Attitudes, and Practices Regarding Dietary Diversity Among Pregnant Women in Mbulu District, Tanzania

<i>Background:</i> Dietary diversity is crucial for maternal and fetal health. However, little is known about pregnant women's knowledge, attitudes and practices (KAP) regarding dietary diversity. This study aimed to evaluate the KAP status on dietary diversity among pregnant women in Mbulu district, Tanzania. <i>Methods:</i> A cross-sectional study was conducted among 384 pregnant women were selected by using a systematic random sampling. Eight health facilities were selected using a purposive sampling method. Data were collected through face-to-face interviews conducted by trained enumerators using a structured, pretested and interviewer-administered questionnaire. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 25. <i>Results:</i> Among the 384 participants, 219 (57%) were aged 25–40 years. Overall, 295 (76.8%) lacked adequate knowledge, 273 (71.1%) had negative attitudes, and 233 (60.7%) demonstrated poor practices regarding dietary diversity. Pregnant women residing in urban areas were nearly twice as likely to be knowledgeable as those in rural areas (AOR = 1.96, 95% CI: 1.15 - 3.33). A higher household monthly income (> 500,000 TZS) was significantly associated with greater knowledge (AOR = 2.49, 95% CI: 1.21 - 5.13). Similarly, those earning between 250 000–500 000 TZS were 1.89 times more likely to be knowledgeable than those earning < 250 000 TZS (AOR = 1.89, 95% CI: 1.05 - 3.41). Urban residents were also 1.81 times more likely to have a positive attitude compared to rural residents (AOR = 1.81, 95% CI: 1.11 - 2.94). <i>Conclusion:</i> Knowledge, attitudes, and practices regarding dietary diversity among pregnant women were generally low. Urban residence and higher household income were significantly associated with better dietary diversity knowledge, while urban residence was also linked to more positive attitudes. No significant factors were identified associated with dietary diversity practices.