Food-to-food fortification: Effectiveness of red spinach-enriched snakehead fish floss for maternal anemia.

Iron deficiency anemia remains a major public health challenge among pregnant women, while adherence to iron supplementation is frequently limited by gastrointestinal side effects. This study evaluated the effectiveness of a ready-to-eat red spinach-fortified snakehead fish (Channa striata) floss as a complementary food-based intervention for improving hemoglobin levels among pregnant women with anemia. A quasi-experimental pre-post study involved 60 pregnant women with mild-to-moderate anemia in Malang Regency, Indonesia. Participants were allocated to an intervention group receiving fortified fish floss alongside routine iron-folic acid supplementation or a control group receiving standard supplementation alone for 21 days. Hemoglobin concentrations were measured before and after the intervention and analyzed using paired and independent t-tests. The intervention group demonstrated a greater increase in hemoglobin levels than the control group (p<0.001). These findings suggest that integrating a locally produced ready-to-eat fortified food into routine antenatal care may enhance hemoglobin recovery as a complementary nutritional strategy.