Effect of Nutrition Education and Iron-folic acid supplementation on anemia among Pregnant Women: A quasi-experimental study

Abstract Background The aim of this study was to assess the effect of nutrition education and counseling using health belief health model constructs along with iron-folic acid supplementation on hemoglobin level and adherence to IFAs during pregnancy Methods The study was a three months quasi-experimental study design in Butajira town, Ethiopia. Community-based nutrition education and counseling sessions using Health belief model, and IFAS for six weeks were given to the pregnant women. Baseline data and hemoglobin levels were measured at the time of enrollment. Maternal adherence to iron-folic acid tablets (IFA) was assessed using pill count based on the number of remaining pills in the retained prescribed bottles or strips. End-line data were collected from 97 intervention and 96 control group of pregnant women after 6 weeks of nutrition education intervention. Analysis of effect of intervention was done using Difference-In-Difference and a Generalized Estimation Equation (GEE) approaches. Results At the end of the nutrition education intervention, there was a significant drop in the proportion of anemia in the intervention group compared to the control group. The prevalence of anemia among intervention group declined from 27.8% at the baseline to 7.2% after intervention. The change in the knowledge score regarding IFAS and maternal adherence to IFAS were significantly higher in the intervention group as compared to the control group (p < 0.001). In this study, the odds of adherence to IFA supplementation were 2.26 (95% CI 1.55 to 3.29) times higher among those who received nutrition education intervention as compared to control group. Conclusion Implementation of community-based nutrition education and counseling along with IFAS improved the hemoglobin level and adherence to IFAS among pregnant women. Therefore, there is need to integrate community-based nutrition education approach by using HBM constructs with antenatal IFAS distribution to improve supplementation and hemoglobin level.