Good Maternal IFA Adherence with Poor Perceptions on Nutritional Iron Supplementation among a Cohort of Anemic South Indian Pregnant Women: The Effect of Nutrition Education on Hb Levels

Abstract

Background: Inadequate dietary intake of iron is the most common cause of anemia among Indian pregnant women. Increasing awareness of nutritional iron supplementation helps to reduce the impact of anemia in pregnancy.Objective: The objective of the study was to evaluate the effect of nutrition education on nutritional knowledge, attitude, practices, compliance to Iron-folate therapy, and hemoglobin levels among anemic pregnant women.Methods: This intervention study was conducted from December 2020 to March 2021 in a secondary care level women and child hospital at Puducherry, India. The intervention group (n=59) and control group (n=58) included mild to moderately anemic pregnant women attending antenatal clinics. Nutrition education intervention and SMS alerts for four weeks were given to the mothers. Baseline data and hemoglobin levels were measured at the time of enrolment. Maternal compliance to iron-folate tablets (IFA) was assessed using a five-item Medical Adherence Rating Scale (MARS-5). End line data were collected after 4 weeks of nutrition education intervention.Results: At the end of the nutrition education intervention, there was a significant improvement in the hemoglobin level in the intervention group compared to the control group (P<0.02). The change in the knowledge, attitude and practice scores regarding nutritional management of anemia and maternal compliance to iron-folate therapy were significantly high in the intervention group over the control group (P<0.001). Conclusion: Individual nutrition education was significantly associated with improved nutritional knowledge, attitude, practice scores, and compliance to IFA tablets. Further, it had a positive impact on the hemoglobin levels in anemic pregnant women.