Effect of Picture-based health education and counselling on knowledge and adherence to preconception Iron-folic acid supplementation among women planning to be pregnant in Eastern Ethiopia: a randomized controlled trial

Abstract

The present study examined the effect of picture-based nutrition education on knowledge and adherence to pre-conception iron–folic acid supplement (IFAS) in Ethiopia, a country where there is a high burden of neural tube defects (NTDs) and anaemia. In eastern Ethiopia, a parallel randomised controlled trial design was employed among women planning to get pregnant. The interventional arm (n 122) received a preconception picture-based nutrition education and counselling along with an IFAS and the control arm (n 122) received only a preconception IFAS. The effects of the intervention between-group differences were assessed using a χ2 and independent sample t-test. Bivariate and multivariable linear regression model was fitted to detect independent variables affecting the outcome. The outcome measures regarding the knowledge and adherence to the IFAS intake during the three months of the intervention period were deteremined. It was observed that large proportion of women in the intervention group (42⋅6 %) had an adherence to IFAS compared to the control group (3⋅3 %); (P < 0⋅0001). Based on bivariate and multivariable linear regression analyses, among NTDs affecting pregnancy, the history of spontaneous abortion and knowledge were independently associated with adherence to the IFAS (P < 0⋅05). Preconception nutrition education with regular follow-ups could be effective in improving knowledge and adherence to the IFAS intake. This intervention is very short, simple, cost-effective and has the potential for adaptation development to a large-scale implementation in the existing healthcare system in Ethiopia to prevent NTDs and adverse birth outcomes among women who plan to get pregnant. This clinical trial was registered on 6 April 2021 under the ClinicalTrials.gov with an identifier number PACTR202104543567379.

Digital versus non-digital health interventions to improve iron supplementation in pregnant women: a systematic review and meta-analysis

“…Trials were published from 2014 to 2023 containing 1,633 participants (mean age: 24.3 to 29.6 years). Three trials were conducted in India ( 34 – 36 ), with the remainder in Indonesia ( 37 ), Saudi Arabia ( 38 ), Ethiopia ( 39 ), Indonesia ( 40 ), Malaysia ( 41 ), Jordan ( 42 ), Ahvaz ( 43 ). The intervention during for the included trials were 4 to 12 weeks, participants were followed up immediately postintervention.…”

“…There is significant variation in the elements of the digital health interventions. Five trials conducted digital health interventions with WhatsApp ( 36 – 38 , 40 , 42 ), four with SMS ( 35 , 36 , 39 , 43 ), two with phone call ( 34 , 36 ), and one with web-based education program ( 41 ). Almost all the trials were multi-component interventions.…”

“…19,7.57], p < 0.001, I 2 = 69%, Figure 4) in pregnant women. If we excluded the study of Berhane et al (39) the I 2 decreased to 23% and the results remained unchanged (1,045 participants, OR = 2.98 [1.99, 4.46], p < 0.001, I 2 = 23%). The funnel plot of objective adherence rate was almost visually symmetrical, indicating that there is no obvious publication bias (Supplementary Figure S1).…”

Effects of intensive nutrition education and counseling on nutritional status of pregnant women in East Shoa Zone, Ethiopia

“…One of the key advantages of nutrition education is improving the knowledge of women on optimal diet during pregnancy, thereby positively influencing the attitude and practice towards good nutrition ( 36 – 38 ). Nutrition education and counseling have been shown to have a positive effect on the awareness of expectant mothers about important micronutrient intake and the negative impact of food aversion during pregnancy ( 39 , 40 ). Integration of nutrition education and counseling supplemented with mobile health during antenatal care should get emphasis to improve the nutritional status of pregnant women and thereby their nutritional status.…”

Effect of intensive nutrition education and counseling on nutritional status of pregnant women in East Shoa Zone, Ethiopia

“…Nutrition education and counseling has shown to have a positive effect on the awareness of expectant mother about important micronutrient intake and the negative impact of food aversion during pregnancy (39,40).…”