RESUMEN
PURPOSE: To determine the effect of individual education through a pictorial handbook on anemia in conjunction with counseling on improving hemoglobin and hematocrit level, birth weight, knowledge, iron-rich food and iron-folic acid (IFA) intake. PATIENTS AND METHODS: The study developed a pictorial handbook that was conceptualized based on the Health Belief Model and adjusted to some cultural and local contexts. A quasi-experimental pre-test-post-test control group design was used, purposefully conducted between two homogenous municipalities, each having a rate of anemic pregnancy that was 40% or greater. The sample consists of 140 anemic pregnant women randomly allocated via lottery into two groups; the intervention group (n=70), which received two home visits-one for education and another for a counseling session, and control group (n=70), which received routine antenatal care. A chi-square test and a Mann-Whitney U-test were conducted to compare the baseline socio-demographics. An analysis of covariance (ANCOVA), controlling some possible confounders, was performed to analyze the effect of intervention. RESULTS: The post-test means of hemoglobin F (1, 132) = 122, p-value <0.001, and hematocrit levels F (1, 132) = 373, p-value <0.001, were significantly different and higher in the intervention group compared to the control group. Similar results were found in knowledge, food frequency score, number of IFA intake (with p-value <0.001), birth weight and daily iron intake from food (with p-value <0.05). The intervention had a particularly large effect on food frequency score and number of IFA intake, and medium effect on hemoglobin and hematocrit levels. CONCLUSION: Individual education through a pictorial handbook on anemia in conjunction with the counseling intervention program had a positive impact on hemoglobin and hematocrit levels for anemic pregnant women in their third trimester of pregnancy.
RESUMEN
BACKGROUND: Estimating vitamin, mineral intakes related to anaemia and describing perception regard pregnancy diet, accessibility to foodstuff among first ANC visitor of anaemic pregnant women aged above 20 years in Province Aceh, Indonesia. METHODS: A cross sectional mixmethod of quantitatively and focus group discussion (FGD) was conducted at two municipalities having more than 40% anaemic pregnancy. One hundred fifty-eight anaemic pregnant women were interviewed regarding socio-demographic and three days of 24-hours food recall, in addition to FGD at each municipality using FGD guidelines about nutritional anaemia. Food recall data was analysed using software NutriSurvey Indonesia, deficiency is defined as daily intake below 77% recommended dietary allowances (RDA) Indonesia. The FGD result was analysed by content analysis and clarified with representative quotes. RESULTS: Prevalence of deficiencies intake were folate (98.7%), vitamin B6 (91.1%), vitamin B2 (90.5%), iron (89.2%), zinc (87.3%), vitamin E (84.8%), vitamin C (79.7%), vitamin A (74.1%), copper (67.1%) and vitamin B12 (30.4%). Anaemic pregnant women noticed to consume more amount of food during pregnancy, and preferred to access foodstuff at shop nearby the house. CONCLUSIONS: Other than low iron intake, more than 90% anaemic pregnant women were also deficiency in folate, vitamin B6 and vitamin B2. Perceived of less acknowledgement about affordable cost micronutrient-rich food, high cost of quality-food, sufficient to varieties foodstuff at neighbourhood shop prevents them from making correct food choices subsequently barrier to the food access and intake.