Effect of intensive nutrition education and counseling on hemoglobin level of pregnant women in East Shoa zone, Ethiopia: randomized controlled trial.

BACKGROUND: The aim of this study was to assess the effect of intensive nutrition education and counseling on hemoglobin level during pregnancy. METHODS AND MATERIALS: The study was a one year two-arm parallel design cluster randomized controlled trial in East Shoa zone, Ethiopia. End-line data were collected from 163 intervention and 163 control group pregnant women. The intervention was a three consecutive trimester based counseling sessions using health belief model, weekly regular SMS sent on mobile phone containing core message and providing leaflet with food menu of Iron rich diet. The women in the control group received routine nutrition education from facilities. After adjusting for potential confounders, a linear mixed-effects model was used to assess the intervention effect. RESULTS: There was a significant change in both hemoglobin level and proportion of anemia in the intervention group. The mean hemoglobin level within intervention group before and after intervention was (12.08± 1.15, 12.53± 1.18) with p value of 0.01. The prevalence of anemia among intervention group declined from 14.7 % at the baseline to 9.2% after intervention. At the end of the trial, women in the intervention group had significantly better hemoglobin level than women in the control group (ß = 0.50, p < 0.01). CONCLUSION: The intervention was effective in improving the hemoglobin level and consumption of iron rich diet among pregnant women. Therefore, employing trimester based counseling by using HBM constructs and regular reminding messages have to be provided to pregnant women as part of the regular antenatal care service.

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

Background: Nutritional status is defined as an individual's health condition as it is influenced by the intake and utilization of nutrients. Maternal malnutrition is widespread throughout the world, with Sub-Saharan Africa and Asia bearing the brunt of the burden. The objective of this study was to evaluate the effect of intensive nutrition education and counseling on nutritional status during pregnancy. Methods and materials: The study was a one-year, two-arm parallel design cluster randomized controlled trial conducted in the East Shoa zone, Ethiopia, from January 1, 2021, to February 30, 2022. A total of 374 participants were enrolled in the intervention (n = 185) and control (n = 189) groups. End-line data were collected from 163 women, from each group. The intervention package provided three counseling sessions by trained midwives, three-page take-home brochures prepared in local languages, and the delivery of 18 weekly serial short text messages. The women in the control group received routine nutrition education from the health facilities. After adjusting for potential confounders, a linear mixed-effects model was employed to assess the intervention effect. Results: After the intervention, the mean mid-upper arm circumference in the intervention group increased by 1.8% (23.08 vs. 23.44, p < 0.01). Similarly, the proportion of undernutrition in the intervention group was 11% (25 vs. 36%, p = 0.02) lower compared to the control arm. At the end of the trial, women in the intervention arm had significantly better nutritional status than women in the control group (ß = 0.47, p < 0.01). Conclusion: The findings showed that intensive nutrition education and counseling using the health belief model was effective in improving nutritional status and reducing undernutrition among pregnant women. As a result, nutrition education and counseling using HBM constructs, as well as regular reminder messages, should be provided to pregnant women as part of the routine antenatal care service.

Determinants of nutritional status among pregnant women in East Shoa zone, Central Ethiopia.

Background: Undernutrition is an insufficient intake of energy and nutrients to meet an individual's needs to maintain good health. Undernutrition during pregnancy severely affects the health of mothers and her baby. Globally it contributes directly or indirectly to 3.5 million maternal deaths annually. This study aimed to determine the level of undernutrition and identify factors associated with undernutrition among pregnant women attending public health facilities in the East Shoa Zone, Central Ethiopia. Methods: Institution-based cross-sectional study was conducted among 472 randomly selected pregnant women from June to August 2021. Sociodemographic, obstetrics, and knowledge related data were collected using a structured interviewer-administered questionnaire, and maternal nutritional status was measured using the Mid Upper Arm Circumference (MUAC). The collected data were entered to EPI-info version 3.5.4 and then exported to SPSS for windows version 26.0 software for analysis. Multivariable regression analysis was fitted to identify determinants of undernutrition. An adjusted odds ratio with 95% confidence intervals and a p-value < 0.05 was considered a statistically significant. Results: The prevalence of undernutrition among pregnant women was 13.9% [95% CI: 11.0-17.4]. On multivariable logistic regression model after adjusting background variables, wealth (AOR: 4.9, 95% CI 1.34-18.20), women's decision making power (AOR: 3.31, 95% CI 1.18-7.79), and nutritional counseling (AOR: 3.53, 95% CI 1.29-9.60) were independently associated with nutritional status of pregnant women. Conclusion: Findings indicated that significant number of pregnant women in the study were undernourished. Higher wealth index, nutritional counseling, and women's decision-making power were inversely associated with undernutrition. The findings imply the need for economic empowerment of women, enhancing decision-making ability of women and routine and consistent nutritional counseling to decrease undernutrition among pregnant women.