Efficacy Of Nutrition Education With An Emphasis On Consumption Of Iron-Rich Foods On Haemoglobin Levels Of Pregnant Women: A Randomized Trial In Gomoa East District Of The Central Region Of Ghana

Abstract

Anaemia in pregnancy continues to be a huge public health problem worldwide with multiple adverse outcomes on both mother and child especially in developing countries. The causes of anaemia among pregnant women (PW) are multifactorial and may be associated with inadequate dietary intake of iron-rich foods. The aim of the study was to evaluate the impact of a nutrition education (NE) intervention on haemoglobin (Hb) levels, knowledge and dietary intake of anaemic PW in Gomoa East (GE) district of the Central region of Ghana. A total of 130 anaemic PW(Hb level 7-11 g/dl) in second trimester who were attending antenatal care (ANC) in four health centres (Buduatta, Ojobi, Okyereko and Nyanyano) were recruited and randomly assigned to an intervention group, IG (n=65) to receive specific NE on anaemia and iron- rich foods in addition to general NE; or control group, CG (n=65) to receive general NE. The education sessions were on individual, face to face basis done through biweekly home visits and biweekly phone calls. Semi-structured questionnaires were used to collect data on background socio-demographic characteristics, morbidity, Hb measurements, and anthropometric measurements at baseline and after 10 weeks of intervention. A total of 119 PW completed the study. Data were analysed using SPSS (version 16). Means and standard deviations were calculated for all continuous variables and frequencies for all categorical variables. All probability values less than 0.05 (p< 0.05) were considered statistically significant. At the end of the intervention, PW in the IG had significantly higher weight gain (2.50±1.07) than the CG (1.09±1.46), p<0.05. Most of the PW in the IG (89.8%) attained good nutritional knowledge on anaemia and iron-rich foods at the end of the NE intervention while none in the CG had good knowledge on anaemia and iron-rich foods. Haemoglobin concentration increased significantly in the IG over the 10 weeks and the absolute change in Hb concentration was significantly higher in the IG (0.1±1.3) than in the CG (-0.6±1.3), p<0.05. The intakes of red meat, legumes, vitamin C-rich foods, grains, roots and tubers became significantly higher for PW in the IG than the CG at the end of intervention period (p<0.05).The NE intervention emphasizing the consumption of iron-rich foods showed positive effects on Hb, weight gain, nutrition knowledge and dietary intake of iron rich foods and could be a practical and effective strategy for improving dietary practices,Hb level as well as adequate weight gain during pregnancy.