Back to Journals » Journal of Multidisciplinary Healthcare » Volume 13

Effect of Integrated Pictorial Handbook Education and Counseling on Improving Anemia Status, Knowledge, Food Intake, and Iron Tablet Compliance Among Anemic Pregnant Women in Indonesia: A Quasi-Experimental Study

Authors Nahrisah P, Somrongthong R, Viriyautsahakul N, Viwattanakulvanid P, Plianbangchang S

Received 31 May 2019

Accepted for publication 13 December 2019

Published 15 January 2020 Volume 2020:13 Pages 43—52

DOI https://doi.org/10.2147/JMDH.S213550

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Putri Nahrisah, 1, 2 Ratana Somrongthong, 1 Napaphan Viriyautsahakul, 1 Pramon Viwattanakulvanid, 1 Samlee Plianbangchang 1

1College of Public Health Sciences, Chulalongkorn University, Pathumwan, Bangkok 10330, Thailand; 2Health Office of Kota Langsa Municipality, Kota Langsa, Province of Aceh, Indonesia

Correspondence: Samlee Plianbangchang
College of Public Health Sciences, Chulalongkorn University, Institute Building 2-3, Soi Chulalongkorn 62, Phyathai Road, Pathumwan, Bangkok 10330, Thailand
Tel +66 2218 8193
Fax +66 2255 6046
Email samleep40@gmail.com

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.

Keywords: anemia pictorial handbook, health believe model, hemoglobin

A Letter to the Editor has been published for this article.


Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]