Data collection tools and measurement
anemia
ANEMIA
Data was collected through a pretested and structured interviewer-administered questioner, anthropometric measurement and a sample collection for hemoglobin measurement form January, 2021 to February 2022. The questionnaires included socio-economic characteristics of women and their households, dietary habit and food intake, food frequency questions (FFQ), obstetric history, prenatal health seeking behavior, and measure variables relevant to maternal nutrition during pregnancy. The questionnaire developed after a thorough review of literature on the subject matter. Data on socio-demographic characteristics and obstetric history were collected at the baseline. Whereas, data on hemoglobin level measurement, food security, nutrition knowledge were taken before and after implementation of the intervention.Six data collector midwives, 4 medical laboratory technologist and 2 supervisors were trained for 3 days using a training manual focused on data collection tool and procedure. Questionnaires initially written in English and translated to Afan Oromo and Amharic then back translated to English by an expert fluent in English and the local languages. The tools were pre-tested before using for actual data collection and questionnaires’ consistency reliability test was done and a Cronbach’s alpha coefficient of >0.70 was held to indicate reliability. The knowledge questionnaire consisted of definitions, causes, signs and symptoms, effects of anemia on mother and child health, and methods of preventing anemia. It was developed according to literature review [All data were obtained in the respondents’ mother tongue language. The privacy of the women was secured during the interview. The supervisors and the principal investigator monitored the data collection procedure. The data collection and counselors team held a daily meeting to discuss challenges encountered during the day. The food frequency questioner was used to find the frequency of iron-rich food intake over the past months. We ranked the frequency of intake on a seven-level scale: 7 indicated a frequency of once a day, 6 of 4-6days per week,5 of 2-3 times per week,4 of once per week, 3 of 2-3 times per month,2 of once per month, 1 of never eat. The FFQ consisted of 121 foods selected form Ethiopian food composition table and only 81 foods were reliable enough to be included in the final version of the questionnaire with cronbach’s alpha coefficient of 0.7.The total possible score ranged from 122 to 274 points; higher scores reflected higher frequencies of intake.Hemoglobin was measured using a portable and battery-operated machine (HemoCue, Angel Holm, Sweden). After swiping the site with disinfectant, a finger prick was made to obtain blood for hemoglobin measurement. The first two drops were swapped away and the third drop was used to fill the micro cuvette for reading of the hemoglobin. The hemocue machine had a sensitivity of 85% and specificity of 94% for capillary blood [