Discussion
malaria, weight gain, trimester-based, anemia
ANEMIA IN PREGNANCY, ANEMIA DURING PREGNANCY, MALARIA, INTESTINAL PARASITES, ANEMIA, ADVERSE EFFECTS
This research provided further evidence that the prenatal nutrition education and counseling intervention improved hemoglobin levels and increased intake of iron-rich foods. The nutrition intervention given for pregnant women focus on dietary diversity, consumption of iron rich diet and diets which increase iron absorption, iron supplementation, and prevention of malaria and intestinal parasites, combined with appropriate antenatal care, significantly reduced the prevalence of anemia in pregnancy.Similar result were observed by a quasi-experimental research conducted by Al-tell MA et al. (2010) found a substantial favorable correlation between dietary habits and raising pregnant women's hemoglobin levels. [Similar to this, individual education and counseling substantially increased the mean hemoglobin levels of pregnant women in a pre-test post-test research on pregnancy conducted by Garg & Kashyap (2006) (0.97 vs. 1.58, P0.001) [The study also revealed that average gestational weight gain during pregnancy was higher in the intervention group compared to control group (9.69 kg vs. 7.75kg). Similar findings were reported by a quasi-experimental study conducted in Indonesia (2014), which showed that the treatment group experienced a higher average gestational weight gain than the control group(3.017kg vs. 1.80kg) [The current study's findings demonstrate that, compared to the control group, pregnant women who got nutrition instruction and a menu plan based on iron-rich foods consumed significantly more red meat, Legumes and nuts, Cereal/Grains, vitamin C-rich fruits, eggs and dark green veggies.This outcome is consistent with a research from Dessie Town that found that pregnant women who received nutrition education and counseling using the HBM had significantly improved dietary habits [The success of this intervention may be attributed to the use of a counseling guide, serial weekly SMS messages sent on a mobile phone, and a nutrition message using a leaflet written in locally appropriate language with culturally appropriate pictures, which might help women in the intervention group remember key messages. Counseling was conducted using a trimester-based teaching technique and a client-centered, two-way dialogue approach. Counseling that encouraged behavior change towards having iron-rich food groups and a diversified diet is given based on the needs of specific women after assessing their existing socioeconomic situation, dietary practice, and knowledge of pregnancy.Additionally, in this study, counseling was given using the HBM constructs. The finding of the study is in line with the study done in Northeast Ethiopia, which shows a positive result on improving pregnant women’s dietary practices by using TPB and HBM constructs during counseling [This could be as a result of the fact that women who received counseling believed that anemia during pregnancy had serious negative impacts on both the mother and the fetus. This might be due to the fact that counseled women perceived that anemia during pregnancy had severe adverse effects on them and their fetus and also perceived themselves as vulnerable to the harmful effects of anemia, which motivated them to improve their dietary habits.Implication: The results of this research have important practical repercussions for improving dietary counseling techniques, which will enhance maternal and infant health. The need for implementing the intervention package at health facility level through health workers using theory-enhanced methods is implied by the fact that considerably more pregnant women have adequate nutritional habits.The merits of this research included its use of a client-centered approach and trimester-based counseling in a randomized controlled experiment. The study has some limitation as all responses were dependent on the women’s memory and honesty in answering questions and also due to the relatively short duration of the intervention, the post-intervention result might not have persisted longer.