ASSIGNMENT: E ect of community based health educa on

on knowledge and a tude towards iron and

folic acid supplementa on among pregnant
women in Kiambu County, Kenya: A quasi
experimental study

❖ The research involved 340 pregnant women aged 18–49 in both intervention and control
groups across five health facilities in Lari Sub-County.

Objectives and Methodology

▪ The primary goals were to evaluate the effectiveness of community based IFAS health
education, delivered by Community Health Volunteers (CHVs), on knowledge,
counseling levels, and attitudes among pregnant women. The study utilized a pretest-
posttest design, with baseline and endline data collected during antenatal care. The
intervention group received weekly IFAS health education and supplements from CHVs,
while the control group received the same from routine healthcare providers. Statistical
analyses, including a Difference-In-Difference approach, were applied to measure the
intervention's impact.

Results and Conclusion

• The findings revealed a significant improvement in IFAS knowledge in the intervention

group, with a 13% overall difference and a substantial 35-percentage-point increase.
Positive attitudes towards IFAS also increased significantly (p<0.001), with a 9-fold
increase in the odds of having a positive attitude at endline compared to baseline. The
study concluded that community-based health education effectively enhanced maternal
knowledge, positive attitudes, and counseling proportions on IFAS. It recommended
integrating community-based approaches with routine antenatal IFAS distribution for
improved supplementation outcomes.

Discussion and Implications

• The discussion explored factors influencing IFAS utilization, emphasizing the correlation
between knowledge, attitude, and practice. It highlighted the role of community-based
health education in addressing inadequate counseling and poor awareness. The study's
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 implications suggest that community-based interventions, particularly through CHVs,
present a promising strategy to enhance maternal healthcare outcomes related to IFAS.

Ethical Considerations

• The ethical considerations prioritized participant protection, voluntary participation,

informed consent, confidentiality, and privacy. Approval was obtained from relevant
ethical and research committees.

❖ In conclusion, this research underscores the potential of community-based health

education in improving IFAS outcomes among pregnant women. The findings have
implications for shaping healthcare strategies to enhance maternal knowledge and
positive attitudes, suggesting a need for broader implementation of community-based
interventions in maternal healthcare practices.

RESULTS

▪ Socio-demographic Characteristics:

o 56% of the participants completed the study.

o Most respondents were 20–29 years old, married, had secondary education,
unemployed, and earned less than USD 100 per month.
o No statistical difference in characteristics at baseline between the two groups.

▪ Effect on Maternal Knowledge Towards IFAS:

o The intervention group showed a 35% improvement in IFAS knowledge

compared to 22% in the control group.
o Factors influencing knowledge included employment status, with the employed
being more knowledgeable.
o Brochures and CHVs were significant sources of IFAS information.

▪ Effect on Maternal Attitude Towards IFAS:

o Positive attitude increased by 26% in the intervention group and 20% in the
control group.
o Factors influencing a positive attitude included a significant change between
baseline and endline.
▪ Discussion and Implications:

o The study emphasizes the role of CHVs in improving maternal knowledge and
attitude towards IFAS.
o While most pregnant women were aware of IFAS, the quality of counseling at
health facilities was found to be inadequate.
o Brochures, CHVs, and health care providers were sources of IFAS information,
with CHVs showing effectiveness in community-level follow-up.
o Continuous training and support for CHVs, alongside policy adjustments, are
recommended for sustained success.

▪ Limitations and Conclusion:

o Limitations include loss to follow-up and potential confounding effects.

o The community-based approach positively impacted maternal knowledge and
attitude towards IFAS.
o The study suggests the need for further strategies involving CHVs to improve
awareness and education on IFAS, promoting better maternal health practices.

❖ This community-based model, utilizing CHVs, offers a promising avenue for enhancing
maternal knowledge and attitudes regarding IFAS, indicating the potential for improved
health outcomes in pregnant women.