F&N Bulletin Vol 23 No 1b - United Nations University

100 T. Gopaldas
in unit 4 (the negative control), they increased from
23% to 35%. The major stated cause of anemia was
“weak blood and deficiency in the diet.” Although
21 messages—not all dietary—were targeted to the
subjects, those that made the greatest impression were
food-related. Even in the specific intervention groups
receiving fermented food (unit 1) and gooseberry juice
(unit 2), all four groups were firmly convinced that
meat (trotter soup) was a good dietary measure to
make the blood strong. Aided recall of “eat fermented
foods and fruits and vegetables” also was high on the
list. Although “drinking more milk” was not in any
of our IEC messages, the spontaneous responses were
significantly higher at the end of the program. Milk
is considered the food of the gods and the affluent,
perhaps accounting for this unexpected response.
Knowledge does not necessarily translate into practice
or behavioral change. The hemoglobin levels of the
women in unit 4 (the negative control) did not show a
change, although their knowledge levels did. Postsurvey
scores were higher for fermented foods, as expected.
As a result of much higher consumption of the fermented
food (iddli) at the workplace and a somewhat
higher consumption at home, the mean hemoglobin
levels of the women increased significantly.
Impact on health practices
Table 6 shows that in addition to gaining knowledge,
the most favored practices were to seek the help of a
doctor or to take the iron supplementation.
Impact on hemoglobin status
As seen in table 7, the hemoglobin status of the women
significantly improved in units 1, 2, and 3. In unit 1,
which received the fermented food intervention, there
was a significant increase in mean hemoglobin from
11.10 to 12.30 g/dl (1.20 g/dl increase). The greatest
benefit, as viewed by the woman, was that it was
basically a food with “properties of making weak
blood strong.” In unit 2, which received IEC plus
gooseberry juice, there was a significant increase in
mean hemoglobin from 11.20 to 12.7 g/dl (1.50 g/dl
increase). The women viewed this intervention as a
“most refreshing drink that also had the ability to
make the blood strong.” In unit 3, which received
deworming plus iron supplementation without IEC,
there was a significant increase in mean hemoglobin
from 11.50 to 13.00 g/dl (1.50 g/dl increase). This
intervention was most successful in eradicating worms
TABLE 6. Practices affecting the control of anemia (% of women displaying practice) before and after intervention
Unit 2: Unit 3: medicinal Unit 4:
Unit 1: iddli gooseberry supplements negative control
(n = 72) juice (n = 80) (n = 70) (n = 80)
Practice Before After Before After Before After Before After
Go to doctor 79 96* 59 94** 50 81*** 68 98***
Do nothing 22 4** 43 5*** 50 29*** 38 3***
Take iron tablets as prescribed 44 74*** 36 63*** 36 57*** 48 52*
* p < .05; ** p < .01; *** p < .001.
TABLE 7. Mean hemoglobin values before and after intervention a
Unit 2: Unit 3: medicinal Unit 4:
Unit 1: iddli gooseberry supplements negative control
(n = 72) juice (n = 80) (n = 70) (n = 80)
Hemoglobin value Before After Before After Before After Before After
Overall mean 11.1 ± 2.1 12.3 ± 1.0 11.2 ± 1.9 12.7 ± 1.1 11.5 ± 1.3 13.0 ± 1.3 10.9 ± 1.4 10.9 ± 1.5
(g/dl) *** *** *** NS
Severe anemia 5.7 10.7 6.9 ± 0.1 11.2 ± 0.5 6.0 ± 0.0 7.5 ± 0.0 6.4 ± 0.0 8.9 ± 0.0
(< 7 g/dl) (1) ***(1) (2) ***(2) (2) ***(2) (2) *** (3)
Moderate anemia 8.9 ± 0.7 11.3 ± 0.9 8.8 ± 0.9 12.3 ± 1.2 No cases No cases 9.40 ± 0.70 9.7 ± 1.2
(7–9.9 g/dl) (21) *** (21) (17) *** (17) (18) NS (18)
Mild anemia 11.0 ± 0.6 12.3± 0.6 11.2 ± 0.5 12.4 ± 0.8 10.9 ± 0.5 12.4 ± 0.5 10.8 ± 0.9 11.0 ± 0.6
(10–11.9 g/dl) (29) *** (29) (36) *** (36) (37) *** (37) (44) NS (44)
Normal 13.8 ± 0.9 13.2 ± 0.6 13.2 ± 0.9 13.5 ± 0.9 12.5 ± 0.3 14.0 ± 0.30 12.7 ± 0.7 12.8 ± 0.5
(≥ 12 g/dl) (21) * (21) (21) NS (25) (31) *** (31) (16) NS (16)
a. The number of subjects for each category of hemoglobin values is given in parentheses.
* p < .05; ** p < .01; *** p