Effectiveness of Short Message Service Reminders and Leaflets in Complying With Iron Supplementation in Pregnant Women in Depok City, Indonesia

Background: Anitasari et al. 2017 is a prospective pseudo experimental method study. The purpose of the study was to obtain an overview of sociodemographic characteristics and clinical characteristics of pregnant women at two community health clinics in Depok city, Indonesia in addition to accessing the effectiveness of SMS reminders in comparison to leaflets in complying with taking iron supplements and improving hemoglobin levels.

Methods: The intervention group included women who checked themselves into two different public centers in Depok city from March to May 2016. 58 participants comprised the leaflet group and 48 participants were in the SMS reminders group. Pre- and post- tests were conducted for each respective group. Samples were taken through a consecutive sampling method. Inclusion criteria were women between the gestational age of 14-32 weeks, who visit community health clinics and receive iron supplements, have cell phone, can read, and are willing to participate. Anyone who signed consent form but did not come to complete the study was excluded. Leaflets were given at the time the participants received their supplements and SMS messages were sent each week for 1 month after receiving supplements. Participants completed a questionnaire and hemoglobin levels were taken  once before and once after the intervention.

Results: Most participants were between the ages of 20-35 y/o, had advanced education, not working, had a previous birth, and knew about anemia and iron supplement tablets. Throughout the study and post-intervention, the number of participants decreased in the non-compliance category and increased in the “medium” and “obedient” compliance categories. In both the leaflet and SMS reminder groups hemoglobin levels increased as more women were categorized as no anemia post-intervention.

Conclusions: Distributing leaflets significantly increased participant compliance but did not significantly increase hemoglobin levels. SMS reminders did not significantly increase participant compliance or hemoglobin levels. No significant difference between leaflets and SMS reminders in changing compliance levels or hemoglobin levels. Recommend future studies longer than one month to determine the impact of leaflets and SMS reminders on levels of compliance and hemoglobin in pregnant women throughout their pregnancy. Also recommend measuring the amount and sources of heme consumed to identify their influence on hemoglobin levels.