Trials of Improved Practices (TIPs) to Enhance the Dietary and Iron-Folate Intake during Pregnancy- A Quasi Experimental Study among Rural Pregnant Women of Varanasi, India

Background: Gestational anemia is a public health problem in India and a leading cause of maternal deaths. Prevention and control of gestational anemia is an integral part of India’s National Health Mission; the program however does not address the behavioral issues of pregnant women and their families. Behavior change communication plays an important role in modifying social and cultural norms. This study aims to examine the effectiveness of ‘Trials of Improved Practices’ (TIPs) on dietary and iron-folate intake during pregnancy.

Methods: This quasi-experimental study with a control group used door-to-door survey to enrol pregnant women. 43 participants were allotted to the TIPs group and control group. TIPs was implemented in addition to ongoing obstetric care through three home visits and assessment; and evaluation visits in control villages. TIPs included interpersonal communication, endorsing active participation of family members, and home-based reminders.

Results: The prevalence of anemia reduced by half in the TIPs group and increased by 2.4% in the control group. Weight gain was statistically significantly higher in the TIPs group. More than 85% of pregnant women were compliant to iron-folate while only 38% were compliant in the control group.

Conclusions: TIPs is an effective approach to improve the nutritional status of pregnant women in the study area. TIPs can be further explored on a larger sample size in different cultural and geographical settings.