Impact of a school-based nutrition educational intervention on knowledge
related to iron deficiency anaemia in rural Karnataka, India: A mixed
methods pre-post interventional study
Objective: To understand the extent to which adolescent
awareness of and attitudes about anaemia and anaemia prevention can be
changed by nutrition messages received at school. Design:
Mixed-methods pre–post intervention study Setting: Three Government
schools in Bagalkot, Belagavi and Raichur districts of Karnataka, India
Population or Sample: Students of grade six and seven and
teachers involved in implementing the intervention. Methods: An
education intervention was co-developed by school teachers and nutrition
experts using locally adapted resource materials that consisted of
lectures, role play and practical demonstrations. Seven half-hour
educational sessions were delivered by school teachers over seven weeks
to 455 students. Pre- and post-intervention tests measured changes in
adolescents’ knowledge about anaemia. In-depth interviews with teachers
and focus groups with students explored reactions to the intervention.
Main outcome measures: Knowledge score related to anaemia
Results: The percentage of children with correct scores increased by 7.3
- 49.0 percentage points for the tested questions after implementation
of the intervention. The mean knowledge score increased by
3.67±0.17(p<0.01). During interviews, teachers and students
highlighted high acceptance of the intervention and materials, an
increase in awareness, a positive attitude towards changing behaviour
around diet, an increase in the demand for iron folic acid supplements
and improved sharing of messages learned with peers and families.
Challenges expressed included need for further training, time
limitations and hesitancy in teaching about menstruation and pregnancy.
Conclusions: Educational interventions carried out for
adolescents by teachers in schools are effective in improving awareness
and attitude related to anaemia.