Effect of Preconception Care on Anemia and Body Mass Index among Women in a Rural and Tribal Area, Nashik District, India.

Abstract

Objective: Preconception care reduces adverse maternal and neonatal outcomes. Despite the World Health Organization's recommendations, it has not been uniformly implemented. The specific objectives of the study were to measure the change in calorie and protein intake, body mass index (BMI), and hemoglobin among women receiving preconception care, including behavioral change communication (BCC).

Materials and methods: We conducted an implementation study with the government's support. Accredited social health activists conducted a house-to-house survey in four blocks (2 for intervention and 2 for comparisons). Each arm had one tribal and one rural block. They enrolled women desiring pregnancy within a year and collected desired information, including a 24-hours dietary recall. A repeat diet survey was carried out after 6 months. The authors provided preconception care in the intervention blocks. Health care workers followed the women monthly. The study was conducted from 2018 to 2020.

Results: The study enrolled 7875 women from four blocks. In the intervention group, the proportion of women with very low-calorie intake reduced from 1.1% to 0.1%, and very low-protein intake reduced from 0.9% to 0.2%. In the comparison group, very-low-calorie intake was reduced from 1.7% to 1.5%, whereas very low protein intake was reduced from 1.6% to 0.8%. The proportion of underweight (BMI < 18.5) decreased from 40.70% at enrolment to 15.35% at the last follow-up. The mean hemoglobin improved from 10.56 gm% (SD = 1.25) to 11.10 gm% (SD = 1.07).

Conclusions: The provision of preconception care, including BCC activities, through the public health system optimized the BMI and increased hemoglobin.