The effect of health and nutrition training among health workers on Anaemina in rural areas of Tanzania : a study in Iramba and Kondoa district

Objective: The study was designed to assess the effect of health and nutrition training among health workers on anaemia in rural communities of Tanzania. Methods: The study utilised two sets of data. Data on haemoglobin levels (secondary data) for under five children and pregnant women attending maternal and child health clinics at the sentinel district hospital was obtained from Tanzania Food and Nutrition Centre (TFNC). Data was collected in the months of May and November from November 1997 to November 1998. At the sentinel laboratory a cyanomethaemoglobin method was used to determine haemoglobin concentration. Haemoglobin levels of less than 11 gm/dl was used to define anaemia for the two population groups. Primary data on knowledge, attitudes and practices among health workers and community members on anaemia were obtained through a cross-sectional study in the intervention and control areas in October 2000. The study areas were among the sentinel districts for anaemia surveillance. The intervention area was randomly selected among those districts where health and nutrition training was provided to the health workers. The control area was selected from the areas where no health and nutrition training was instituted to the health workers. Control area had similar socioeconomic and geographical characteristics with the intervention area. Results: Anaemia was highly prevalent in the two study population in both areas, the intervention area having significantly higher prevalence (82%) than the control area (76%) in under five children (p = 0.028). A similar trend was observed in pregnant women, 75 percent being anaemic in the intervention area as opposed to 72 percent in the control area but the difference between the two areas was not significant. For both groups prevalence of anaemia was observed to be high in May than in November (p < 0.001). Regarding knowledge, health workers and respondents at household level in the intervention area had higher knowledge than in the control area. However, the percentage of respondents with good knowledge was very low. Although there was some improved practices in the intervention area, it did not reflect the knowledge improvement as compared to the control area. Dietary practices favorable to prevent anaemia were found to be more in the control area than in the intervention area. Staples were the food group regularly consumed by the majority in both areas at household level than any other food groups. Conclusion: Findings of this study indicate that the observed high prevalence of anaemia in the intervention area may partly be explained by lack of good knowledge on anaemia among the majority of health workers. Further, this may have lead to poor practices for the prevention and control of anaemia at community level. Therefore, there is a need for reviewing the health and nutrition training programme so that its future implementation can bring desirable change through improved knowledge among the health workers, involvement of policy makers and active cooperation of the community members. KEY WORDS: anaemia, iron deficiency anaemia, health and nutrition education, knowledge, attitudes and practices, health workers, Tanzani