Local wisdom-based counseling on preventing iron deficiency anemia among pregnant women

Arm 1: The local wisdom-based counseling intervention group: This group consisted of 50 pregnant women as participants identified by cluster random sampling technique. The intervention is given to the participants for 1 months (6 sessions) with 1-week intervals. The duration for each sessions is 45-75 minutes: Session 1: Introduction and research explanations, including Hemoglobin (Hb) examination. Session 2: Mutual trust building and pregnancy overview. Session 3: Counseling on iron deficiency anemia and explanation about Hb examination with the cultural approach. Session 4: Counseling on the iron tablets intake with the cultural approach. Session 5: Counseling on husband's supporting role for the iron tablets intake control with the cultural approach. Session 6: Review, follow up, and Hb examination. The method used in session 1 and session 6 is a group counseling method attended by all participants, while the method used in sessions 2 through session 5 is a group counseling method, each group consisting of 7-9 participants. Arm 2: The health-based counseling intervention group: This group consisted of 50 pregnant women as participants identified by cluster random sampling technique. The intervention is given to the participants for 1 months (6 sessions) with 1-week intervals. The duration for each sessions is 45-75 minutes: Session 1: Introduction and research explanations, including Hemoglobin (Hb) examination. Session 2: Mutual trust building and pregnancy overview. Session 3: Counseling on iron deficiency anemia and explanation about Hb examination. Session 4: Counseling on the iron tablets intake. Session 5: Counseling on husband's supporting role for the iron tablets intake control. Session 6: Review, follow up, and Hb examination. The method used in session 1 and session 6 is a group counseling method attended by all participants, while the method used in sessions 2 through session 5 is a group counseling method, each group consisting of 7-9 participants. Arm 3: The control group: This group consisted of 50 pregnant women as participants identified by cluster random sampling technique. Standard antenatal counseling will be applied for 1 months. Participants will also receive a pretest and posttest questionnaires and Hb examinations. Both intervention given to the participants is carried out by trained nurse-midwives who worked at the Public Health Center that receive training from the researcher for 2 days with 45-75 minutes for each session. The training will be conducted in 6 sessions given to the counselor and the training step is same as the intervention program that they will do for the participant. The interventions will be given through face-to-face meetings in groups with 5-6 participants by counselors. The difference between the two types of counseling will be given: 1. The counseling module as a guide that has been designed for the two intervention groups in content differs between each other. 2. Counselors are recruited and selected from different Public Health Center (PHC), which are three PHCs for counselors based on local wisdom and three PHCs for counselors based on health. The one that providing the counseling is different between each intervention group. The process of providing interventions will follow the ethical principles of health research. Strategies used to assess the adherence to the interventions in these three groups are: 1. By checking the attendance list for each session attended by pregnant women. 2. By assessing the control card for monitoring iron tablets consumption during the intervention given and during the follow-up 1 (2 weeks after the intervention) and follow-up 2 (4 weeks after follow up 1).