Effects of Video‐Based Health Education on Birth Outcomes and Anaemia Status of Mothers in Dirashe District South Ethiopia: A Cluster Randomized Controlled Trial

Undernutrition and infections during pregnancy result in low birth weight (LBW) and maternal anaemia. Social behaviour change communication (SBCC) can promote recommended health practices, potentially improving maternal and neonatal outcomes. This cluster-randomized controlled trial assessed the effects of video-based health education on adherence to iron-folic acid (IFA) supplementation, pregnancy outcomes, and anaemia status among pregnant women in rural Dirashe District, South Ethiopia. Pregnant women in their first trimester across 16 villages were cluster-randomized into either the intervention or control arms. The control arm received standard antenatal care counselling, while the intervention arm received biweekly video-based nutrition and health education at home until delivery. The primary outcomes included adherence to IFA supplementation, birth outcomes, including neonatal length and weight, and maternal haemoglobin concentrations (Hb) throughout pregnancy. Among 596 enroled pregnant women, 519 provided data until delivery. The intervention significantly improved adherence to IFA supplementation, with a mean difference (95% Confidence Interval) of 25.98 (15.60, 36.36) in IFA disappearance rate and a mean percent difference of 14.80% (3.42, 63.99) in self-reported adherence. The intervention significantly improved birth weight, with a mean difference of 204.9 g (38.7, 371.2). Maternal Hb near delivery improved statistically with a mean difference of 0.22 g/dL (0.15, 0.42), with lower anaemia (Hb < 11.0 g/dL) prevalence, with a mean percent difference of -0.08% (-0.12, -0.04). However, no significant effect on birth length or LBW was observed. Video-based SBCC improved IFA adherence, birth weight, and reduced anaemia near delivery. It is a promising approach for community health education in resource-limited settings. REGISTRATION: The study was registered as a clinical trial with the US National Institute of Health (www//.ClinicalTrials.gov; NCT04414527).