Association of Structured Antenatal Health Education with Maternal Haemoglobin and Skilled Birth Attendance

Maternal anaemia and childbirth without skilled attendance remain important maternal health challenges in Nigeria. Antenatal education may support nutritional practices and informed delivery decisions. This study assessed the effect of structured antenatal health education on maternal haemoglobin levels and skilled birth attendance among pregnant women. A quasi-experimental study was conducted in 16 model primary healthcare centres across 10 local government areas. Facilities were allocated by balloting to intervention and control groups. Of 516 women enrolled, 506 completed follow-ups: 256 in the intervention group and 250 in the control group, representing 98.1% retention. The intervention comprised six monthly, interactive, 45–60-minute educational sessions delivered by trained nurses and midwife’s alongside routine antenatal care. Controls received routine care and conventional health talks. Questionnaires and clinical records provided data. Haemoglobin was assessed at baseline and delivery, and skilled attendance was documented at childbirth. Analyses included independent-samples and paired-samples t-tests, chi-square tests, and risk ratios with 95% confidence intervals. Mean baseline haemoglobin was 10.27 ± 1.04 g/dL in the intervention group and 10.30 ± 1.06 g/dL in controls (p = 0.731). At delivery, corresponding means were 11.45 ± 1.17 in the intervention group and 10.30 ± 1.08 g/dL in the control group (p < .001). Skilled birth attendance occurred in 196 intervention participants (76.6%) and 119 controls (47.6%), an absolute difference of 29.0 percentage points (risk ratio = 1.61, 95% CI [1.39, 1.86]; p < 0.001). Structured antenatal health education was associated with higher maternal haemoglobin at delivery and greater skilled birth attendance. Integration into routine antenatal services warrants consideration, alongside measures addressing access to delivery care.