Longitudinal Analysis of the Impact of Community Health Education on Maternal Anaemia Outcomes in Rural North West Nigeria

Maternal anaemia remains a critical pregnancy complication in North West Nigeria, shaped by nutritional deficiencies, frequent childbearing, and inadequate preventive health education. This study conducted a longitudinal randomised controlled trial to assess the impact of community health education on maternal anaemia outcomes among pregnant women in rural communities of Katsina and Sokoto states. Forty communities were randomised to receive either a structured community health education programme targeting iron-rich dietary practices, iron supplementation adherence, and malaria prevention, or routine antenatal care only as control. A total of 480 pregnant women were enrolled in the third trimester and followed until eight weeks postpartum. Haemoglobin levels were measured at enrolment, 36 weeks gestation, and postpartum. Multilevel mixed-effects linear regression was applied to control for clustering and time effects. Results showed a significantly smaller decline in haemoglobin levels between enrolment and postpartum in intervention communities compared to controls (adjusted mean difference 1.4 g/dL, p less than 0.001). Iron supplementation adherence and dietary diversity scores were significantly higher in intervention communities. The study provides rigorous experimental evidence for the effectiveness of community health education in improving maternal anaemia outcomes. Keywords: maternal anaemia, community health education, randomised controlled trial, North West Nigeria, iron supplementation