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Effect of Preconception Anaemia Education on Anaemia Prevention Practices among Women of Reproductive Age in Nigeria

Abstract

Anaemia is an important public health problem among women of reproductive age in Nigeria and may have serious consequences for maternal health, pregnancy outcomes, and overall well-being. Women may enter pregnancy with undiagnosed or untreated anaemia due to inadequate dietary iron intake, micronutrient deficiencies, malaria and other infections, menstrual blood loss, closely spaced pregnancies, and limited access to preventive healthcare. Preconception health education provides an opportunity to address anaemia risk before pregnancy occurs by improving women's knowledge of nutritious diets, iron and folate intake, appropriate supplementation, infection prevention, screening, and timely healthcare utilization. Against this background, this study investigates the effect of preconception anaemia education on anaemia prevention practices among women of reproductive age in Nigeria. The study will be anchored on the Health Belief Model, Social Cognitive Theory, and Social Ecological Model. The Health Belief Model explains how women's perceptions of their susceptibility to anaemia, perceived severity, perceived benefits of prevention, perceived barriers, and cues to action may influence their adoption of preventive practices. Social Cognitive Theory emphasizes self-efficacy, observational learning, behavioural reinforcement, and social support in the development and maintenance of healthy practices. The Social Ecological Model emphasizes the interaction between individual, family, community, healthcare, and broader socioeconomic factors in shaping women's health behaviours. Collectively, these theoretical perspectives provide a suitable framework for explaining how preconception anaemia education may influence anaemia prevention practices among women of reproductive age in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise women aged 15–49 years residing in selected urban, semi-urban, and rural communities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, households, and eligible women. Preconception anaemia education will be assessed using indicators such as exposure to structured education, frequency and duration of educational sessions, knowledge of anaemia risk factors, iron-rich foods, dietary diversification, iron and folate supplementation where indicated, infection prevention, menstrual health, pregnancy spacing, anaemia screening, and appropriate healthcare-seeking. Anaemia prevention practices will be assessed using indicators such as consumption of iron-rich and diversified foods, appropriate use of recommended iron and folic acid supplements, adherence to prescribed supplementation, prevention and treatment of infections, attendance at health screening services, haemoglobin testing where appropriate, management of heavy menstrual bleeding where indicated, and utilization of preconception healthcare services. Data will be collected using structured questionnaires, validated nutrition and anaemia knowledge instruments, dietary assessment tools, healthcare records where appropriately available, haemoglobin screening results where included in the study protocol, and community health programme records. Descriptive statistics will be used to summarize participants' characteristics, exposure to preconception anaemia education, and anaemia prevention practices. Inferential statistical techniques, including chi-square tests, t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of preconception anaemia education on anaemia prevention practices. Where a quasi-experimental design is adopted, prevention-practice scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the programme. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that preconception anaemia education has a significant positive effect on anaemia prevention practices among women of reproductive age in Nigeria. Women exposed to structured and practical education are expected to demonstrate improved dietary practices, increased awareness and appropriate use of iron and folic acid supplementation, improved uptake of anaemia screening, greater attention to infection prevention, and increased utilization of preconception healthcare services. Education may help women recognize anaemia risk factors before pregnancy and understand the importance of correcting nutritional deficiencies and other contributing conditions early. Community education, counselling, practical nutrition demonstrations, and reinforcement through primary healthcare services may further strengthen preventive practices. However, food insecurity, poverty, limited access to diverse nutritious foods, cost of supplements and healthcare services, cultural beliefs, misinformation, inadequate screening services, and poor continuity of care may limit the effectiveness of preconception education. The study therefore expects accessible, culturally appropriate, practical, and regularly reinforced preconception anaemia education to contribute significantly to improved anaemia prevention practices among women of reproductive age in Nigeria. The study is expected to contribute to the literature on preconception health, anaemia education, anaemia prevention practices, women's reproductive health, maternal health, nutrition, micronutrient deficiency prevention, primary healthcare, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency, state ministries of health, primary healthcare facilities, maternal and reproductive health programmes, nutritionists, community health workers, women's health organizations, development partners, and policymakers regarding strategies for preventing anaemia before pregnancy. The study will also provide evidence-based recommendations for integrating anaemia education into preconception and reproductive health services, strengthening access to affordable iron and folate supplementation, improving nutrition counselling, increasing screening opportunities, addressing infection-related causes of anaemia, and developing sustainable preconception health programmes for women across Nigeria.

Keywords: Preconception anaemia education, anaemia prevention practices, women of reproductive age, iron deficiency, iron and folic acid supplementation, preconception health, women's health, maternal health, nutrition education, Nigeria, public health.