This parallel randomized control trial study assessed the effect of food-based strategies in improving the haemoglobin level; decreasing anaemia and thus the iron status of pregnant women. The study randomized 195 anaemic women enrolled from four randomly selected health centres in Dire Dawa while attending ANC into two intervention groups and control; and followed for 12weeks. The study intervened diet-based supplementation of 90mg/day vitamin C divided and consumed in three doses; combined with nutrition education intervention in intervention group 1; while only nutrition education intervention in group 2. Dietary diversity was assessed using past 24-hours and 7-days dietary recall approaches and haemoglobin levels were determined at baseline and end-line and compared to analyse treatment effects. By end of the study, intervention group 1 and 2 had significantly increased mean haemoglobin by 0.77 ± 0.11gm/dl and 0.398 ± 0.073gm/dl respectively; however, the control had significant decrease by -0.193 ± 0.05gm/dl. Anaemia prevalence also significantly decreased by 29% and 19.7% in intervention group 1 and 2 respectively. However, all women in the control were anaemic. Intervention group 1 and 2 also had significantly higher dietary diversity, consumption of vitamin C-rich fruits and vegetables, nutritional knowledge and modification practices. The researcher thus concludes that diet-based vitamin C supplementation integrated with nutrition education has a significant effect in improving haemoglobin, decreasing anaemia and thus improving the iron status of pregnant women in Dire Dawa. Based on the findings, the researcher developed a framework for an integrated food-based strategy for improving the iron status of pregnant women in Ethiopia. / Health Studies / D. Litt. et Phil. (Health Studies)

Post-natal care is a care given to the mother and the newborn during post-natal period. This period is crucial to save the lives of the mother and the newborn. Despite its importance, the utilisation of this service is very low in Ethiopia. This study was conducted to establish the views and experiences of women and health care workers on post-natal care services and determine the factors influencing its utilisation with the ultimate purpose of developing guidelines to improve uptake and quality of the services in South West Shoa Zone of Oromia Region, Ethiopia. The objectives of the study were to explore and describe the women’s views and experiences on utilisation of post-natal care service. Furthermore, the study sought to explore and describe health care workers views and experiences on provision of the services and to assess the factors facilitating or hindering to the utilisation of it. Ultimately, the study had intended to develop guidelines that would contribute towards improving the uptake and quality of the post-natal care services. The study used a qualitative descriptive and explorative research design to address the research questions. Qualitative data were collected from 19 women who gave birth in the past six months and from 24 health care workers providing post-natal care services (health care workers and health extension workers) and coordinating the overall maternal, neonatal and child health services in the study area (Zone and district health officials; primary health care units heads). The study used in-depth interview guides to collect data from the aforementioned study participants. Inductive thematic analysis was performed on the verbatim transcriptions using the Atlas ti version 8 qualitative data analysis software. Overall, the emerged themes from the analysis are categorised into women’s views and experiences on utilisation of PNC services, views and experiences of health care workers on PNC and factors facilitating and hindering the utilisation of PNC services. The study identified wide range of socio-cultural, knowledge and attitude related, physical, health facility related and health care workers related factors affecting the utilisation of post-natal care services. Consequently, after a systemic review of literature and stakeholders consultation the researcher used the findings of the study to develop guidelines to improve the uptake and quality of post-natal care services. The developed guidelines were also validated by maternal, neonatal and child health service providers and program leaders and the researcher strongly recommend the use of the developed guidelines that would improve the uptake and quality of post-natal care services. / Health Studies / Ph. D. (Public Health)