The Open Public Health Journal

ISSN: 1874-9445 ― Volume 14, 2021

Effect of Behaviour Change Communication to Prevent Anemia and Hemoglobin Concentration Among Children Growth Age 6 -59 Months In Central Highland Of Ethiopia: Cluster Randomized Control Trial

Abebe Ferede1, *, Tefera Belachew2, Muluemebet Abera3
1 Department of Public Health, Arsi University, Ethiopia,
2 Nutrition and dietetics Department, Jimma University, Ethiopia
3 Department of Population and Family Health, Jimma University, Ethiopia



Although, Behavioral Change Communication (BCC) on iron-rich dietary intake rather than iron supplementation trial among individual children is effective. This study aimed to assess the effect of BCC on hemoglobin concentration among the growth of children age 6 to 59 months.

Materials and Methods:

A clustered Randomized Control Trial (CRCT) from February 2017 to April 2019. “Kebeles” (small administration units) were randomly assigned to either the intervention or control clustered arm and sufficient buffer zone made between these clusters to avoid information contamination. Mothers (Care) givers and their index children were selected from each cluster using a simple random sampling technique. Blood samples for Hemoglobin (Hb) were collected from children before and after 15 months of BCC intervention to determine Hb concentration. Descriptive statistics and SPSS - Independent sample T-test and a Generalized Estimating Equations (GEE) models were fitted to isolate independent predictors of hemoglobin concentration.


At baseline 1012 and end-line 815 mothers and their index children were participated in the study. The mean (±sd) Hbc level was 143g/L+1.6g/L and 148.34 +14.91g/L for the intervention and control groups had 130.73+14.92g/L. The difference of differences in the mean hemoglobin level was 7.69 for the intervention and 3.81 for the control (P=0.001). On the Generalized Estimating Equations analyses model after adjusting for the background variables the intervention group had increased Hbc by 9.93 mg/dl (β=9.93, P <0.05). Similarly, height for age Z-score was positively associated with Hbc mean level (β =7.151, P <0.05).


The study demonstrated the positive effect of behavior change communication on hemoglobin concentration of children implying the need for the galvanizing efforts to disseminate nutrition behavior change communications to mothers and caregivers of the under five years old children to curb the increasing concern of anemia among these target group.

Keywords: Haemoglobin concentration Children growth, Dietary intake, Behavioral change, Highland, Ethiopia.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 14
Publisher Item Identifier (PII): BMS-TOPHJ-2020-65

Article History:

Electronic publication date: 03/11/2020
Collection year: 2020

© 2020 Ferede et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Public Health, Arsi University, Ethiopia; E-mail:

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