Health Promotion Model-Based Education and Iron Tablet Adherence in Pregnant Women in West Seram, Indonesia

Abstract

Adherence to iron supplementation during pregnancy is central to anemia-prevention programs, yet daily tablet use may be limited by forgetting, adverse effects and health beliefs. This two-group quasi-experimental pretest–posttest study examined Health Promotion Model-based education among 116 pregnant women at four primary health centers in West Seram Regency, Indonesia. Fifty-eight women received a structured module (PASTI) delivered in three face-to-face education meetings; 58 controls received routine advice about iron tablets. The MMAS-8 questionnaire measured self-reported adherence before and after the program. Mean scores in the intervention group increased from 4.14 ± 2.29 to 6.16 ± 1.30, while comparison scores changed from 4.36 ± 1.74 to 4.67 ± 1.62. The proportion classified as having low adherence fell from 43/58 (74.1%) to 18/58 (31.0%) in the intervention arm, compared with 44/58 (75.9%) to 43/58 (74.1%) in the comparison arm. The thesis reported a within-group Wilcoxon p < 0.001 in the intervention group and a post-intervention between-group p < 0.001. Education informed by perceived benefits and barriers was associated with improved adherence scores. Nonrandomized design, inconsistent sampling descriptions and self-reported outcomes limit causal inference and do not demonstrate prevention of anemia.