Optimizing Health Communication via Job Aids to Enhance Maternal Knowledge of Antenatal Nutrition: A Randomized Controlled Trial in Ondo State, Nigeria

Abstract

Background: Effective health communication is a cornerstone of improved maternal nutritional literacy; however, its implementation within Nigerian antenatal clinics remains sub-optimal. While job aids are recognized as valuable tools in enhancing health education, their systematic integration into antenatal nutrition education remains limited.

Aims: This study sought to assess maternal knowledge on nutritional information provided during antenatal care and evaluate the efficacy of job aids in enhancing maternal knowledge of antenatal nutrition in Ondo State.

Patients and Methods: A randomized controlled trial was conducted involving 200 pregnant women, who were assigned to either the intervention group (n = 100) or a control group (n = 100). The intervention group received specialized job aids—comprising pictorial materials, posters, and a comprehensive booklet on antenatal nutrition—whereas the control group received routine care. Data were collected via a semi-structured, interviewer-administered questionnaire evaluating socio-demographic characteristics and four key components of antenatal nutrition knowledge: general health literacy, antenatal nutritional messages, nutrient-food associations, and gestational food taboos. Knowledge was quantified employing a 40-point scale, with scores ≥23 categorized as "good" and <23 as poor. Baseline and end-line difference were analyzed through paired t-tests, with statistical significance set at p < 0.05.

Results: The mean ages of the intervention (29.0 ± 3.9 years) and control groups (28.1 ± 4.5 years) exhibited no significant demographic variance. Most participants possessed tertiary-level education and a parity of one to three children. At baseline, mean nutritional knowledge scores for the control (23.1 ± 3.6) and intervention (23.6 ± 4.9) groups were comparable (p > 0.05), with 60.0% and 57.0% of the cohorts, respectively, demonstrating adequate knowledge. Following the intervention, the mean knowledge score significantly increased in the intervention group (27.9 ± 4.3; p < 0.001), whereas the control group remains stagnant (23.0 ± 5.2; p = 0.410). By the study’s conclusion, the proportion of participants with "good" knowledge rose to 91.8% in the intervention group, compared to 61.0% in the control group.

Conclusion: The findings demonstrate that the strategic utilization of job aids significantly enhances maternal knowledge regarding antenatal nutrition. Consequently, this study advocates for the formal incorporation of these educational tools into routine antenatal nutrition education protocols to improve maternal health outcomes.

Keywords: Antenatal Nutrition Education; Maternal Health Literacy; Nutritional Intervention; Healthcare Pedagogical Tools; Social and Behavior Change Communication (SBCC).