A high percentage of women at 20 to 26 weeks of pregnancy had mild to moderate anemia. Pica, tea consumption, and low intake of eggs and red meat were associated with anemia. Women of childbearing age should be provided nutritional education regarding food sources of iron, especially prior to becoming pregnant, and taught how food choices can either enhance or interfere with iron absorption.
In households where food insecurity exists, knowledge of care practices may not be sufficient, and interventions such as food subsidies must precede or accompany educational efforts. Further follow-up is required to explore the effect of gender differences on child care.
Objective To assess the effectiveness of a community based lifestyle intervention on blood pressure in children and young adults in a developing country setting.Design Cluster randomised controlled trial.Setting 12 randomly selected geographical census based clusters in Karachi, Pakistan.Participants 4023 people aged 5-39 years.Intervention Three monthly family based home health education delivered by lay health workers.Main outcome measure Change in blood pressure from randomisation to end of follow-up at 2 years.Results Analysed using the intention to treat principle, the change in systolic blood pressure (adjusted for age, sex, and baseline blood pressure) was significant; it increased by 1.5 (95% confidence interval 1.1 to 1.9) mm Hg in the control group and by 0.1 (−0.3 to 0.5) mm Hg in the home health education group (P for difference between groups=0.02). Findings for diastolic blood pressure were similar; the change was 1.5 mm Hg greater in the control group than in the intervention group (P=0.002).Conclusions Simple, family based home health education delivered by trained lay health workers significantly ameliorated the usual increase in blood pressure with age in children and young adults in the general population of Pakistan, a low income developing country. This strategy is potentially feasible for up-scaling within the existing healthcare systems of Indo-Asia.Trial registration Clinical trials NCT00327574.
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