Associations of Knowledge, Attitude, and Practices toward Anemia with Anemia Prevalence and Height-for-Age Z-Score among Indonesian Adolescent Girls

Abstract

Background: Crucial gaps persist in knowledge, attitude, and practice (KAP) of adolescent girls that affect anemia and linear growth failure. Objective: To understand the role of KAP as a risk factor of anemia and linear growth problem in adolescent girls. Methods: We conducted a cross-sectional survey of 335 adolescent girls selected by clustered random sampling. The KAP questionnaire had 18 variables consisting of 9 knowledge, 3 attitude, and 6 practice components. Twelve variables addressed nutrition, dietary diversity, and health environments related to both anemia and stunting. The questionnaire was adapted from the 2014 Food and Agriculture Organization nutrition-related KAP guidelines for anemia. Dietary practice was evaluated from 2-day 24-hour recalls and a semi-quantitative food-frequency questionnaire. Associations between KAP and anemia, and height-for-age z-score (HAZ), were analyzed using multivariate logistic and linear regression models, respectively. Results: The mean hemoglobin (Hb) level was 119.7 g/L, with 44% of the adolescent girls being anemic (Hb < 120 g/L) and mean height was 151.0 cm with 25% being stunted (HAZ < −2 standard deviation [SD]). The median KAP score was 7 and ranged from 3 to 10. Low to moderate KAP scores were not significantly associated with being anemic (adjusted odds ratio [AOR] = 1.26; P = .43), however 1-point KAP score increment was associated with an increase of HAZ by 0.037 SD ( P = .012). Conclusions: The KAP related to diet and healthy environments was not associated with anemia prevalence, but was positively associated with increased HAZ among adolescent girls. Strategy to reduce anemia risk in this population should combine KAP improvement with other known effective nutrition interventions.

The Effect of Mobile Health (m-Health) Education Based on WANTER Application on Knowledge, Attitude, and Practice (KAP) Regarding Anemia among Female Students in a Rural Area of Indonesia

“…Anemia is a condition where the oxygen-carrying capacity in the blood is insufficient [ 1 ]. The normal level of hemoglobin in adolescent girls is 12 g/dL [ 2 ]. Several factors can cause anemia, such as deficiency of vitamin A, vitamin B12, folate, and iron, chronic inflammation, parasitic infections, and congenital conditions.…”

Effectiveness of Triple Benefit Health Education Intervention on Knowledge, Attitude and Food Security towards Malnutrition among Adolescent Girls in Borno State, Nigeria

“…The result showed significant improvement in overall knowledge ( p < 0.05) after the educational intervention, as it has proven to bridge the gap in knowledge among adolescent girls. Knowledge is the corner stone of attitude, and limited access to knowledge has been assumed to be among the causes of malnutrition [ 58 ]. Adolescents with good nutritional knowledge have higher odds of following healthy eating habits and lifestyle, as nutrition education intervention has been promising in improving these for this age group.…”

Anemia, a moderate public health problem among adolescent school girls in Aysaita district, the pastoral community of the Afar region, Ethiopia

“…However, the prevalence was higher than studies in rural Ethiopia, 8.7% (Seyoum et al , 2019), Bahir Dar City, 11.1% (Mengistu et al , 2019), Nepal, 14.74% (Budhathoki et al , 2021) and lower than studies conducted in three districts of Ethiopia, 29% (Gebreyesus et al , 2019), eastern Ethiopia, 32% (Teji et al , 2016), southwest Ethiopia, 26.7% (Fentie et al , 2020), west Ethiopia, 39% (Tura et al , 2020), Oromia Ethiopia, 27% (Regasa and Haidar, 2019), Kenya, 26.5% (Nelima, 2015), Pakistan, 47.9% (Habib et al , 2020), India, range from 48.63% to 87% (Ahankari et al , 2017; Chandrakumari et al , 2019; Chapparbandi and Nigudgi, 2016; Arya et al , 2017; Kamble et al , 2021; Subramanian et al , 2022) and Indonesia, 44% (Agustina et al , 2021). The variation might be differences in sociodemographic status, educational status, health service accessibility, household food security, awareness of dietary diversity, dietary intake, study periods, study settings, sample size and target population.…”