THE EFFECTIVENESS OF BIA (BOOKLET IBU ANEMIA) ON IRON–FOLIC ACID (IFA) TABLET CONSUMPTION IN  INCREASING HEMOGLOBIN LEVELS IN ANEMIC PREGNANT WOMEN

Anisah Tifani Maulidyanti; Mika Oktarina; Puteri Andika

doi:10.34011/jmp2k.v35i4.3170

Authors

Anisah Tifani Maulidyanti STIKES Tri Mandiri Sakti Bengkulu, Bengkulu, Indonesia
Mika Oktarina STIKES Tri Mandiri Sakti Bengkulu, Bengkulu, Indonesia
Puteri Andika STIKES Tri Mandiri Sakti Bengkulu, Bengkulu, Indonesia

DOI:

https://doi.org/10.34011/jmp2k.v35i4.3170

Keywords:

Booklet Ibu Anemia, Hemoglobin, ibu hamil, kepatuhan, tablet tambah darah

Abstract

Kejadian anemia pada ibu hamil di Indonesia tahun 2019 masih tinggi, yaitu 48,9% yang mendekati masalah kesehatan berat (severe health problem) dengan prevalensi anemia lebih dari 40%. Kondisi ini menunjukkan perlunya media edukasi yang dapat meningkatkan pengetahuan dan kepatuhan ibu hamil dalam mengonsumsi tablet tambah darah. Salah satu media yang dapat digunakan adalah Booklet Ibu Anemia (BIA), yang dalam penelitian ini dikaji pengaruhnya terhadap peningkatan kadar hemoglobin. Penelitian ini bertujuan menganalisis pengaruh BIA pada ibu hamil anemia yang mengonsumsi tablet tambah darah terhadap peningkatan kadar hemoglobin. Desain penelitian kuantitatif dengan quasi eksperimen rancangan pretest-posttest group design. Lokasi penelitian di Puskesmas Nusa Indah, Puskesmas Muara Bangkahulu, Puskesmas Telaga Dewa dan Puskesmas Lempuing Kota Bengkulu pada bulan Juli-Agustus 2024. Sampel adalah ibu hamil sebanyak 60 responden menggunakan teknik purposive sampling dengan pertimbangan tertentu yang memerlukan kriteria khusus. Kelompok intervensi berjumlah 30 responden diberikan BIA dan tablet tambah darah selama 30 hari dengan dosis pemberian sehari sebanyak 1 tablet (60 mg tablet tambah darah dan 0,25 mg asam folat). Analisis data menggunakan uji t dan Mann-Whitney. Pada kelompok intervensi, kadar hemoglobin meningkat dari 9,9 gr%/dL menjadi 10,85 gr%/dL dengan rata-rata kenaikan 0,95 gr%/dL. Pada kelompok kontrol, kadar hemoglobin meningkat dari 9,86 gr%/dL menjadi 11,75 gr%/dL dengan rata-rata kenaikan 1,95 gr%/dL. Analisis menunjukkan perbedaan bermakna antara kedua kelompok (p=0,000). Temuan ini mengindikasikan bahwa BIA berkontribusi terhadap perubahan perilaku konsumsi tablet tambah darah, meskipun peningkatan kadar hemoglobin lebih tinggi pada kelompok kontrol menunjukkan bahwa faktor lain diluar intervensi kemungkinan turut memengaruhi hasil.

References

World Health Organization, “Anaemia,” 2025. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/anaemia.

J. T. M. P. M. Badireddy., “Anemia,” Treasure Island (FL): StatPearls Publishing, 2023. https://www.ncbi.nlm.nih.gov/books/NBK499994/ (accessed Apr. 24, 2025).

W. M. Gardner et al., “Prevalence, years lived with disability, and trends in anaemia burden by severity and cause, 1990–2021: findings from the Global Burden of Disease Study 2021,” Lancet Haematol., vol. 10, no. 9, pp. e713–e734, 2023, doi: 10.1016/S2352-3026(23)00160-6.

G. M. Brittenham et al., “Biology of Anemia: A Public Health Perspective,” J. Nutr., vol. 153, no. May, pp. S7–S28, 2023, doi: 10.1016/j.tjnut.2023.07.018.

Kumar S, Arnipalli S, Mehta P, Carrau S, and Ziouzenkova O, “Iron Deficiency Anemia: Efficacy and limitations of nutritional and comprehensive mitigation strategies,” Nutrients, vol. 14, no. 2976, 2022, [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9315959/.

S. Safiri et al., “Burden of anemia and its underlying causes in 204 countries and territories, 1990–2019: results from the Global Burden of Disease Study 2019,” J. Hematol. Oncol., vol. 14, no. 1, pp. 1–16, 2021, doi: 10.1186/s13045-021-01202-2.

S. Anitha et al., “Millets Can Have a Major Impact on Improving Iron Status, Hemoglobin Level, and in Reducing Iron Deficiency Anemia–A Systematic Review and Meta-Analysis,” Front. Nutr., vol. 8, no. October, pp. 1–14, 2021, doi: 10.3389/fnut.2021.725529.

Yuli Arisyah Siregar, Haslinah Ahmad, and Anto J. Hadi, “Faktor yang Berhubungan dengan Kejadian Anemia pada Ibu Hamil di Puskesmas Rawat Inap Batangtoru Kabupaten Tapanuli Selatan,” Media Publ. Promosi Kesehat. Indones., vol. 6, no. 7, pp. 1432–1438, 2023, doi: 10.56338/mppki.v6i7.3706.

M. Syari, R. Fitria, E. S. Sinaga, N. R. Harahap, and Y. Oktafirnanda, “Efetivitas tablet Fe dalam meningkatkan kadar hemoglobin ibu hamil,” J. Pharm. Sci., vol. 6, no. 3, pp. 1257–1264, 2023, doi: 10.36490/journal-jps.com.v6i3.208.

M. B. Rahardja, E. Sahiratmadja, E. P. Setiawati, R. Panigoro, and I. M. Surbakti, “Pengetahuan Tentang Anemia pada Remaja dan Dewasa Muda di Jakarta dan Jawa Barat: Survei Demografi dan Kesehatan Indonesia 2017,” J. Indones. Med. Assoc., vol. 74, no. 2, pp. 71–78, 2024, doi: 10.47830/jinma-vol.74.2-2024-392.

Riskesdas Bengkulu, “Laporan Provinsi Bengkulu RISKESDAS 2018,” Kementrian Kesehat. Republik Indones., p. 123, 2018.

N. K. Y. Devi, N. L. G. P. Yanti, and D. Prihatiningsih, “Perbedaan Kadar Hemoglobin Sebelum Dan Sesudah Pemberian Tablet Fe Pada Ibu Hamil Trimester Iii,” J. Ris. Kesehat. Nas., vol. 7, no. 2, pp. 140–149, 2023, doi: 10.37294/jrkn.v7i2.514.

M. Nasir, M. W. Lestari, G. Nugraha, and ..., “Pencegahan Anemia Defisiensi Besi Dengan Metode Abc (Amati, Beri, Cek) Di Pp Putri Wahid Hasyim Bangil,” Community …, vol. 4, no. 5, pp. 10855–10860, 2023, [Online]. Available: http://journal.universitaspahlawan.ac.id/index.php/cdj/article/view/21801.

Y. N. Sa’adah and F. Rizky, “Aplikasi mytheraphy dalam peningkatan kepatuhan konsumsi tablet fe pada ibu hamil trimester iii 1,2,” J. Ilm. Ilmu Kebidanan dan Kesehat., vol. 16, no. 1, pp. 51–57, 2025, doi: https://doi.org/10.52299/jks.v16i01.374.

M. Obradovic et al., “Leptin and Obesity: Role and Clinical Implication,” Front. Endocrinol. (Lausanne)., vol. 12, no. May, pp. 1–14, 2021, doi: 10.3389/fendo.2021.585887.

A. T. Maulidyanti and E. K. Sahiratmadja, “Pengetahuan dan Kepatuhan Ibu Hamil Trimester III Dalam Konsumsi Tablet Tambah Darah di Puskesmas Beringin Raya Kota Bengkulu,” J. kebidanan Harapan Ibu Pekalongan, vol. 10, no. 2, pp. 59–66, 2023, doi: 10.37402/jurbidhip.vol10.iss2.265.

Putri, W. I. Purnama Eka Sari, and I. F. Andini, “Hubungan Kepatuhan Konsumsi Tablet Fe Terhadap Kejadian Anemia Pada Ibu Hamil,” J. Midwifery, vol. 11, no. 2, pp. 280–288, 2023, doi: 10.37676/jm.v11i2.5115.

F. I. Shofiana, D. Widari, and S. Sumarmi, “Pengaruh Usia, Pendidikan, dan Pengetahuan Terhadap Konsumsi Tablet Tambah Darah pada Ibu Hamil di Puskesmas Maron, Kabupaten Probolinggo,” Amerta Nutr., vol. 2, no. 4, p. 356, 2018.

A. R. Fertimah, S. Mulyani, and Widyawati, “Efektifitas Penggunaan Media Audiovisual dan Aplikasi Permitasi Terhadap Pengetahuan dan Kepatuhan Ibu Meminum Tablet Besi The effectiveness of Audio-visual media use and Permitasi app for mothers ’ knowledge and the consumption compliance of Iron tablets,” J. Keperawatan Klin. dan Komunitas, vol. 5, no. November, pp. 134–145, 2021.

Purwoastuti and Walyani, Panduan Materi Kesehatan Reproduksi dan Keluarga Berencana. Yogyakarta: Pustaka Baru Press, 2020.

M. Safitri, Susaldi, and Istiana, “Hubungan Plasenta Previa, Konsumsi Kafein dan Kadar Hb dengan Kejadian Bayi Berat Lahir Rendah (BBLR) di RSUD Pagelaran Cianjur Tahun 2023,” vol. 03, no. 02, pp. 1099–1106, 2024, doi: 10.53801/oajjhs.v3i2.233.

S. FI, W. D, and S. S., Pengaruh usia, pendidikan, dan pengetahuan terhadap konsumsi tablet tambah darah pada ibu hamil di puskesmas Maron, Kabupaten Probolinggo. Departemen Gizi Kesehatan, Fakultas Kesehatan Masyarakat, Universitas Airlangga, 2018.

A. T. Maulidyanti, P. Andika, and K. F. Syahnaz, “Description Of The Characteristics Of Pregnant Women’s Knowledge About Blood Supplementing Tablets In Bengkulu City,” Matern. Neonatal J. Kebidanan, vol. 12, no. 1, pp. 53–60, 2024, doi: https://doi.org/10.30606/jmn.v12i1.2541.

S. Yanniarti, E. Yorita, E. Yulita, and T. S. Wahyuni, “Specific educational program for adolescent anemia prevention (Progres MIRA) to adolescent girls in remote areas of Bengkulu, Indonesia,” Malahayati Int. J. Nurs. Heal. Sci., vol. 6, no. 5, pp. 413–418, 2023, doi: 10.33024/minh.v6i5.12631.

Y. Qiao et al., “Prevalence and influencing factors of anemia among pregnant women across first, second and third trimesters of pregnancy in monitoring areas, from 2016 to 2020: a population-based multi-center cohort study,” BMC Public Health, vol. 24, no. 1, pp. 1–9, 2024, doi: 10.1186/s12889-024-18610-x.

N. B. Elsharkawy, E. M. Abdelaziz, M. M. Ouda, and F. A. Oraby, “Effectiveness of Health Information Package Program on Knowledge and Compliance among Pregnant Women with Anemia: A Randomized Controlled Trial,” Int. J. Environ. Res. Public Health, vol. 19, no. 5, 2022, doi: 10.3390/ijerph19052724.

L. Gosdin et al., “A School-Based Weekly Iron and Folic Acid Supplementation Program Effectively Reduces Anemia in a Prospective Cohort of Ghanaian Adolescent Girls,” J. Nutr., vol. 151, no. 6, pp. 1646–1655, 2021.

Lina, Arbaiyah, and Meliani Sukmadewi Harahap, “Relationship between Chronic Energy Deficiency and Compliance with Taking Fe Tablets with the Incidence of Anemia in Pregnant Women at Kuala Simpang City Health Center Aceh Tamiang,” Sci. Midwifery, vol. 10, no. 4, pp. 3047–3052, 2022, doi: 10.35335/midwifery.v10i4.759.

S. Karyuni, A. Bungawati, and E. Prasetia Hati Baculu, “The Relationship between Knowledge and Compliance Consuming Iron (Fe) Tablets with Incidence of Anemia in Trimester I Pregnant Women at Bulili Public Health Center,” Int. J. Heal. Econ. Soc. Sci., vol. 2, no. 2, pp. 108–113, 2020, doi: 10.56338/ijhess.v2i2.1258.

H. M. Lekas, K. Pahl, and C. Fuller Lewis, “Rethinking Cultural Competence: Shifting to Cultural Humility,” Heal. Serv. Insights, vol. 13, pp. 4–7, 2020, doi: 10.1177/1178632920970580.

I. Ayu Wulandari, “Hubungan Tingkat Pengetahuan dengan Kejadian Anemia Pada Ibu Hamil di Puskesmas Jongaya Makassar Tahun 2018,” J. Kesehat. Delima Pelamonia, vol. 2, no. 2, pp. 155–158, 2018, doi: 10.37337/jkdp.v2i2.83.

Y. Handayani, S. Winarso, and F. W. Ningtyias, “The Effectiveness Of Android Based Applications An Adherence Monitoring System For Adolescent Female Consumption Fe Tablets,” J. Kesehat. dr.Soebandi, vol. 9, no. 2, pp. 115–124, 2021.

P. G, M. A, Widjanarko, and B, “Pengaruh faktor pengetahuan dan sikap terhadap kepatuhan ibu hamil dalam mengonsumsi tablet Fe di pusksmas Borgor Tengah,” J. promosi Kesehat. Indones., vol. 11, no. 2, pp. 110–115, 2016.

A. A. Juwitasari, Harini, R., & Rosyad, “Husband Support Mediates the Association between Self-Efficacy and Cervical Cancer Screening among Women in the Rural Area of Indonesia. Asia-Pacific,” J. Oncol. Nurs., vol. 8, no. 5, pp. 560–564, 2021, doi: 10.4103/apjon.apjon-2085.

M.-S. T, M. TAburto, Aburto N, and K. R, “Strengthen iron folate supplementation of pregnant women in Ntchisi District, Malawi,” World Nutr., vol. 9, no. 3, pp. 254–260, 2018, doi: 10.26596/wn.201893254-260.

S. E. Detlefs, M. D. Jochum, B. Salmanian, J. R. McKinney, and K. M. Aagaard, “The impact of response to iron therapy on maternal and neonatal outcomes among pregnant women with anemia,” Am. J. Obstet. Gynecol. MFM, vol. 4, no. 2, p. 100569, 2022.

G. Beressa, S. J. Whiting, and T. Belachew, “Effect of nutrition education on hemoglobin level of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial,” BMC Public Health, vol. 25, no. 1, 2025, doi: 10.1186/s12889-025-21699-3.

B. A. Kang, R. N. Rimal, J. Bingenheimer, R. Ganjoo, H. Yilma, and E. Sedlander, “Promoting iron folic acid consumption using social norms as a mechanism of change in the Reduction in Anemia through Normative Innovations (RANI) project: a randomized controlled trial,” BMC Nutr., vol. 11, no. 1, 2025, doi: 10.1186/s40795-025-01053-x

E. Susilawati, Y. Suryanti, L. Artika Sar, and I. Murtiyarini, “The Impact of an Android Application on Compliance With Iron Supplementations in Pregnant Women,” J. Client-centered Nurs. Care, vol. 7, no. 3, pp. 237–244, 2021.

Khairunnisa;, J. Agus, and Fahrurazi, “Hubungan Usia, Pengetahuan Dan Kepatuhan Konsumsi Tablet Fe Dengan Kejadian Anemia Pada Ibu Hamil Di Wilayah Kerja Puskesmas Sungai Jingah Kota Banjarmasin Tahun 2022,” FKM UIK Muhammad Irsyad, 2022.

M. L. Pathirathna, K. M. S. Wimalasiri, K. Sekijima, and M. Sadakata, “Maternal compliance to recommended iron and folic acid supplementation in pregnancy, Sri Lanka: A hospital-based cross-sectional study,” Nutrients, vol. 12, no. 11, pp. 1–10, 2020.