A Health Belief Model-based educational intervention significantly increased iron-folic acid supplement intake among pregnant women in Southern Afghanistan, with women receiving education taking supplements nearly twice as often per week compared to those receiving standard care. According to Gram Research analysis of this 2026 quasi-experimental study of 177 pregnant women, the intervention increased weekly supplement intake by 1.93 doses and substantially improved women’s beliefs about supplement benefits, their perceived risk without supplements, and their confidence in taking them regularly.
A new study from Southern Afghanistan shows that teaching pregnant women about the importance of iron and folic acid supplements significantly increases how many actually take them. Researchers worked with 177 pregnant women, giving half of them special educational sessions based on health belief principles. The women who received the education took their supplements more consistently and felt more confident about their importance. While the study didn’t show major changes in blood iron levels yet, the findings suggest that simple, targeted education can help pregnant women in low-resource areas get the nutrients they and their babies need.
Key Statistics
A 2026 quasi-experimental study of 177 pregnant women in Southern Afghanistan found that an educational intervention increased weekly iron-folic acid supplement intake by 1.93 doses compared to standard prenatal care.
According to research reviewed by Gram, the Health Belief Model-based intervention significantly improved perceived supplement benefits (5.37-point increase), reduced perceived barriers (5.99-point decrease), and increased self-efficacy (3.61-point increase) among pregnant women.
A study of 177 pregnant women in Southern Afghanistan showed that women receiving health belief-based education had mean hemoglobin levels of 11.23 g/dL compared to 10.88 g/dL in the control group, though this difference was not statistically significant.
The 2026 intervention study demonstrated that educational sessions improved women’s perception of susceptibility to iron deficiency (3.16-point increase) and recognition of supplement-taking cues (2.58-point increase) among 177 pregnant participants.
The Quick Take
- What they studied: Whether teaching pregnant women about iron and folic acid supplements using a specific educational approach would help them take the pills more regularly
- Who participated: 177 pregnant women in Southern Afghanistan attending healthcare clinics. Half received special educational sessions, and half received regular prenatal care
- Key finding: Women who received the education took their iron-folic acid supplements nearly twice as often per week compared to those who didn’t receive the education, and they felt much more confident about taking them
- What it means for you: If you’re pregnant or know pregnant women in areas with limited healthcare resources, simple education about why supplements matter can make a real difference in whether they get taken consistently. This is especially important because iron deficiency during pregnancy can affect both mother and baby health
The Research Details
Researchers in Southern Afghanistan recruited 182 pregnant women from four healthcare clinics and divided them into two groups. One group (91 women) received special educational sessions based on the Health Belief Model—a framework that helps people understand and change health behaviors by addressing their beliefs about disease risk, benefits of treatment, and confidence in their ability to take action. The other group (91 women) received standard prenatal care without the special education. The study ran from December 2025 through March 2026.
The educational intervention focused on helping women understand why iron and folic acid matter during pregnancy, what risks they face without supplements, and how to overcome barriers to taking them regularly. Researchers measured how many supplements women actually took each week, tracked changes in their health beliefs, and checked their blood iron levels before and after the intervention.
This type of study design—called quasi-experimental—is useful for testing whether an intervention works in real-world settings, though it’s not quite as rigorous as a fully randomized trial where participants are randomly assigned to groups.
Understanding what actually changes people’s health behaviors is crucial, especially in areas where healthcare resources are limited. Simply telling pregnant women to take supplements isn’t always enough—they need to understand why it matters and feel confident they can do it. This study used a proven framework for behavior change, making the findings more likely to work in similar settings
The study had good follow-up rates (177 of 182 participants completed it), used validated measurement tools, and analyzed data with appropriate statistical methods. However, because participants weren’t randomly assigned to groups, there’s a possibility that the groups differed in ways that affected results. The study was also conducted in one specific region of Afghanistan, so results may not apply everywhere
What the Results Show
The educational intervention had a strong effect on how often women took their iron-folic acid supplements. Women in the education group took supplements about 1.93 more times per week than the control group—a statistically significant difference. This means the intervention roughly doubled supplement intake frequency.
Beyond just taking the pills, the education changed how women thought about supplements. They reported significantly stronger beliefs that the supplements would help them (perceived benefits increased by 5.37 points), felt more at risk without them (susceptibility increased by 3.16 points), and felt more confident they could take them regularly (self-efficacy increased by 3.61 points). Importantly, women also reported fewer barriers to taking supplements—perceived barriers decreased by 5.99 points, suggesting the education helped them overcome real or imagined obstacles.
The intervention also helped women understand the seriousness of iron deficiency (severity scores increased by 2.18 points) and recognize reminders to take their supplements (cues to action increased by 2.58 points). All of these changes were statistically significant, meaning they weren’t due to chance.
While the study didn’t show a statistically significant change in blood hemoglobin levels (the measure of iron in blood), women in the education group did have slightly higher average hemoglobin levels (11.23 g/dL) compared to the control group (10.88 g/dL). This 0.35 g/dL difference, while not reaching statistical significance, suggests the intervention may be moving in the right direction. The lack of significant hemoglobin change might be because the study period was relatively short, or because it takes longer for improved supplement intake to translate into measurable blood changes
According to Gram Research analysis, this study aligns with existing evidence showing that educational interventions improve supplement adherence in pregnant women. However, most previous research comes from higher-income countries or different regions. This study is valuable because it demonstrates that Health Belief Model-based education works specifically in Southern Afghanistan, where healthcare resources are limited and cultural factors may affect health behaviors differently than in other settings
The study has several important limitations. First, women weren’t randomly assigned to groups, so we can’t be completely certain the education caused the improvements rather than other differences between groups. Second, the study relied on women self-reporting how many supplements they took, which may not be perfectly accurate. Third, the study only lasted about three months, which may not be long enough to see changes in blood iron levels. Finally, the findings come from one region of Afghanistan, so they may not apply to pregnant women in other areas or countries
The Bottom Line
Healthcare providers in low-resource settings should consider using Health Belief Model-based educational interventions to help pregnant women take iron-folic acid supplements consistently. The evidence strongly supports that this approach improves supplement intake (high confidence). While blood iron level improvements weren’t statistically significant in this study, the increased supplement intake suggests benefits are likely with longer follow-up (moderate confidence)
Pregnant women in Afghanistan and similar low-resource settings should care about this research, as should healthcare providers, public health officials, and organizations working to improve maternal health. The findings are most relevant to settings with similar healthcare infrastructure and cultural contexts. Pregnant women in high-income countries with well-established supplement programs may already have high adherence rates
Women in the study increased their supplement intake immediately after receiving education. However, seeing measurable improvements in blood iron levels typically takes several weeks to months of consistent supplementation, so pregnant women shouldn’t expect overnight changes in blood tests
Frequently Asked Questions
Does teaching pregnant women about iron supplements actually make them take them more?
Yes. A 2026 study of 177 pregnant women in Afghanistan found that educational sessions increased weekly supplement intake by nearly two additional doses per week. Women also reported stronger beliefs about supplement benefits and greater confidence in taking them consistently.
What’s the Health Belief Model and why does it work for supplements?
The Health Belief Model is a framework that addresses why people do or don’t follow health recommendations. It works by helping people understand disease risk, recognize treatment benefits, overcome barriers, and build confidence. For supplements, it helps pregnant women see why iron matters and feel capable of taking pills regularly.
Will taking iron supplements more often actually improve my blood iron levels?
Probably yes, though this study didn’t show statistically significant blood changes in three months. Women receiving education had slightly higher hemoglobin levels (11.23 vs 10.88 g/dL), suggesting benefits are likely with longer-term consistent use.
Can this education approach work in countries other than Afghanistan?
The study was conducted in Southern Afghanistan specifically, so results may vary in other regions. However, the Health Belief Model is used successfully worldwide, suggesting the approach could work in similar low-resource settings with appropriate cultural adaptation.
What barriers to taking supplements did the education help overcome?
The study didn’t specify individual barriers, but the education reduced perceived barriers by 5.99 points overall. Common barriers typically include forgetting, side effects, skepticism about benefits, and access issues—all addressed through the educational sessions.
Want to Apply This Research?
- Track weekly iron-folic acid supplement intake by logging each dose taken. Set a specific goal (e.g., 7 doses per week) and monitor progress weekly to maintain consistency
- Use the app to receive educational reminders about why iron and folic acid matter during pregnancy, set daily supplement-taking alarms, and track barriers you face so you can problem-solve solutions
- Log supplement intake daily, review weekly adherence rates, and periodically revisit educational content about benefits and ways to overcome barriers. Share progress with healthcare providers at prenatal visits
This research describes findings from a single study in Southern Afghanistan and should not replace personalized medical advice from your healthcare provider. Pregnant women should always consult with their doctor or midwife before starting, stopping, or changing any supplements. While this study shows educational interventions can improve supplement-taking behavior, individual results may vary based on personal health conditions, medications, and circumstances. The study did not show statistically significant changes in blood iron levels, so longer-term follow-up is needed to confirm health benefits. This information is for educational purposes and is not a substitute for professional medical diagnosis or treatment.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.