Improving iron folic acid consumption through interpersonal communication: Findings from the Reduction in Anemia through Normative Innovations (RANI) project.

The study was done in rural villages in Angul, Odisha, so results may not apply to other parts of India or to communities where women work long hours away from home. The intervention components were delivered together: group learning sessions, videos followed by discussions, and monthly hemoglobin testing with community discussions. The study cannot show which component mattered. Anemia-specific communication was not measured at baseline, so the study could not compare change in this outcome between intervention and control communities. Most key information was self-reported, and women in the intervention arm knew the goals, so they may have reported more communication or supplement use to please interviewers. The general health communication measure was limited to health-related conversations, not all social interactions, and men's communication was not recorded. Other mass media campaigns may have contributed, although randomization should make this similar in both arms. The control and intervention groups differed slightly in mean age at baseline, 31.1 years in treatment versus 30.4 years in control.

The project was funded by the Bill and Melinda Gates Foundation to George Washington University. The authors declare no conflicts of interest.

Do not conclude that interpersonal communication alone caused the increase in iron folic acid use. The intervention also included group learning sessions, videos followed by discussions, and monthly finger-prick hemoglobin testing with community discussions, so the contribution of any single component cannot be separated. Do not treat the anemia-specific communication result as a measured change over time, because it was not assessed at baseline.