Promoting Interpersonal Communication for Anemia Reduction: Findings From the Reduction in Anemia Through Normative Innovations (RANI) Project

More than half of women of reproductive age in India are anemic, a condition treatable through regular iron folic acid uptake. Previous studies have shown the importance of participatory interactions and interpersonal communication in improving women’s health. The Reduction in Anemia through Normative Innovations (RANI) study investigated the effect of general health and anemia- specific interpersonal communication on improving iron folic acid use among women of reproductive age. The RANI Project is a cluster randomized trial that collected longitudinal data from control (N = 1896) and treatment (N = 1898) communities in Odisha, India at baseline and at midline, 6 months later. Structural equation models assessed the intervention effect on iron folic acid use through both, general health interpersonal communication focused on “the health of women in the community” and anemia-specific interpersonal communication. Compared to the control arm, iron folic acid use significantly increased in the treatment arm; health communication and anemia-specific communication also increased. The impact of the intervention on iron folic acid use was mediated through anemia-specific interpersonal communication (p < 0.001). The effect of general health interpersonal communication on iron folic acid uptake was only manifest in the indirect pathway, with anemia-specific interpersonal communication serving as the mediator. Many rural Indian women do not have access to health information through mass and social media thus interventions need to rely on novel ways of disseminating health information. These results indicate that interpersonal communication can serve this function as increased interpersonal communication among participants, resulted in improved iron folic acid use. These findings also emphasize the importance of distinguishing between general interpersonal communication and health topic-specific interpersonal communication. Strategic use of targeted interpersonal communication in promoting behavior change is a viable strategy in increasing iron folic acid use, leading to anemia reduction. This study was supported by a grant from The Bill and Melinda Gates Foundation.