The Effectiveness of Nutritional Educational Comics in Increasing haemoglobin Level among Anemic Adolescent Girls

Objective. This study aimed to determine the effectiveness of comic-based nutrition education in increasing haemoglobin (Hb) levels in adolescent girls with anaemia by improving their energy, protein, vitamin C, calcium, iron, zinc, and folic acid intake.

Methods. A pre-test–post-test quasi-experimental design was used. Over four months, nutrition education was delivered through the comic Balanced Nutrition, Lost Anaemia as an intervention for nutritional problems. Nutritional issues were assessed via 24-hour dietary recalls and six-day food records, analyzed using Nutrisurvey 2008 and Linear Programming. Effectiveness was measured by comparing energy, folic acid, and zinc intake using paired t-tests, and protein, iron, vitamin C intake, and Hb levels using the Wilcoxon test, before and after the intervention. The study was conducted at an Islamic boarding school (pesantren) in Malang, Indonesia. A total of 84 adolescent girls with anaemia (Hb <12 g/dL) were included. Hb levels were validated via venous blood examination using cyanometry.

Results. After nutrition education, participants had significantly higher energy, protein, and vitamin C intake (P <0.001) and increased Hb levels (P <0.001). Among the participants, 69 (82.15%) achieved normal Hb levels.

Conclusion. Nutrition education using comics with colorful images facilitates understanding and application of nutritional guidance, effectively increasing nutrient intake and reducing the prevalence of anaemia among adolescent girls.