The Effect of Health Education Using a Flip Chart on Compliance with Fe Tablet Consumption in Pregnant Women in the Working Area of the South City Health Center
Abstract
Compliance of pregnant women in taking Fe tablets is an important effort in preventing anemia during pregnancy, but the level of compliance is still relatively low due to the lack of understanding of pregnant women regarding the benefits and proper ways to consume Fe tablets. Health education using flip chart media is one of the methods that can increase understanding and encourage changes in compliance behavior. This study aims to determine the effect of health education using flip sheets on compliance with Fe tablet consumption in pregnant women in the working area of the South City Health Center. The results of the Wilcoxon test obtained a p value = 0.000 (p < 0.05), which shows a significant influence of health education using flip sheets on compliance with Fe tablet consumption in pregnant women. It was concluded that health education using flip sheets was effective in increasing compliance with Fe tablet consumption. It is recommended that the South City Health Center optimize the use of flip sheet media in antenatal care services.
References
Aida, M. (2025). Overview of Pregnant Women's Behavior in the Consumption of FE Tablets in the Practice of Independent Midwives BDN Y (Doctoral dissertation, Bhakti Kencana University).
Aisyah, S., & Andriani, A. (2023). The effectiveness of counseling using flip sheet and power point media on increasing the knowledge of adolescent girls about anemia at SMAN 11 Banda Aceh. NASUWAKES: Journal of Scientific Health, 16(2), 102-109.
Akili, N. L., Wulansari, I., & Salawali, S. H. (2025). The Relationship of Family Support and Anxiety with Chemotherapy Adherence in Breast Cancer Patients. Gorontalo Journal of Public Health, 8(1), 1-9.
Asmin, E., Salulinggi, A., Titaley, C. R., & Bension, J. (2021). The relationship between knowledge and compliance of pregnant women consuming blood-boosting tablets with the incidence of anemia in South Leitimur and Ambon Bay Districts. Journal of Community Health Epidemiology, 6(1), 229–236.
Astuti, H. (2022). The Effect of Education Using E-Booklets on Knowledge and Compliance of Taking Iron Tablets in Pregnant Women in Kapanewon Samigaluh (Doctoral Dissertation, Polytechnic of the Ministry of Health, Yogyakarta).
Ayupir, A. (2021). Health Education and Iron (Fe) Tablet Therapy for Hemoglobin in Adolescent Women. HIGEIA Journal Of Public Health Research And Development, 5(3), 441–451.
Azzahra, L., & Darmiyanti, A. (2024). The Role of Educational Psychology in the Learning Process in the Classroom for Diverse Students. Journal of Psychology, 1(4), 23.
Baruroh, D., Komang Suwita, I., & Aroni, H. (2022). Before and after education using flipbooks on knowledge about anemia in pregnant women in the working area of the Jatibening Health Center, Situbondo Regency. Journal of Nutrition, 1(2), 29–35.
Dolo, L. S., Yusuf, A., & Azis, R. (2021). Analysis of factors affecting the adherence to treatment of elderly people with hypertension during the covid-19 pandemic at the Bulili Health Center, Palu City. PREPOTIF: Journal of Public Health, 5(2), 828-842.
Dolorosa, M., Rosida, Nikma Alfi, & Utami, ratih dwilestari praise (2023). The Effect of Health Education Using Audiovisual Media on the Level of Knowledge and Attitude of Parents in Handling Fever Seizures in Children at Posyandu RW 05 Keprabon. Kusuma Husada University Surakarta.
Elmika, R., Simbolon, D., & Yuliantini, E. (2018). Nutrition Education with CAMIL is as Effective as Leaflets in Anemia Prevention Behavior in Pregnant Women. Journal of Health Science and Technology, 6(1), 82-93.
Ernawati, A. (2022). Health promotion media to increase maternal knowledge about stunting. Journal of Research and Development: Information Media for Research, Development and Science and Technology, 18(2), 139–152.
Ersila, W., & ST, S. (2024). The role of cadres in optimizing food safety in pregnant women. Challenges and Problems of Public Health Sciences, 27.
Fahmie, M. A. S. (2024). Overview of Knowledge, Iron Intake and Habits of Consuming Blood Supplement Tablets in Adolescent Girls at SMA Negeri 14 Bandar Lampung in 2024 (Doctoral Dissertation, Polytechnic of the Ministry of Health, Tanjungkarang).
Garpenassy, M., Saudah, N., & Prasastia, C. (2024). Overview of physiological changes in pregnant women in the 1st trimester in the working area of the Puri Health Center, Mojokerto Regency.
Hakimia S, H., Albertus, J., Panjongko, J., & Erna P, Y. (2023). Counseling on Fe Tablet Consumption Using Educational Videos for Young Women at SMPN 17 Semarang. Proceedings of the Public Health Seminar, 1 (October), 252–257.
Hamranani, S. S. T., Permatasari, D., & Murti, S. A. (2020). Factors that affect the adherence to taking Fe tablets in adolescents. Journal of Professional Nursing Research, 2(5474), 1333–1336.
Handayani, R. (2023). The Effect of Nutrition Counseling on Anemia Using Video Media on Knowledge and Compliance of Taking Blood Supplement Tablets in School-Age Adolescents in Batu Ampar District. Palangkaraya Health Polytechnic, 1(1), 1–14.
Hidayah, E. R. (2020). The Effectiveness of Nutrition Counseling through Rotary Wheels and Leaflets on Balanced Nutrition Knowledge and Attitudes in Elementary School Students (Doctoral Dissertation, Polytechnic of the Ministry of Health Yogyakarta).
Inayah, M., Sari, E. P., Rahmawati, E., & Aisyah, S. (2024). Factors related to compliance with consuming Fe tablets in pregnant women at PMB Husniyati, Palembang City. Journal of Indra Husada Health, 12(2), 96-101.
Jayul, A., & Irwanto, E. (2020). The online learning model is an alternative to the physical education learning process in the midst of the Covid-19 pandemic. Journal of Recreational Health Education, 6(2), 190-199.
Ministry of Health of the Republic of Indonesia. (2021). Guidelines for the Prevention and Control of Anemia in Pregnant Women. Jakarta: Ministry of Health of the Republic of Indonesia.
Ministry of Health of the Republic of Indonesia. (2022). Technical Instructions for Giving Blood Supplement Tablets for Pregnant Women. Directorate of Community Nutrition, Directorate General of Public Health. Jakarta: Ministry of Health of the Republic of Indonesia.
Laikingis, E. A. (2025). Study on the Implementation of Specific Nutrition Interventions in Naitae Village, West Fatuleu District in 2023. Antigen: Journal of Public Health and Nutrition Sciences, 3(2), 174-185.
Laili, N., & Tanoto, W. (2021). The public health belief model in the implementation of the Covid-19 vaccine. Scientific Journal of Nursing Health, 17(3).
Ludin, P. F., Wulandari, R. C. L., & Meiranny, A. (2023). Compliance of Pregnant Women in Taking Fe-Tablets: Literature Review. Indonesian Health Promotion Publication Media (MPPKI), 6(10), 1933-1939.
Maulida, L. S. (2020). The Effect of the Use of Viesif Media (Exclusive Breastfeeding Education Video) in Counseling on the Knowledge and Attitudes of Pregnant Women in the Working Area of the Umbulharjo 1 Health Center (Doctoral dissertation, Polytechnic of the Ministry of Health, Yogyakarta).
Maulida, N. I., Fitrianingtyas, R., & Sari, M. P. (2023). The Effect of Education on Knowledge, Attitudes, Consumption Behavior of Blood Supplement Tablets and Hemoglobin Levels of Pregnant Women in the Second Trimester (Doctoral dissertation, dr. SOEBANDI University).
Maysaropah, S., Noviyani, E. P., & Ciptiasrini, U. (2024). Effectiveness of Egg and Fe Tablet Consumption on Increasing Hemoglobin Levels in Adolescent Girls Experiencing Anemia at the Ciputat Health Center in 2023. Quantum Wellness: Journal of Health Sciences, 1(4), 64-70.
Muhammadiah, M. U., Tamam, M. B., Wijanarko, T., Mahendika, D., Mas'ud, I. A., Yufrinalis, M., & Setiadi, B. (2023). Empowering Youth for a Brighter Future: Providing Education, Mentorship, Employment Opportunities, and Mental Health Support. Journal of Western Science, 2(05), 354-363.
Mulyati, N., Makmun, I., & Cahyaningtyas, D. K. (2025). The Relationship between Nutritional Status and Hemoglobin Level on the Incidence of Anemia in Pregnant Women in the Third Trimester. Qamarul Huda Health Journal, 13(1), 41-49.
Mursaha, S., & Ryadinency, R. (2025). The Effect of Education Using Flipchart Media on Knowledge and Compliance Actions for Consumption of Blood Supplement Tablets to Prevent Anemia in Pregnant Women at the North Wara City Health Center. Indonesian Journal of Science and Public Health, 2(1), 201-209.
Mursaha, S., & Ryadinency, R. (2025). The Effect of Education Using Flipchart Media on Knowledge and Compliance Actions for Consumption of Blood Supplement Tablets to Prevent Anemia in Pregnant Women at the North Wara City Health Center. Indonesian Journal of Science and Public Health, 2(1), 201-209.
Mutalazimah, M., Isnaeni, F. N., Mardiyati, L., Pujiani, K. N., Bella, S., Study Program, P., Nutrition, I., & Health, I. (2021). Education on the Prevention of Disturbances Due to Iodine Deficiency (GAKY) Based on Learning Media Flipchart Article Info. LPM Journal of Medicine, 24(4), 753–754.
Novianti, S. (2024). Behavioral Factors Affecting the Consumption of Fe Tablets and the Incidence of Anemia in Pregnant Women at the Karanganyar Health Center, Tasikmalaya City. Journal of Nusantara Health and Midwifery, 2(1), 1-5.
Novianti, S. (2024). Behavioral Factors Affecting the Consumption of Fe Tablets and the Incidence of Anemia in Pregnant Women at the Karanganyar Health Center, Tasikmalaya City. Journal of Nusantara Health and Midwifery, 2(1), 1-5.
Nur (2025). The Relationship of Knowledge About Anemia with Blood Supplement Tablet Consumption Compliance in Pregnant Women in the Second Trimester in the Working Area of the Pamboang Health Center (Doctoral Dissertation, University of West Sulawesi).
Nur Azizah, F., Carlian, E., & Pratiwi, W. (2022). The Effectiveness of the Use of Flip Chart Media on the Knowledge of Pregnant Women in the Consumption of Fe tablets. Journal of Edubase, 3(2), 101–108. Ibn Khaldun University Bogor.
Nurbaya, N., Haji Saeni, R., & Irwan, Z. (2022). Improving the knowledge and skills of Posyandu cadres through educational and simulation activities. JMM (Journal of Independent Society), 6(1), 678.
Nurjaman, A. (2021). Improving critical thinking skills in Islamic religious education learning through the implementation of the "Assure" learning design. Publisher Adab.
Prihatiningsih, T., Wulandari, R. D., & Shaluhiyah, Z. (2019). Adherence to iron supplementation amongst pregnant mothers in Surabaya, Indonesia. Asia Pacific Journal of Clinical Nutrition, 28(3), 543–550.
Priyanto, S., & Irawati, D. (2020). anemia in pregnancy. E-Book Publisher Stikes Majapahit.
Putri, A. A., & Salsabila, S. (2023). The Impact of KEK Disease on Pregnant Women. Student Scientific Creativity Journal, 1(3), 246-253.
Putri, C. C. A. (2025). The Influence of Health Education through Animated Videos on Pregnant Women's Knowledge of Exclusive Breastfeeding in the Working Area of the Margorejo Health Center, Pati Regency (Doctoral dissertation, Sultan Agung Islamic University, Semarang).
Putri, D. (2025). Literature Review of Behavioral Barriers to Compliance in Iron Tablet Consumption in Pregnant Women. VitaMedica: Journal of General Health, 3(3), 405-415.
Putri, D. (2025). Literature Review of Behavioral Barriers to Compliance in Iron Tablet Consumption in Pregnant Women. VitaMedica: Journal of General Health, 3(3), 405-415.
Putri, D. T. (2024). The Effect of Video Media (Audio-Visual) on Fe Tablets on Knowledge and Compliance in Consuming Blood Supplement Tablets in Pregnant Women at the Bumi Agung Runyai Health Center, Way Kanan Regency in 2024 (Doctoral dissertation, Polytechnic of the Ministry of Health, Tanjungkarang).
Putri, D., Diarti, D. P., Kartika, R. C., Ratri, P. R., & Olivia, Z. (2024). The Effectiveness of Counseling-Based Nutrition Education Using Flipchart Media on Knowledge of Anemia in Pregnant Women. HARENA: Journal of Nutrition, 4(2), 75-80.
Putri, D., Diarti, D. P., Kartika, R. C., Ratri, P. R., & Olivia, Z. (2024). The Effectiveness of Counseling-Based Nutrition Education Using Flipchart Media on Knowledge of Anemia in Pregnant Women. Journal of Economics, 5(1), 101-110.
Putri, E. M. R. (2023). The Relationship between Motivation and Compliance with Taking Blood Supplement Tablets in Pregnant Women with Anemia at the Nguter Sukoharjo Health Center (Doctoral dissertation, Kusuma Husada University, Surakarta).
Rangkuti, N. A., & Harahap, M. A. (2020). The relationship between knowledge and age of pregnant women and high-risk pregnancies at the labuhan rasoki health center. Journal of Education and Development, 8(4), 561931.
Raza, S., Hameed, R., Batool, S., et al. (2023). Methods used to assess adherence to iron supplementation in pregnant women: A systematic review. Nutrients, 15(1), 140.
Retnowati, Y., Gusriani, G., & Umami, N. (2023). Education for Pregnant Women (Edumil) to Prevent Anemia and Stunting. Borneo Community Health Service Journal, 3(2), 67-71.
Rustiawan, A., & Pratiwi, A. (2022). Evaluation of the program of giving blood supplement tablets to pregnant women at the Gedongtengen Health Center. Scott, 61-71.
Safitri, H., Norhapifah, H., Anam, K., & Masyita, G. (2025). The Effect of Fe Tablet Consumption Compliance on the Incidence of Anemia in Pregnant Women in the Third Trimester at the Gunung Sari Ulu Health Center, Balikpapan City. Innovative: Journal Of Social Science Research, 5(2), 3539-3555.
Safitri, R. (2024). The Relationship between Internal Motivation and Compliance with Consuming Anti-Hypertension Drugs (OAH) in the Elderly at the Puskesmas Bersama Malang City (Doctoral dissertation, STIKes Panti Waluya Malang).
Salsabila (2023). Overview of Knowledge and Attitudes as well as Teachers' Support in Consuming Fe Tablets in Adolescent Women at Mts Nurul Huda, Pringsewu Regency (Doctoral Dissertation, Polytechnic of the Ministry of Health, Tanjungkarang).
Sitepu, S. A., Purba, T. J., Sari, N. M., Sitepu, M. S., & Hayati, E. (2021). The impact of anemia on pregnant women and childbirth. Journal of Community Service of Putri Hijau, 1(4), 47-53.
Sopiana (2023). Development of Interactive E-LKPD Based on Liveworksheet on Flat Building Materials for Class IV Elementary School (Doctoral dissertation, Hamzanwadi University).
Sugihastuti, L., Sugesti, R., & Yolandia, R. A. (2022). The Relationship between Tea Drinking Habits, FE Tablet Consumption Compliance and Nutritional Status on the Incidence of Anemia in Pregnant Women. Indonesian Journal of Interprofessional Health, 2(1), 203-210.
Thirunavukkarasu, B., Kuppusamy, M., & Kar, S. S. (2023). Assessment of adherence to oral iron supplementation guidelines in patients with iron deficiency anemia: A cross-sectional study. Cureus, 15(6), e39494.
Wickramasinghe, N. D., Gunathunga, M. W., Peiris, T. S., & Hemachandra, N. A. (2020). Maternal compliance to recommended iron and folic acid supplementation in pregnancy, Sri Lanka: A hospital-based cross-sectional study. BMC Pregnancy and Childbirth, 20, 506.
Widhiastuti, R., Pratwi, A., Yani, M., Febriani, Z., Muslim, F. J., Anastasia, D. Z., & Aryani, B. T. (2025). Education on the Prevention of Anemia in Pregnant Women in Coastal Areas: Strategies to Improve Maternal Health of Fishing Communities. Journal of Community Service of the Nation, 2(12), 5746-5749.
Widyaningsih, R., & Pratiwi, R. D. (2022). The Effectiveness of Health Education on Increasing Knowledge and Compliance of Pregnant Women in Consuming Fe Tablets at the Karanganyar Health Center. Indonesian Journal of Public Health Sciences, 3(1), 45–52.
Wigati, A., Nisak, A. Z., & Azizah, N. (2021). The incidence of anemia is based on the adherence of pregnant women in the consumption of Fe tablets. Indonesia Journal of Midwifery, 5(1), 1-7.
World Health Organization. (2021). The Global Prevalence of Anemia in Women of Reproductive Age and Pregnant Women: WHO Report 2021. Geneva: WHO Press.
Wulandari, S., Sanjaya, D. M., & Yulastini, F. (2025). Education on the Compliance of Blood Supplement Tablet (Fe) Consumption as an Effort to Prevent Anemia in Pregnant Women. SAMBARA: Journal of Community Service, 3(2), 260-267.
Wulandini, P. (2020). The Relationship of Pregnant Women's Knowledge About Anemia with Compliance with Consuming Fe Tablets in the Puskesmas RI Karya Wanita Pekanbaru Area. Tower of Knowledge: Journal of Research and Scientific Studies, 14(2).
Yulinda, F., & Sari, A. (2022). The Effectiveness of Back-to-Back Media Education on Protein, Iron, and Hemoglobin Intake in Anemic Adolescent Girls at MAN 2 Samarinda. Journal of Nutrition, 8(3), 210-218.
Yustanti, S. V. (2020). Making a Nutrition Flipchart for Hypertensive Patients as Nutrition Education at the Situbondo Regency Auxiliary Health Center (Doctoral dissertation, Jember State Polytechnic).
Zakiyyah, N., Rahayu, S., Wulandari, R., & Utami, I. T. (2025). The relationship between adolescent knowledge and adherence to Fe tablet consumption with the incidence of anemia in Mts. 3 (August 2024), 63–78.
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