The Effect of Fresh Moringa Leaf Consumption During Pregnancy on Maternal Hemoglobin Level in Southern Ethiopia: Multilevel Analysis of a Comparative Cross-Sectional Study

Purpose: Anemia, especially iron-deficiency anemia during pregnancy, significantly impacts maternal health, fetal growth, and development. Moringa leaf is an iron-rich food that can overcome anemia, but there is a lack of evidence on the association between fresh moringa leaf consumption and maternal hemoglobin level during pregnancy. The aim of this study is to test the effect of fresh moringa leaf consumption during pregnancy on maternal hemoglobin levels in southern Ethiopia. Methods: A community-based comparative cross-sectional study was conducted from May to June 2022 among 230 fresh moringa leaf consumers and 230 non-consumers pregnant women. Data were collected using an interviewer-administered structured questionnaire and hemoglobin level was determined by HemoCue Hb 301. Multivariate multilevel linear regression models were fitted using Statistical Software for Data Science (STATA) version 14. Results: The overall mean hemoglobin level among pregnant women was 11.76 g/dl & PLUSMN; 1.47 [12.06 g/dl & PLUSMN; 1.22 among fresh moringa leaf consumers and 11.45 g/dl & PLUSMN; 1.64 among non-consumers] with a significant coefficient of association (13) of 0.90 g/dl [13 = 0.90 g/dl, 95% CI: 0.54, 1.27]. A number of under-five children, bleeding during the current pregnancy, male-headed household, and current antenatal care visit were the individual-level factors. Distance from the nearest health facility and urban dweller was identified as the community-level factor associated with maternal hemoglobin level during pregnancy. Conclusion: This study showed that the consumption of fresh moringa leaf during pregnancy increases the level of hemoglobin. So policymakers and maternal and child health program managers need to target moringa tree scale-up and encourage fresh moringa leaf consumption during pregnancy, but its use needs additional rigorous clinical trials. In addition to this, mark the above factors in their efforts to increase maternal hemoglobin levels during pregnancy.