scholarly journals Effect of long-term intermittent supplementation with multiple micronutrients compared with iron-and-folic acid supplementation on Hb and micronutrient status of non-anaemic adolescent schoolgirls in rural Bangladesh

2012 ◽  
Vol 108 (8) ◽  
pp. 1484-1493 ◽  
Author(s):  
Faruk Ahmed ◽  
Moududur R. Khan ◽  
Mohammad Akhtaruzzaman ◽  
Rezaul Karim ◽  
Gail Williams ◽  
...  
Keyword(s):  
Folic Acid ◽  
Adolescent Girls ◽  
Folic Acid Supplementation ◽  
Double Blind ◽  
Rural Bangladesh ◽  
Micronutrient Status ◽  
Acid Status ◽  
Iron And Folic Acid ◽  
Hb Concentration

The present study examined whether long-term supplementation with once- and twice-weekly multiple micronutrients (MMN-1 and MMN-2) can improve Hb and micronutrient status more than twice-weekly Fe–folic acid (IFA-2) supplementation in non-anaemic adolescent girls in Bangladesh. An equal number of 324 rural schoolgirls aged 11–17 years were given MMN-1 or MMN-2 or IFA-2 supplements for 52 weeks in a randomised, double-blind trial. Blood samples were collected at baseline, and at 26 and 52 weeks of supplementation. The girls receiving IFA-2 supplements were more likely to be anaemic than the girls receiving MMN-2 supplements for 26 weeks (OR 5·1, 95 % CI 1·3, 19·5; P = 0·018). All three supplements reduced Fe deficiency effectively. Both the MMN-1 and MMN-2 groups showed significantly greater improvements in vitamins A, B2 and C status than the girls in the IFA-2 group, as might be expected. Receiving a MMN-1 supplement was found to be less effective than MMN-2 supplement in improving Fe, vitamins A, B2 and folic acid status. Receiving micronutrient supplements beyond 26 weeks showed little additional benefit in improving micronutrient status. In conclusion, given twice-weekly for 26 weeks, MMN supplements can improve micronutrient status effectively with no significant increase in Hb concentration compared with IFA supplements in non-anaemic Bangladeshi adolescent girls. However, it significantly reduces the risk of anaemia. Before any recommendations can be made, further research, including into cost-effectiveness, is needed to see whether MMN supplementation has any additional longer-term health benefits over that of IFA supplementation in this population.

scholarly journals Population-level effective coverage of adolescent weekly iron and folic acid supplementation is low in rural West Bengal, India

2020 ◽  
Vol 23 (15) ◽  
pp. 2819-2823
Author(s):  
Christopher R Sudfeld ◽  
Rajesh Kumar Rai ◽  
Anamitra Barik ◽  
Joseph J Valadez ◽  
Wafaie W Fawzi
Keyword(s):  
Folic Acid ◽  
Adolescent Girls ◽  
West Bengal ◽  
Folic Acid Supplementation ◽  
Cross Sectional Survey ◽  
Effective Coverage ◽  
Acid Supplementation ◽  
School Girls ◽  
Iron And Folic Acid ◽  
Out Of School

AbstractObjective:To assess the coverage of the adolescent weekly iron and folic acid supplementation (WIFS) programme in rural West Bengal, India.Design:We conducted a population-based cross-sectional survey of intended WIFS programme beneficiaries (in-school adolescent girls and boys and out-of-school adolescent girls).Setting:Birbhum Health and Demographic Surveillance System.Participants:A total of 4448 adolescents 10–19 years of age participated in the study.Results:The percentage of adolescents who reported taking four WIFS tablets during the last month as intended by the national programme was 9·4 % among in-school girls, 7·1 % for in-school boys and 2·3 % for out-of-school girls. The low effective coverage was due to the combination of large deficits in WIFS provision and poor adherence. A large proportion of adolescents reported they were not provided any WIFS tablets in the last month: 61·7 % of in-school girls, 73·3 % of in-school boys and 97·1 % of out-of-school girls. In terms of adherence, only 41·6 % of in-school girls, 38·1 % of in-school boys and 47·4 % of out-of-school girls reported that they consumed all WIFS tablets they received. Counselling from teachers, administrators and school staff was the primary reason adolescents reported taking WIFS tablets, whereas the major reasons for non-adherence were lack of perceived benefit, peer suggestion not to take WIFS and a reported history of side effects.Conclusions:The effective coverage of the WIFS programme for in-school adolescents and out-of-school adolescent girls is low in rural Birbhum. Integrated supply- and demand-side strategies appear to be necessary to increase the effective coverage and potential benefits of the WIFS programme.

scholarly journals Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India

2012 ◽  
Vol 16 (2) ◽  
pp. 377-380 ◽  
Author(s):  
Tapas Chakma ◽  
Pinnamneni Vinay Rao ◽  
Pradeep Kumar Meshram
Keyword(s):  
Folic Acid ◽  
Adolescent Girls ◽  
Compliance Rate ◽  
Folic Acid Supplementation ◽  
Madhya Pradesh ◽  
High Compliance ◽  
Factors Associated ◽  
Blister Pack ◽  
Iron And Folic Acid

AbstractObjectiveTo study the feasibility of iron and folic acid (IFA) supplementation among tribal adolescent girls and identify factors associated with high compliance.DesignIntervention study with IFA supplementation among tribal adolescent girls of Bijadandi block, Mandla district, Madhya Pradesh, India. Girls (n 274) from twelve villages randomly selected out of 100 potential villages received daily tablets containing iron (iii) hydroxide polymaltose complex equivalent to 100 mg of elemental Fe and 350 μg of folic acid (commercially available as Feritas tablets, marketed by Intas Pharmaceutical Ltd, India). IFA was given for 100 d and supervised by school teachers and anganwadi workers. Compliance was measured using cards and interviews.SettingCommunity-based iron supplementation programme.SubjectsTribal adolescent girls aged 12–19 years.ResultsIn total 233 girls completed the study. Prevalence of anaemia was reduced from 94 % at baseline to 69 % after the intervention. Compliance rate (>80 tablets) was 89 %. Minor side-effects were reported by three girls, yet they consumed >80 tablets. Factors associated with compliance included fasting during the local festival (χ2 = 72·74, df 3; P < 0·0001) and counselling (χ2 = 72·74, df 3; P < 0·0001). Other qualitative factors like social mobilization, timely supply of tablets, quality of tablets (blister pack) and availability of teachers and anganwadi workers were also associated with the compliance and feasibility.ConclusionsHigh compliance indicates that IFA supplementation with tablets is feasible among the tribal adolescent girls of Bijadandi block, Mandla district.

scholarly journals The Adolescent Girls’ Anaemia Control Programme: a decade of programming experience to break the inter-generational cycle of malnutrition in India

2013 ◽  
Vol 16 (9) ◽  
pp. 1667-1676 ◽  
Author(s):  
Víctor M Aguayo ◽  
Kajali Paintal ◽  
Gayatri Singh
Keyword(s):  
Folic Acid ◽  
Adolescent Girls ◽  
Scale Up ◽  
Scaling Up ◽  
Folic Acid Supplementation ◽  
Control Programme ◽  
Lessons Learned ◽  
Nutrition Interventions ◽  
Critical Elements ◽  
Iron And Folic Acid

AbstractObjectiveTo document the scale-up of India's Adolescent Girls’ Anaemia Control Programme following a knowledge-centred framework for scaling up nutrition interventions and to identify the critical elements of and lessons learned from a decade of programme experience for the control of anaemia in adolescent girls.DesignWe reviewed all articles, programme and project reports, and baseline and endline assessments published between 1995 and 2012 regarding the control of anaemia through intermittent iron and folic acid supplementation; key programme specialists and managers were interviewed to complete or verify information wherever needed.SettingIndia.SubjectsAdolescent girls.ResultsThe scale-up of India's Adolescent Girls’ Anaemia Control Programme followed a knowledge-centred programme cycle comprising five phases: Evidence, Innovation, Evaluation, Replication and Universalization. By the end of 2011, the programme was being rolled out in thirteen states and was reaching 27·6 million adolescent girls of whom 16·3 million were school-going girls and 11·3 million were out-of-school girls. Building on the critical elements of and lessons learned from the programme, the Government of India launched in 2012 the national Weekly Iron and Folic Acid Supplementation (WIFS) programme to universalize the benefits of anaemia control to the overall population of Indian adolescents.ConclusionsThe Adolescent Girls’ Anaemia Control Programme in India provides a good example of how a knowledge-centred approach can successfully guide the scaling up of public health nutrition interventions and facilitate intersectoral convergence among different government departments and development partners to break the inter-generational cycle of undernutrition and deprivation.

scholarly journals Compliance with Weekly Iron and Folic Acid Supplementation and Its Associated Factors among Adolescent Girls in Tamale Metropolis of Ghana

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
S. Dajaan Dubik ◽  
Kingsley E. Amegah ◽  
Amshawu Alhassan ◽  
Louis N. Mornah ◽  
Loveland Fiagbe
Keyword(s):  
Logistic Regression ◽  
Folic Acid ◽  
Adolescent Girls ◽  
Associated Factors ◽  
School Health ◽  
Folic Acid Supplementation ◽  
Good Knowledge ◽  
Acid Supplementation ◽  
Tamale Metropolis ◽  
Iron And Folic Acid

Background. In Ghana, anaemia is a severe public health problem among adolescent girls. In an attempt to deal with this phenomenon, Ghana Ministry of Health in collaboration with other development partners developed and launched weekly iron and folic acid supplementation program for adolescent girls in Ghanaian junior high schools. Therefore, the main aim of this study was to determine the level of compliance with iron and folic acid supplementation (IFAS) and its associated factors among adolescent girls in the Tamale Metropolis of Ghana. Methods. A cross-sectional study was conducted among 424 randomly sampled adolescent girls in the Tamale Metropolis of Ghana from April to July 2019 using an interviewer-administered structured questionnaire. Twenty school health coordinators were purposively selected to answer questions on the challenges they face in implementing the IFAS program at the school level. Bivariate logistic regression and multivariate logistic regression were used to determine associations and strength of associations, respectively, at a significant threshold of p<0.05. Results. Compliance with the IFAS was low (26.2%). Adolescent girls who were aware of anaemia (AOR = 3.57 (95% CI: 1.96, 6.51) p<0.01), had good knowledge of anaemia (AOR = 1.82 (95% CI: 1.17, 2.81) p=0.01), and had good knowledge of the IFAS program (AOR = 2.29 (95% CI: 1.47, 3.57) p<0.01) were significantly associated with compliance with the IFAS. The majority (60%) of the adolescent girls have ever missed taking the iron and folic acid (IFA) tablet because it was not issued to them by the teacher’s concern while about 48.3% (169) of the adolescent girls are taking the tablet because it prevents anaemia. Adolescent girls perceiving the tablet as family planning medicine (88.8%) and unavailability of water in classrooms (18.8%) were cited as the major challenges by school health coordinators. Conclusion. Compliance with the IFAS among adolescent girls was low. Level of education and occupation of mothers of adolescent girls, awareness on anaemia, and good knowledge of anaemia and of the IFAS program were significant predictors of compliance with the IFAS. Educating the adolescent girls on anaemia and benefits of the IFAS, constant supply of the IFA tablet, and engaging parents of the adolescent girls on the program will help improve the compliance level of the adolescent girls with the IFAS.

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