2.

Weekly Iron & Folic Acid Supplement Program for Adolescents

Goal of the Program

Long term goal - Break the inter-generational cycle of anemia Short term goal - Nutritionally improved human capital

Objective
To reduce the prevalence and severity of nutritional anemia in adolescent population (10-19 years)

Key Elements of WIFS:

1. Convergence 2. Procurement and distribution 3. Capacity building 4. Programme communication/ IEC

5. Monitoring, evaluation and knowledge management

Target Group
Implemented in both rural and urban areas & focus onSchool Based (Boys & Girls) School going adolescent girls and boys in government/ gov.aided /municipal schools from 6th to 12 th class (10-19Years) Community based through Anganwadi Center (Girls Only) Adolescent girls who out of school/Married /pregnant and lactating adolescent girls

WIFS Strategy
Administration of WIFS Screening of target groups for moderate/severe anemia & referring these cases to health facility Biannual Albendazole (400 mg) for deworming Information & counseling

Benefits - WIFS
WIFS may be a more efficient preventive approach because:Fewer side effects Easier to manage at the community level More sustainable Daily dosing of iron & folic acid reduce the risk for Neural tube defects (NTDs) Neonatal mortality Enhance maternal & infant health

Benefits - WIFS
Weekly vs daily supplementation with 60 mg of iron had similar impact, except in severity

Source-Issue-WIFS in women of reproductive age: Its role in promoting optimal maternal & child health

Conditions for Providing WIFS

Prevalence of anemia is >20% among women of reproductive age Anemia prevalence is >40% in pregnant women or children under five years of age In absence of any anemia prevalence data, dietary patterns and socioeconomic status
Source-Issue-WIFS in women of reproductive age: Its role in promoting optimal maternal & child health

Guideline on Consumption of WIFS Tablets

Take WIFS with the main meal of the day If complain of side effects take after dinner Increase intake of food rich in vitamin C Drinking of tea & coffee within an hour of consuming meal will be discouraged. Motivated to correct hygiene practices

Strategies for Prevention

Administration of free WIFS of 100mg elemental iron and 500g Folic acid to target population. Screening of target groups for moderate/severe anaemia and referring.

Coverage and Approach

Rural & urban coverage of 13 - Schools, UHC & AWC
Fixed day approach - Monday as National WIFS Day National de-worming month- February and August

Strategies for Prevention

Biannual de-worming ( Albendazole 400mg), six months apart, for control of Helminthes infestation. Information & counselling Improving dietary intake Prevention of intestinal worm infestation. Fixed day strategy under which preferably Monday to be declared as Anaemia Control day or WIFS day

Adolescent Girls Anemia Control Programme

Iron - folic acid tablets ( IFA- Large ) are given to the adolescent girls in schools , once a week ( On Monesday ) .

Vadodara Project

Background for the Project

Baseline prevalence of anemia 75% in adolescent school girls Similar among rural, tribal and urban areas Readiness to take IFA tablets to 98% level Technical and Administrative Assistance available All 426 schools covered under the program

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Department of Education
Association Of Teachers and Principal

Adolescent Anemia Control Program

UNICEF Gujarat (Technical & Financial Help) Medical College Vadodara Project Support unit (Technical Guidance and Documentation)

Department of Health & Family Welfare

Indian Medical Association Regional Deputy Director Health & Chief District Health Officer
MOs PHCs

Vadodara District District Education officer

Medical Officer of Health V. M.Corporation

Education Inspectors More than 4000 Teachers

193 Rural Schools 177 Urban Schools 56 Tribal Schools

MOs VMC

426 Total Schools

Beneficiaries in the schools More than 65000 Adolescent Girls

Project Inputs
Once a week supervised IFA tablet IEC for girls, teachers and parents Training & Logistics Monitoring Individual, Class (weekly), School SVS District level

Prevalence of Anemia at Different Hb. Cut off Points Before and After Intervention
80 70 60 50 40 30 20 10 0
Cumulative Percentage

Before

After
57.1 39.7

74.7

53.2 35.6

16.7 21.6 1.6 0.5 70 7.9 100 110 Hemoglobin gm/L

115

120

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Positive Lessons

Easy, doable and successful program. Replicable and effective to control anemia Effective in reducing anemia by 20% with improvement in hemoglobin for 82% of girls in 17 months of the intervention period Compliance for the schoolgirls to went up to 90%.... In 2003 in Vadodara district.
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Thank You..
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