Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
    Users Online: 346
Home Print this page Email this page Small font size Default font size Increase font size


 
 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 28-33

Factors influencing weekly iron folic acid supplementation programme among school children: Where to focus our attention?


1 Department of Community Medicine, Vinayaka Missions Kirupananda Variyar Medical College, Salem, Tamil Nadu, India
2 Department of Community Medicine, Tripura Medical College and Dr. BRAM Teaching Hospital, Agartala, Tripura, India
3 Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India
4 Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India

Date of Web Publication23-May-2016

Correspondence Address:
Shib Sekhar Datta
Department of Community Medicine, Tripura Medical College and Dr. BRAM Teaching Hospital, Agartala - 799 014, Tripura
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-0521.182863

Rights and Permissions
  Abstract 

Background: Iron-deficiency anemia is a public-health concern in developing countries. Weekly iron folic acid (IFA) consumption can significantly reduce the prevalence of nutritional anemia among adolescents. The government of India launched the Weekly IFA Supplementation (WIFS) programme in 2012 to the reduce prevalence and severity of nutritional anemia among adolescent population. Objectives: To study factors influencing WIFS programme at selected schools in rural Puducherry and to explore perceptions regarding WIFS programme qualitatively. Methodology: A school-based cross-sectional study was conducted during July-December 2013 in selected government schools of Bahour commune in rural Puducherry. After obtaining permission from school headmasters, a total of 240 school children (both boys and girls from 9 th to 10 th standards) were interviewed. Pretested pro forma in local language was used, and multistage sampling technique was followed for quantitative data collection. Qualitative information was collected through 6 focus group discussions. Data were analyzed using SPSS version 17.0 (SPSS Inc., Chicago, Illinois, USA) and Anthropac 4.98.1/X software. Results: About 47.2% children were consuming IFA tablets regularly, 52.8% were consuming occasionally or rarely. Stomach pain (41.7%), nausea and vomiting (24.5%), and disliking of tablets (22.3%) were predominant causes for IFA tablet refusal. Reduced fatigue (43.7%), increased appetite (41.1%), and improved concentration (37.7%) were cited as major benefits of IFA tablets. Gender, type of family, parents' education, and occupation were not associated with consumption of IFA tablets. Girls perceived that IFA tablets causes weight gain, and may have side effects such as bad taste, pain abdomen, and giddiness. Boys considered that these tablets were not necessary and have side effects such as stomach pain and nausea and often throw away tablets. Occasional unavailability of IFA tablets, poor awareness regarding importance of IFA tablets, and casual programme implementation were other important factors. Conclusion: Creating awareness regarding the importance of IFA supplementation and careful programme implementation including regular supply of IFA tablets should be considered to make WIFS programme successful.

Keywords: Adolescent, anemia, iron folic acid, school children


How to cite this article:
Priya S H, Datta SS, Bahurupi YA, Narayan K A, Nishanthini N, Ramya M R. Factors influencing weekly iron folic acid supplementation programme among school children: Where to focus our attention?. Saudi J Health Sci 2016;5:28-33

How to cite this URL:
Priya S H, Datta SS, Bahurupi YA, Narayan K A, Nishanthini N, Ramya M R. Factors influencing weekly iron folic acid supplementation programme among school children: Where to focus our attention?. Saudi J Health Sci [serial online] 2016 [cited 2022 Jan 24];5:28-33. Available from: https://www.saudijhealthsci.org/text.asp?2016/5/1/28/182863


  Introduction Top


Iron deficiency anemia is a public health concern in most developing countries. Nutritional anemia results in impaired physical growth, poor cognitive development, reduced physical fitness, decreased concentration, weakness, and menstrual irregularities among girls affecting physical and mental health of school children. The common causes of iron deficiency are incorrect dietary habits, infections, infestations, and menstrual blood loss among girls. Anemia among school children can be prevented by deworming, iron supplementation, and proper diet. [1]

The prevalence of anemia (girls Hb <12 g% and boys Hb <13 g%) according to National Family Health Survey-3 (NFHS-3) [2] (2005-2006) was >55% among both adolescent boys and girls. In this direction, Government of India launched the Weekly Iron and Folic Acid Supplementation (WIFS) Programme in year 2012 to reduce prevalence and severity of nutritional anemia among adolescent age group population. WIFS is also supposed to reach out-of-school boys and girls in the age group of 10-19 years through the platform of Anganwadi centers (located in every village). This strategy involves a "fixed day-Monday" approach for iron folic acid (IFA) tablet distribution among children. Teachers in schools and Anganwadi workers for nonschool-going children are supposed to ensure the ingestion of IFA tablets by the children. [3]

According to WIFS programme, IFA tablet containing 100 mg elemental iron and 500 mg folic acid will be supplemented for 52 weeks in a year. In addition to IFA supplements, albendazole tablets for deworming will also be administered twice a year to the same target group. [3],[4]

Objectives

  • To study the factors influencing WIFS at selected schools in rural Puducherry
  • To explore the perceptions regarding WIFS programme among school children, teachers, and parents qualitatively.



  Methodology Top


Quantitative data collection

A school-based cross-sectional study was conducted during July-December 2013 in selected two government schools of Bahour commune in rural Puducherry (Vanidhasan Government Higher Secondary School, Seliamedu, and Kasthuribai Government School, Bahour). After obtaining permission from school headmasters, students from 9 th to 10 th standards from selected 2 schools and willing to participate in the study were included as study subjects. Considering prevalence of anemia among adolescent population as 65.3%, [5] (calculated sample size 207), a total 240 school children (30 boys and 30 girls from 9 th to 10 th standard from both the schools) were interviewed. Boys and girls from each standard and school were selected systematically.

The quantitative data were collected by trained medical professionals using a predesigned and pretested pro forma in local language (Tamil) during afternoon hours in the respective schools. Information on background characteristics, symptoms suggestive of anemia, consumption of IFA tablets, and problems faced due to IFA tablet consumption by school children were obtained. Clinical examination was done to assess signs suggestive of iron deficiency anemia among school children. It took approximately 18-20 min to complete one study pro forma.

Qualitative data collection

Qualitative data about perceptions of school children, teachers, and parents regarding benefits and problems of WIFS programme were collected in a triangulated manner in the form of focus group discussion (FGD) (PRIA guidelines were used), [6] free listing and pile sorting exercise (Dawson et al. 2008). [7] For this purpose, two semi-structured FGDs each with school boys, girls, and teachers (total 6 FGDs) till point of exhaustion (around 40-45 min each) were conducted by the study investigator. FGDs were supervised by faculty from Department of Community Medicine with >5 years of experience in qualitative research. FGDs included 8-12 purposefully selected participants who can talk freely and were willing to participate.

Data analysis

Quantitative data were analyzed using Statistical Package for the Social Sciences software for Windows (SPSS Inc., Chicago, Illinois, USA) version 18.0. The data were presented in the form of numbers, distribution, and percentages. P < 0.05 was considered statistically significant. The content analysis of FGDs, free listing, and pile sorting exercise was undertaken using Anthropac 4.98.1/X computer software. [8]


  Results Top


A total of 240 school children were interviewed, 120 were girls and 120 were boys. The mean age of study children was 14.5 ± 2.4 years. About 46.7% of mothers and 40.8% fathers of study children were educated till primary level only (<7 years of schooling). Among the total children, 75.8% belonged to nuclear family and 24.2% children were from joint families. Gender, type of family, parent's education, and occupation were not associated with consumption of IFA tablets.

[Table 1] shows various symptoms suggestive of anemia as perceived by school children. About 26.3% of the school children had easy fatigability, followed by difficulty in concentration (22.9%) and giddiness (15.8%). Among total 240 children, 117 boys and 116 girls, total 233 (97.1%) were taking tablets. Among those children, 45.8% were consuming IFA tablets regularly. Among the children with regular consumption of IFA tablets, proportion of boys (73%) was double in number when compared to girls (37%). This is reverse in the occasional conception of IFA tablet (37 boys and 64 girls). About 51.3% were consuming occasionally (42.0%) or rarely (9.2%). Around 179 (76.8%) children were consuming IFA tablet after meals and 54 (22.5%) children were consuming without meals or before meals. There is no marked difference between boys (28%) and girls (26%) in consuming the IFA tablets without meals.

After consuming IFA tablets, 63.4% children could perceive positive effects of IFA tablets, 16% told that no positive benefits were noticed, and 20.6% said that they could not assess.
Table 2: Reasons narrated by school children for not consuming iron folic acid tablet

Click here to view


[Table 2] shows one-fourth of the children had stomach pain (24.2%), 14.2% children perceived nausea followed by disliking (12.9%) the IFA and headache (7.1%). Nearly, 7% were not consuming due to bad taste and black-colored stools. Around 10% were due to other reasons such as sickness, fear of weight gain, leave from school, nonavailability of tablets, and consuming antiepileptic drugs.

Children who were consuming IFA tablets, 28.3% perceived reduced fatigability and increased appetite (25.8%), followed by one-fourth of the children reported improved concentration (24.6%). Reduced giddiness (10.4%) and menstrual regulations (10.4%) and reduced white discharge were also reported by the children [Table 3].
Table 3: Benefits perceived by school children after consuming iron folic acid tablets

Click here to view


Among 240 children, 28.8% were found to be pale during general examination; among boys 20.8% had pallor and 36.7% girls were found to be pale. This difference was statistically significant (Chi-square value 7.34, P < 0.001). Among all children with pallor, 36.2% were boys and 63.8% were girls.

Among the total 240 children, 233 were consuming IFA tablets (97.1%), among them 71.7% did not have pallor, remaining 28.3% had pallor; whereas among nonconsuming children 42.9% had pallor and 57.1% did not have pallor. However, this difference was statistically not significant (P = 0.403). Thus, there was no significant association between consumption of IFA tablets and pallor; the probable reason could be, even though they are not consuming IFA tablet, the fulfillment of their iron requirement is being achieved by adequate intake of iron rich foods and already staying healthy.

Qualitative analysis

Factors influencing WIFS programme and the perceptions regarding this programme among school children, teachers, and parents were explored qualitatively in a triangulated manner in the form of 2 FGDs (2 with boys and 2 with girls and 2 with teachers), and free listing and pile sorting exercise.

Girls perceived that IFA tablets produce side effects such as abdominal pain, nausea, giddiness, bad taste, and causes weight gain. Boys considered that these tablets were not necessary and have side effects such as stomach pain and nausea and often they threw away tablets. Occasional unavailability of IFA tablets, poor awareness, and casual programme implementation were other important issues raised during FGDs.

Free listing

Factors responsible for not consuming IFA tablets as per discussion with school children (with descending Smith's S value, as per Salience analysis, which accounts for frequency of mention by participants) were stomach pain, fear of side effects, bad taste, disliking, and poor awareness among students and their parents, not necessary, giddiness, black-colored stool, and peer influence.

Pile sort analysis

School children could identify 3 broad categories of barriers for IFA consumption among both boys and girls during the study. First broad category of factors responsible for barrier of IFA consisted of stomach ache and nausea, metallic taste, disliking, and giddiness. The second group consisted of fear of side effects of IFA tablets and thinking of IFA was not necessary. The third group consisted lack of awareness and peer influence on not consuming tablets [Figure 1]. Thus, participants could enumerate a different set of factors which acted as barriers for IFA consumption in the study area.
Figure 1: Two-dimensional hierarchal cluster analysis: Barriers of iron folic acid consumption. (a) 1-Stomach pain, nausea, 3-Taste and smell, 4-Disliking, 7-Giddiness, 8-Black stools (b) 2-Fear of side effects, 6-Not necessary (c) 5-Awareness, 9-Peer influence

Click here to view



  Discussion Top


Adolescence is a period of transition from childhood to adulthood. It is characterized by rapid physical, biological, and hormonal changes resulting in psychosocial, behavioral, and sexual maturation. [9] Adolescence is a period of rapid growth and this will lead to increased iron requirement. Failure to fulfill this iron requirement leads to iron deficiency anemia.

Nutritional anemia is a major preventable public health problem in both developing and under developed countries. During adolescence, anemia is prevalent in both sexes but more among girls, especially during menarche. Iron deficiency anemia among females is one of the major risk factors for infant mortality, maternal mortality, and preterm birth. It is becoming increasingly evident that the control of anemia in pregnant women can be more easily achieved if a satisfactory iron status can be ensured in the adolescent females before marriage. [10] The reasons for the high incidence of anemia among adolescent girls include increased iron requirements because of growth, menstrual loss, discrepancy between high iron need for hemoglobin formation and low intake of iron-containing foods, erratic eating habits, and dislike for foods which are rich in iron, such as green leafy vegetables, iron absorption inhibitors in food (phytates/tannins). [11]

In our study among 240 children, 97.1% were consuming IFA tablets. About 45.8% children were consuming IFA tablets regularly. Around 51.3% were consuming occasionally or rarely. Stomach pain (24.2%), nausea and vomiting (14.2%), and disliking of tablets (12.9%), bad taste and headache were predominant causes for IFA tablet refusal. Fears of weight gain, sickness, leave days, and nonavailability of tablets were also reported as barrier for IFA conception. These findings were supported by a study conducted by Bhatt et al., [1] where 66% of study population discontinued IFA tablets due to side effects which were mainly vomiting, gastric problem, and giddiness. About 50% girls, who participated in the initial phase (2000-2005) of Adolescent Girls Anaemia Control Programme, reported some undesirable effects such as black stools, nausea, giddiness, heartburn, and vomiting. The incidence of side effects declined as the programme matured. For example in Gujarat state, the reported side effects have come down from 30% during initial phase to 14% at programme end line. It was also supported by UNICEF intensified technical support to state governments for effective IEC strategy, monitoring and evaluation of Adolescent Girls Anaemia Control Programme during consolidation phase (2006-2010). [9]

In the present study, among 240 children, 28.8% were found to be pale (36.2% were boys and 63.8% were girls) during general examination; among boys 20.8% had pallor and 36.7% girls were found to have pallor. This difference was statistically significant (Chi-square value 7.34, P < 0.001). In comparison, NFHS-3 [2] data showed that >55% of adolescent girls in India and boys were anemic.

Our study findings are comparable with a study conducted in Nepal by Singh et al., [12] which documented that 29.7% adolescent girl and 22.4% adolescent boys were anemic. It also documented that irregular eating habits and lower consumption of animal source foods contributes to the development of nutritional anemia. In both these studies, girls were having higher incidence of anemia. Higher proportion of anemia (78.75%) among adolescents was observed by another study conducted in Chennai by Premalatha et al. [13] This study also concluded that though initiation of iron fortification has been initiated by Government of India, it should be in commonly reachable vehicles such as salt, sugar, and available for all, which does not demand individual cooperation.

Similarly, higher proportion of anemia was also noticed by Saratha et al. in Puducherry, where out of 300 college students, 228 (76%) were anemic, 32.3% students gave a history of passing worms in stool. In our study, only 8.3% reported passage of worms in stools. This could be due to supplementation of IFA tablet and biannual deworming in schools through WIFS programme; whereas this provision is not in institutions and they also added that in the same institution, most of the students were staying in hostels and have a modified dietary pattern. [14]

Children who consumed IFA tablets, 63% (151) could perceive positive effects of IFA tablets, 16% communicated that no positive benefits were noticed, and 20.6% said that they could not assess. Similarly, study conducted in Ahmedabad by Bhatt et al. [1] also observed that nearly 47% of the subjects were unaware of positive effects.

Reduced fatigue (43.7%), increased appetite (41.1%), and improved concentration (37.7%) were cited as major benefits of IFA tablets. Similar benefits were also obtained from a study conducted in Wardha district by Dongre et al., [15] they also documented that weekly IFA tablet consumption can significantly reduce the prevalence of nutritional anemia (from 73.8% to 54.6%) among adolescent girls. In addition, improvement in awareness regarding iron-rich foods among mothers of children was also observed in the same study.

Relatively similar benefits were documented in Adolescent Girls Anaemia Control Programme also. About 80% of girls who were covered under this programme perceived various benefits and they reported that do not feel tired, can concentrate better on their studies, do not fall sick, not feeling sleepy, feeling healthier, having more energy, having regular menstrual cycle, and reduced abdominal pain during menstruation. This programme became an important platform for intersectoral convergence among key government departments and UNICEF programs to empower adolescent girls, reduce gender and social inequities, and break the intergenerational cycle of undernutrition and deprivation in India. [9] Hence, documented benefits under this programme support our study findings on perceived benefits by school children after IFA consumption.

During the FGD with school children, even though the IFA supplementation programme was going well, we observed that nutritional health education sessions were not conducted regularly (monthly interval - as it is stated in WIFS operational framework manual) [16] to school children by nodal teachers. Children were unaware of benefits of IFA tablets and these issues were supposed to be insisted by teachers. Furthermore, nodal teachers could have consumed the IFA in front of students to get their confidence and reassurance (as per manual).

In this survey, we observed that 76.8% children were consuming IFA tablet after meals and 23.5% were consuming without meals also. Since approximately one-fourth children were consuming IFA in empty stomach, it is important to educate the students to consume the tablet after meals so that majority of the gastric side effects can be avoided. On the other hand, after health education sessions, children were also insisting that nutritional health education session should be conducted by doctors or health staffs instead of nonhealth worker such as teachers. This can also be suggested to the health department because students had been strictly handled or warned instead of getting aware by teachers. Thus, problems such as students not showing interest in IFA tablets could be rectified easily.

Discussion with teachers revealed that, on the whole teachers were not comfortable with this programme because the programme is time-consuming, pressured by government, overloaded with extra work such as maintaining and issuing the IFA tablets, often thrown away tablets by students even after giving instructions, issues with the side effects of the tablets and mainly they raised the issue that they were not the health staff to do all these work. Hence, keeping this in mind, as the government is giving incentives for health worker (e.g., under family planning and institutional delivery programs), incentives can also be given to the teachers, especially nodal teachers for successful implementation of this programme.


  Conclusion Top


Most of the school students consume IFA tablets under WIFS programme although irregularly and inadequately. Barriers of IFA tablet consumption such as side effects, lack of awareness among students, and irregular supply of tablets should be considered. Iron fortification of foods and/or changing composition of iron preparation to avoid side effects may also be considered in future.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Bhatt RJ, Mehta HK, Khatri V, Chhaya J, Rahul K, Patel P. A study of access and compliance of iron and folic acid tablets for prevention and cure of anaemia among adolescent age group females in Ahmedabad district of India surveyed under multi indicator cluster survey. Glob J Med Public Health 2011;2:1-6. Available from: http://www.gjmedph.org/uploads/O7-Vo2No4.pdf. [Last cited on 2014 Oct 27].  Back to cited text no. 1
    
2.
International Institute for Population. Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), 2005-06: India. Vol. I; 2007. Available from: http://www.rchiips.org/nfhs/NFHS-3%20Data/VOL-1/Front%20Matter (15080K).pdf. [Last cited on 2014 Oct 30].  Back to cited text no. 2
    
3.
Operational framework. Weekly Iron and Folic Acid Supplementation Programme for Adolescents. Ministry of Health and Family Welfare. Government of India; 2012. Available from: http://www.nrhm.gov.in/images/pdf/programmes/wifs/operational-framework-wifs/operational_framework_wifs.pdf. [Last cited on 2014 Oct 25].  Back to cited text no. 3
    
4.
Iron Plus Initiative. Guidelines for Control of Iron Deficiency Anaemia. Adolescent Division. Ministry of Health and Family Welfare. Government of India. Available from: http://www.nrhm.gov.in/images/pdf/programmes/child-health/guidelines/Control-of-Iron-Deficiency-Anaemia.pdf. [Last cited on 2014 Nov 02].  Back to cited text no. 4
    
5.
Deshmukh PR, Garg BS, Bharambe MS. Effectiveness of weekly supplementation of iron to control anaemia among adolescent girls of Nashik, Maharashtra, India. J Health Popul Nutr 2008;26:74-8.  Back to cited text no. 5
    
6.
Achrya B, Verma S, Tandon R. Process Documentation in Social Development Programme (Mimeo). New Delhi: Society for Participatory Research in Asia; 1993.  Back to cited text no. 6
    
7.
Dawson S, Manderson L, Tallo VL. The Focus Group Manual: Methods for Social Research in Disease. Boston: International Nutrition Foundation for Developing Countries (INFDC); 2008.  Back to cited text no. 7
    
8.
Borgatii SP. ANTHROPAC [Computer Program]: Version 4.98.1/X. Natik, MA: Analytic Technologies; 1992.  Back to cited text no. 8
    
9.
The Adolescent Girls Anaemia Control Programme Breaking the Inter-Generational Cycle of Under nutrition in India with a focus on Adolescent Girls. The United Nations Children's Fund. New Delhi; 2011. Available from: http://www.unicef.org/india/14._Adolescent_Anaemia_Control_Programme.pdf. [Last cited on 2014 Oct 28].  Back to cited text no. 9
    
10.
Shekhar A. The iron status of adolescent girls and its effect on their physical fitness. Indian J Nutr Diet 2005;42:451-6.  Back to cited text no. 10
    
11.
Biradar SS, Biradar SP, Alatagi AC, Wantamutte AS, Malur PR. Prevalence of anaemia among adolescent girls: A one year cross sectional study. J Clin Diagn Res 2012;6:372-7.  Back to cited text no. 11
    
12.
Singh P, Khan S, Ansari M, Mittal RK. Anemia amongst adolescent girls and boys attending outpatients and inpatient facilities in far western part of Nepal. Ibnosina J Med Biomed Sci 2013;5:330-4.  Back to cited text no. 12
    
13.
Premalatha T, Valarmathi S, Srijayanth P, Sundar JS, Kalpana S. Prevalence of anemia and its associated factors among adolescent school girls in Chennai, Tamil Nadu, India. Epidemiology 2012;2:118-21.  Back to cited text no. 13
    
14.
Saratha A, Singh Z, Datta SS, Boratne AV, Senthilvel V, Joice S. Prevalence of anaemia among young adult female students in a medical teaching institution in Pondicherry. Indian J Matern Child Health 2010;12:1-8.  Back to cited text no. 14
    
15.
Dongre AR, Deshmukh PR, Garg BS. Community-led initiative for control of anemia among children 6 to 35 months of age and unmarried adolescent girls in rural Wardha, India. Food Nutr Bull 2011;32:315-23.  Back to cited text no. 15
    
16.
Guidelines for Teachers and Principals. Operational Guidelines for Weekly IFA Supplementation Programme for School Based Adolescents. Available from: http://www.nrhm.gov.in/images/pdf/programmes/wifs/guidelines/edu_school_operational_guidelines_for_wifs.pdf. [Last cited on 2014 Nov 03].  Back to cited text no. 16
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]


This article has been cited by
1 A School-Based Weekly Iron and Folic Acid Supplementation Program Effectively Reduces Anemia in a Prospective Cohort of Ghanaian Adolescent Girls
Lucas Gosdin,Andrea J Sharma,Katie Tripp,Esi Foriwa Amoaful,Abraham B Mahama,Lilian Selenje,Maria Elena Jefferds,Reynaldo Martorell,Usha Ramakrishnan,O Yaw Addo
The Journal of Nutrition. 2021;
[Pubmed] | [DOI]
2 Association of iron supplementation and dietary diversity with nutritional status and learning outcomes among adolescents: Results from a longitudinal study in Uttar Pradesh and Bihar, India
Sachin Shinde,Isabel Madzorera,Wafaie W Fawzi
Journal of Global Health. 2021; 11
[Pubmed] | [DOI]
3 Barriers to and Facilitators of Iron and Folic Acid Supplementation within a School-Based Integrated Nutrition and Health Promotion Program among Ghanaian Adolescent Girls
Lucas Gosdin,Andrea J Sharma,Katie Tripp,Esi F Amoaful,Abraham B Mahama,Lilian Selenje,Maria E Jefferds,Usha Ramakrishnan,Reynaldo Martorell,O Yaw Addo
Current Developments in Nutrition. 2020; 4(9)
[Pubmed] | [DOI]
4 Moving beyond individual barriers and identifying multi-level strategies to reduce anemia in Odisha India
Erica Sedlander,Michael W. Long,Satyanarayan Mohanty,Ashita Munjral,Jeffrey B. Bingenheimer,Hagere Yilma,Rajiv N. Rimal
BMC Public Health. 2020; 20(1)
[Pubmed] | [DOI]
5 Proximal and contextual correlates of childhood stunting in India: A geo-spatial analysis
Ashish Kumar Gupta,K. G. Santhya,Kannan Navaneetham
PLOS ONE. 2020; 15(8): e0237661
[Pubmed] | [DOI]
6 Gambaran Pengetahuan, Sikap, dan Perilaku Kader Palang Merah Remaja (PMR) di SMAN 2 Lamongan Terhadap Program Suplementasi Tablet Tambah Darah
Stefania Widya Setyaningtyas, Thinni Nurul Rochmah, Trias Mahmudiono, Susi Hidayah, Yurike D Adhela
Amerta Nutrition. 2020; 4(3): 213
[Pubmed] | [DOI]
7 School Readiness in Weekly Iron Folic Acid Supplementation Program in Urban Area, West Java, Indonesia
Apriningsih Apriningsih, Siti Madanijah, Cesilia Meti Dwiriani, Risatianti Kolopaking, Yessi Crosita
Amerta Nutrition. 2020; 4(4): 291
[Pubmed] | [DOI]
8 Awareness about Anaemia and Weekly Iron-Folic Acid Supplementation (WIFAS) among School-Going Adolescent Girls and Parents in East Java and East Nusa Tenggara, Indonesia
Annisa Utami SEMINAR,Dodik BRIAWAN,Ali KHOMSAN,Mira DEWI,Ikeu EKAYANTI,Ikeu MARDEWI,Manoj Kumar RAUT,Abanti ZAKARIA,Marion Leslie ROCHE
Journal of Nutritional Science and Vitaminology. 2020; 66(Supplement): S111
[Pubmed] | [DOI]
9 Compliance with Weekly Iron and Folic Acid Supplementation and Its Associated Factors among Adolescent Girls in Tamale Metropolis of Ghana
S. Dajaan Dubik,Kingsley E. Amegah,Amshawu Alhassan,Louis N. Mornah,Loveland Fiagbe
Journal of Nutrition and Metabolism. 2019; 2019: 1
[Pubmed] | [DOI]
10 Designing a socio-normative intervention to reduce anemia in Odisha India: A formative research protocol
Erica Sedlander,Rajiv N Rimal,Sameera A. Talegawkar,Hagere Yilma,Wolfgang Munar
Gates Open Research. 2018; 2: 15
[Pubmed] | [DOI]
11 The RANI Project: A socio-normative intervention to reduce anemia in Odisha, India: A formative research protocol
Erica Sedlander,Rajiv N Rimal,Sameera A. Talegawkar,Hagere Yilma,Wolfgang Munar
Gates Open Research. 2018; 2: 15
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Methodology
Results
Discussion
Conclusion
References
Article Figures
Article Tables

 Article Access Statistics
    Viewed5849    
    Printed120    
    Emailed0    
    PDF Downloaded543    
    Comments [Add]    
    Cited by others 11    

Recommend this journal