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

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.