Demonstrating Effectiveness of Delivering Weekly Iron and Folic Acid Supplementation (WIFS) through Government Systems in Chhattisgarh, India
Manpreet Chadha *
Micronutrient Initiative, New Delhi, India.
Pravin H. Khobragade
Micronutrient Initiative, New Delhi, India.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Recognizing that low iron stores pre-conception continue during pregnancy, the government of Chhattisgarh and Micronutrient Initiative (MI) implemented weekly IFA supplementation (WIFS) program from July 2011 till May 2012 among school-going adolescent girls in classes 9 to 12 (SG) and out-of-school adolescent girls aged 11-18 years (OG).
The aim of this program was to demonstrate effective approaches of achieving high rates of coverage and utilization of WIFS among SG and OG.
Methods: The project involved multi-department government coordination and was implemented through schools for SG and ‘community based centres for women and children’ - anganwadi centres (AWCs) – for OG. A cascade approach was adopted to train teachers, peer guides and anganwadi workers. Supervised weekly dose of enteric coated IFA was administered to over 95,000 adolescent girls in 424 schools and 6,832 AWCs after counselling for probable side-effects. MI facilitated supportive supervision, program reviews and completion of baseline and endline surveys.
Results: 93.8% SG and 73% OG received free IFA tablets. 48.1% of SG and 31.4% of OG completed at least 80 % of the recommended dosage. Post side-effect counselling added to an incremental compliance of 15.4% to a full recommended weekly dose. There was 22.5% increase in the knowledge level among adolescent girls on atleast three causes and prevention of anaemia.
Conclusions: Effective multi-department coordination, health and nutrition education and effective counselling on side effects are important success factors for WIFS. Convinced with the impact of WIFS, the program is being scaled up across the state.