Prevalence of anemia and its associated factors among adolescent girls on weekly iron folic acid supplementation (WIFAS) implemented and non-implemented schools at Tokha Municipality, Kathmandu.

Thesis Report.

ABSTRACT:

Introduction: One of the WHO's eight primary effective actions for enhancing adolescent nutrition that is outlined in the 2018 recommendations is WIFAS (weekly iron and folic acid supplementation). There is a window of opportunity for kids to improve their nutritional status during the adolescent years. Nutritional deficiencies can have long-term effects, but if we act appropriately now, we can prevent them. In Nepal, very few studies on adolescent anemia have been conducted. Weekly iron folic acid supplementation is relatively a new program and it could be the most cost-effective intervention to break the intergenerational cycle of anemia. Several studies have shown a statistically significant link between taking folic acid and iron supplements and preventing anemia

Methods: The general objective of the study was to assess the difference in the prevalence of anemia and its associated factors among adolescent girls on Weekly Iron Folic Acid Supplementation (WIFAS) implemented and non-implemented schools at Tokha Municipality, Kathmandu. A cross-sectional study was carried out among 602 adolescent girls from classes 6-10 equally divided into two groups from government schools (WIFAS implemented) and private schools (WIFAS not implemented). The (PPS) method was used to determine the number of class cluster and the students from each cluster was included. Hemoglobin estimation was done using the HemoCue method to determine the hemoglobin estimation. The validated tool was used to collect the data. The univariate, bivariate and multivariate analysis was done using SPSS version 25 to identify significant association between dependent and independent variables.

Results: The overall prevalence of anemia was found to be 17.4 %. Among the total sample, 14%(42) and 20.9 % (63) of adolescent girls from government and private schools were anemic respectively whereas 86% (259) and 79.1% (238) were non anemic respectively. Bivariate analysis of the variables revealed that age, mother’s education, fathers’education, mothers’occupations, compliance, knowledge on anemia, knowledge on WIFAS, class and dietary diversity were found to be significantly associated with anemia. The factors like fathers’ education, knowledge on WIFAS and dietary diversity were only found to be associated with anemia during multivariate regression analysis. Similarly, the factors like class, type of family and provision of school health nurse were found to be associated with compliance in WIFAS implemented schools during multivariate regression analysis. According to the WHO classification on prevalence of anemia, the study site ranks as having mild public health problems of anemia among school going adolescent girls in Tokha municipality.

Conclusion: In the study, the prevalence of anemia among the WIFAS implemented school was lower as compared to the not implemented school. The present study revealed that the supervision by the school teacher or supervisor increases the compliance to WIFAS which ultimately help to lower the prevalence of anemia among adolescent girls. In the study, the factors like fathers’ education, knowledge on WIFAS, and dietary diversity were found to be associated with anemia. Promotion of proper utilization of Weekly Iron and Folic Acid Supplementation (WIFS) program is recommended. The development of a peer-led strategy, or a girl-to-girl approach, is required in order to inform and counsel adolescent girls about the program advantages in order to increase the compliance and decrease the prevalence of anemia among adolescent girls.