ABSTRACT
Objective: To estimate incidence of side effects after weekly iron and folic acidsupplementation (WIFS) in Delhi and Haryana. Methods: In this cross-sectional school-based study, data were collected from 4,183 adolescents on WIFS consumption and sideeffects experienced first time of receipt of WIFS (week 1), and in last two consecutive weeks(week 2,3). Week 3 was 48 hours preceding the survey. Results: WIFS consumption in week1, 2 and 3 was 85%, 63% and 52%, respectively. Side effects reported were highest in firstweek (25%) and reduced to 7% (week 2) and 5% (week 3). Side effects most reported wereabdominal pain (80%) and nausea (10%). Adolescents (45%) who faced a side-effect in week1 did not consume WIFS in subsequent week. Conclusion: Incidence of side effects was low,but it affected compliance. Positive reinforcement to students who face side effects requiresstrengthening by teachers.
ABSTRACT
Objectives: In India, 56% of adolescent girls are anemic. In response to this situation and building on 13 years of evidence-generation using a knowledge-centred framework (evidence, innovation, evaluation and replication), India's adolescent girls anemia control programme was universalized in 2013 covering 130 million adolescents. Implemented jointly by Ministries - Health, Education and Women and Child Development, services delivered by the programme include: 1) weekly iron and folic acid supplementation; 2) bi-annual deworming; and 3) nutrition counselling. UNICEF is technically supporting the government in roll out of the programme in 14 Indian states that house 88 percent of total adolescent girls in India. Methods: Using information emanating from programme reports analyses, structured interviews with state programme implementors and a national consultation, this presentation highlights ten make-or-break elements to address the most important challenges encountered in the universal rollout of the programme. Results: Ten make-or-break elements are: 1) political will along with well-defined inter-ministerial convergence and accountability mechanisms; 2) solving procurement challenges and continued supply monitoring; 3) instituting emergency response mechanisms (teams, helplines, standardized tools) for managing undesirable events; 4) sustained media engagement; 5) ensuring technical human resource support to state governments where capacity is sub-optimal; 6) devising a supplementation strategy during school vacations; 7) monitoring and evaluating the programme implementation independently through civil society/academia; 8) associating celebrities, parliamentarians and religious/peer leaders to mass communication campaigns; 9) ensuring functional review mechanisms; and 10) specific strategies to reach the unreached. Conclusions: All the ten make-or-break elements are critical for ensuring success of an universal adolescent anemia control programme.