Prevention of iron deficiency anaemia in adolescents

Anaemia is one of the most common and intractable nutritional problems globally, affecting both developing and developed countries with major consequences for human health as well as social and economic development. Iron deficiency anaemia occurs at all stages of the life cycle, but is more prevalent in pregnant women and young children. Adolescents, especially girls, are particularly vulnerable to iron deficiency. The highest prevalence is between the ages of 12-15 years when requirements are at a peak. In all Member States of the South-East Asia Region, except Thailand, more than 25% of adolescent girls are reported to be anaemic; in some countries the prevalence is as high as 50%. Interventions to prevent and correct iron deficiency anaemia therefore must include measures to increase iron intake through food-based approaches, namely dietary diversification and food fortification with iron; iron supplementation and by improved health services and sanitation. Adolescence is an opportune time for interventions to address anaemia. Not only is there need (growth, preparation for pregnancy), but large numbers of both boys and girls can be reached easily if school attendance or participation in other group activities is high. Also, adolescents are open to new information and new practices since they are often striving for physical or academic excellence. In countries where anaemia prevalence exceeds 40% in pregnant women, universal iron supplements for adolescent girls (particularly those aged 12 to 16 years) and women of childbearing age is necessary. More than 40 years of iron supplementation programs aimed at controlling gestational anaemia have been ineffective in several countries. Adherence to the daily regime, however, is frequently poor for a variety of reasons, including the unpleasant symptoms of nausea, a medicinal after-taste, etc. In view of this weekly administration of iron-folic acid supplementation has been tried as a public health approach in several countries. This document presents a brief review of evidence on weekly iron-folic acid supplementation (WIFS) from the existing scientific literature. It presents findings from a number of WIFS trials and programmes that were launched in the late 1990s and early 2000 in a number of developing countries of Asia, Africa and South America.