Action - Weekly Iron Folic Acid Supplementation - Nutrition International - Kenya - Iron and folic acid supplementation - Adolescents

Programme: Weekly Iron Folic Acid Supplementation - Nutrition International - Kenya

Programme description

Iron deficiency anaemia is now recognized as the number one cause of lost disability adjusted life years (DALYs) in adolescent girls globally.[1] Anaemia has three major consequences for adolescent girls: (i) decreased school performance (and challenges in concentration); (ii) loss of productivity; and (iii) decreased current and future reproductive health, for those that become pregnant. Related to this, young maternal age increases the risk of maternal anaemia during pregnancy. 

After infancy, adolescence (10-19 years of age) is the most rapid period of development. Adolescents have the highest nutritional needs and provide a second window of opportunity for catch-up growth.[2]  While WHO and others formally acknowledge adolescents as a group with specific nutrition needs, until recently, Adolescent Nutrition has been neglected in global and national investment, policy and programming in developing countries. The 2014 WHO report “Health for the World’s Adolescents” notes that progress for adolescents lags behind gains made in maternal and child health programs. 

Improving adolescent anaemia is critical to general anaemia gains. The World Health Assembly has called for a 50% reduction in anaemia in women of reproductive age (15-49 years of age) by 2025.[3] Although adolescent specific data are lacking globally, it is estimated that approximately 30% of adolescents are anaemic.[4]  Therefore, to reach this goal, the approximately 600 million adolescent girls living in developing countries must become a prime focus of anaemia reduction efforts. 

The WHO recommends intermittent iron and folic acid supplementation (at least once weekly for three months, twice yearly) as an effective strategy to prevent anaemia in populations where anaemia in women of reproductive age is of public health concern (>20% anaemia).[5] Despite this WHO recommendation, the policy environment for WIFAS remains a challenge. In coordination with government and other partners, NI aims to improve the health and well-being of girls by reducing anaemia in adolescent girls through Weekly Iron and Folic Acid Supplementation (WIFAS), and contribute to empowering girls through Adolescent Nutrition education. Adolescent boys also benefit from the nutrition education. These Adolescent Nutrition programs are informed by gender-analysis and consider the inequalities in anemia, as well as gendered barriers to attending school and accessing health systems.

Nutrition International contributes to the WIFAS program in Kenya by:

  • Providing technical leadership and support to the government.
  • Improving the enabling environment by influencing and shaping national policies and guidelines for adolescent health, nutrition education and WIFAS through technical assistance and advocacy to the government. 
  • Designing and implementing Adolescent Nutrition programs to reach in-school girls, with smaller demonstration project to assess feasible delivery options for out-of-school girls.
  • Supporting procurement, forecasting and supply chain management plans for iron supplements for adolescent girls
  • Implementing a Nutrition Interventions Monitoring survey (NIMS) and setting up a monitoring system for the Adolescent Nutrition project. 
  • Developing training curriculum, manual, and job aids for health workers, and training frontline service providers in each of the selected delivery platforms (teachers, and facility- and community-based health workers). 
  • Conducting formative research, including gender analysis, to inform the development of a gender-sensitive Behaviour Change Intervention (BCI) strategy
  • Developing and disseminating the BCI strategy which includes key messages and other materials for the Adolescent Nutrition program. 

These activities are implemented in partnership with the Ministry of Health, the Ministry of Education, and Population Services Kenya. The program is being implemented with national level support for technical guidance and advocacy, and sub-nationally in three counties: Kitui, Busia and Nakuru. There are plans to scale up in six additional counties (Kakamega, Kisumu, Kwale, Bomet, Vihiga, and Laikipia) from June 2018 to December 2019. NI started providing support to the government for Adolescent Nutrition in 2016, and this support is on-going.

Programme type



  1. WHO, AA-HA! Global Accelerated Action for the Health of Adolescents (AA-HA!) – Guidance to Support Country Implementation – Summary.
  2. Prentice AM, Ward KA, Goldberg GR, Jarjou LM, Moore SE, Fulford AJ, Prentice A. Critical windows for nutritional interventions against stunting. The American journal of clinical nutrition. 2013 May 1;97(5):911-8.
  3. WHO, WHA Global Nutrition Targets 2025: Anaemia Policy Brief. 2014 
  4. UNICEF, Progress for Children: A report card on adolescents, 2012.
  5. WHO. Guideline: Intermittent iron and folic acid supplementation in menstruating women. Geneva, World Health Organization, 2011.

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Revision log

Thu, 10/18/2018 - 21:02zillmerkpublishedpublished
Thu, 10/18/2018 - 18:29GINAadminNIAction edited by GINAadminNI.needs_review
Thu, 10/18/2018 - 18:29GINAadminNIAction edited by GINAadminNI.draft
Wed, 10/03/2018 - 17:05GINAadminNIAction edited by GINAadminNI.draft
Wed, 10/03/2018 - 17:02GINAadminNIAction edited by GINAadminNI.draft
Wed, 10/03/2018 - 17:02GINAadminNIAction edited by GINAadminNI.draft
Wed, 10/03/2018 - 17:01GINAadminNIAction edited by GINAadminNI.draft
Tue, 10/02/2018 - 16:21engesveenkEdited by GINAadminNI.published
Tue, 09/11/2018 - 16:10GINAadminNIEdited by GINAadminNI.delegated
Tue, 09/11/2018 - 15:44GINAadminNIEdited by GINAadminNI.delegated
Thu, 08/23/2018 - 22:58GINAadminNIEdited by GINAadminNI.delegated
Mon, 07/23/2018 - 15:44GINAadminNIEdited by GINAadminNI.delegated
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Fri, 07/20/2018 - 16:54vhollaEdited by vholla.needs_review
Fri, 07/20/2018 - 15:44vhollaEdited by vholla.draft
Thu, 07/19/2018 - 22:52vhollaEdited by vholla.draft
Wed, 07/18/2018 - 15:02vhollaCreated by vholla.draft
Wed, 07/18/2018 - 15:01vhollaAction created by vholla.draft