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

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

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.

In Senegal, the WIFAS program has built upon on implementation research supported by Nutrition International in 2005 on delivering weekly iron folic acid supplements to reduce anaemia among school age boys and girls (6-12 years). Implemented by the Ministry of Education, the new program targets girls in school 10-19 years of age.

Nutrition International contributes to the WIFAS program in Senegal by:

  • Providing technical leadership and support to the government.
  • Advocating and providing technical support to nutrition policy, strategic plans, guidelines, and training materials.
  • Supporting procurement, supply chain management, and distribution of WIFAS to adolescent school girls.
  • Conducting formative research, including gender analysis, and developing a gender sensitive Behaviour Change Intervention (BCI) strategy to create demand and raise awareness for WIFAS and adolescent nutrition. 
  • Conducting monitoring activities to manage quality of WIFA supplementation, data records and to track stock out.
  • Developing, distributing and producing gender sensitive BCI materials to teachers, health service providers, and community health workers (CHWs) for their use in counselling adolescent girls on WIFAS and nutrition.
  • Capacity building for implementing WIFAS, including training teachers and health workers, as well as parents, supervisors and managers 
  • Providing supportive supervision to ensure quality services including procurement, delivery and counselling. 
  • Developing and implementing WIFAS monitoring tools.
  • Strengthening coordination across Ministry of Health and Ministry of Education. 

These activities are implemented in partnership with the Ministry of Education, Ministry of Health, and La Cellule de Lutte Contre la Malnutrition. NI provides national level technical assistance and support on nutrition policies, national guidelines and procurement, and works sub-nationally in seven regions (Thiès, Dakar, Saint-Louis regions, Ziguinchor, Kolda, Kaolack, and Sédhiou). NI started providing support to the government for Adolescent Nutrition in 2016, and this support is ongoing.

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 - 21:11zillmerkpublishedpublished
Thu, 10/18/2018 - 19:16GINAadminNIAction edited by GINAadminNI.needs_review
Thu, 10/18/2018 - 19:10GINAadminNIAction edited by GINAadminNI.draft
Tue, 10/02/2018 - 16:21engesveenkEdited by GINAadminNI.published
Tue, 09/11/2018 - 16:07GINAadminNIEdited by GINAadminNI.delegated
Thu, 08/23/2018 - 23:03GINAadminNIEdited by GINAadminNI.delegated
Mon, 07/23/2018 - 15:43GINAadminNIEdited by GINAadminNI.delegated
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Fri, 07/20/2018 - 16:53vhollaEdited by vholla.needs_review
Fri, 07/20/2018 - 16:20vhollaEdited by vholla.draft
Thu, 07/19/2018 - 22:51vhollaEdited by vholla.draft
Thu, 07/19/2018 - 22:50vhollaEdited by vholla.draft
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