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

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

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 Tanzania by:

  • Providing technical leadership and support to the government.
  • Developing plans, tools and guidelines to support implementation
  • Designing and delivering curricula and training for key intermediaries involved in the delivery of the package of interventions
  • Developing and distributing Behaviour Change Intervention (BCI) materials and training guidelines from NI partners and programs 
  • Establishing supply chain management systems
  • Supporting procurement of weekly iron folic acid supplements
  • Providing technical support to advocacy and awareness-raising
  • Designing and conducting a rapid assessment to gather key insights from adolescent girls and influencers, which included a gender analysis of the barriers to school attendance and accessing the health system, as well as adolescent girls’ aspirations and motivations. 
  • Supporting delivery of the package of nutrition education and weekly iron folic acid supplementation to in-school and out of school girls
  • Conducting joint supportive supervision to monitor implementation of the program. 
  • Engaging with, and providing updates to, the technical steering committee. 

These activities are implemented in partnership with the Ministry of Health Community Development, Gender, Elderly and Children, the Tanzania Food and Nutrition Centre, Local Government Authorities, and AMREF. The project is implemented sub-nationally, in four districts of Simiyu region. Tanzania is a new country of implementation for NI. NI started working in Tanzania in 2016 and has supported the government for WIFAS since then. 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 - 21:09zillmerkpublishedpublished
Thu, 10/18/2018 - 19:04GINAadminNIAction edited by GINAadminNI.needs_review
Thu, 10/18/2018 - 19:01GINAadminNIAction edited by GINAadminNI.draft
Thu, 10/18/2018 - 19:00GINAadminNIAction edited by GINAadminNI.draft
Tue, 10/02/2018 - 16:20engesveenkEdited by GINAadminNI.published
Tue, 09/11/2018 - 16:08GINAadminNIEdited by GINAadminNI.delegated
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Fri, 07/20/2018 - 16:52vhollaEdited by vholla.needs_review
Fri, 07/20/2018 - 16:39vhollaEdited by vholla.draft
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Wed, 07/18/2018 - 15:20vhollaAction created by vholla.draft