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

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

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 Indonesia by:

  • Providing technical leadership and support to the government.
  • Procuring and supplying WIFAS tablets to the District Health Offices (DHOs) and supporting with procurement and forecasting planning
  • Supervising IFA tablet administration to adolescent girls at both public and private schools. 
  • Developing monitoring tools to track distribution of supplements. 
  • Producing and distributing Behaviour Change Intervention (BCI) materials based on the gender sensitive BCI plan, developed with insights from adolescents, to advocate for promotion of gender sensitive nutrition education in secondary schools. 
  • Facilitating collaboration between the Ministries and providing supportive supervision to the DHOs.
  • Developing training materials and training key staff in health and education sectors. 
  • Conducting on-the-job training for school staff to ensure engagement and efficiency in distribution of supplements, tracking of consumption, and reporting across sectors. 
  • Conducting formative research, including gender analysis, and developing and implementing gender sensitive behaviour change intervention strategies.
  • Designing surveys to evaluate demonstration project and scale up. 
  • Leveraging the Springster platform to magnify messages and gender sensitive behaviour change interventions to spread awareness about WIFAS amongst adolescent girls in its program areas. 

These activities are being implemented in partnership with the Ministry of Health, Ministry of Education and Culture, and Ministry of Religious Affairs, as well as the respective Provincial and District Offices of each sector. This project is sub-national, and is implemented in 35 districts of West Java province. It runs in parallel (sharing some activities and through the promotion of cross-learning) with ‘MITRA Youth’ – a project funded by the Department of Foreign Affairs and Trade (DFAT) of the Australian Government that supports similar adolescent nutrition in 10 districts of East Java and 10 districts of East Nusa Tenggara. NI started providing support to the government for Adolescent Nutrition in 2015, 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 - 21:26zillmerkpublishedpublished
Thu, 10/18/2018 - 19:29GINAadminNIAction edited by GINAadminNI.needs_review
Thu, 10/18/2018 - 19:29GINAadminNIAction edited by GINAadminNI.draft
Tue, 10/02/2018 - 16:20engesveenkEdited by GINAadminNI.published
Wed, 09/12/2018 - 17:15GINAadminNIEdited by GINAadminNI.delegated
Thu, 08/23/2018 - 23:08GINAadminNIEdited by GINAadminNI.delegated
Mon, 07/23/2018 - 15:42GINAadminNIEdited by GINAadminNI.delegated
Fri, 07/20/2018 - 18:21zillmerkdelegateddelegated
Fri, 07/20/2018 - 16:52vhollaEdited by vholla.needs_review
Fri, 07/20/2018 - 16:47vhollaEdited by vholla.draft
Thu, 07/19/2018 - 22:36vhollaEdited by vholla.draft
Wed, 07/18/2018 - 15:54vhollaCreated by vholla.draft
Wed, 07/18/2018 - 15:50vhollaAction created by vholla.draft