Anemia status and associated factors among adolescent girls under weekly iron and folic acid supplementation (WIFAS) and non-WIFAS program of public schools in Janamora district, Northwest Ethiopia 2023; A Comparative Cross-sectional Study

Abstract

Background: Iron deficiency Anemia (IDA) is a major public health problem for adolescent girls in Ethiopia. Despite many interventions being made for anemia reduction, it is still a public health problem in Ethiopia. To prevail this concern, weekly Iron and Folic Acid Supplementation (WIFAS) school-based Programme is an initiative to decrease the burden of anemia among adolescent girls studying in government schools. Even though the existence of difference in anemia status among adolescent girls under WIFAS and non-WIFAS programs is expected. But there no study was conducted on the evaluation of program effectiveness as to whether or not it meets the objective. So, this study helps to show to what extent the WIFAS school program decrease the magnitudes of anemia compared to non-WIFAS school program among school-going adolescents. Objectives: This study aims to compare anemia status and associated factors among adolescent girls in WIFAS schools with non-WIFAS school programs in Janamora district, Northwest Ethiopia. Methods: A school-based comparative cross-sectional study was conducted among adolescent girls in government schools who received weekly iron and folic acid supplementation (on WIFAS) and those who did not receive (not on WIFAS). The total sample size was 361 (180 from WIFAS and 181 from non-WIFAS schools), selected by multistage sampling technique. Data was collected using an interviewer-based questionnaire, anthropometric measurements, and a hemoglobin level laboratory test. A pre-designed questionnaire via electronic-based application was used. Later exported and analyzed by STATA version 17. The hemoglobin level was measured using a portable, battery-operated HemoCue Hb 301+ analyzer, and the reading was categorized as normal if it was greater than or equal to 12 g/dl and as anemic if it was less than that amount based on the WHO's 2011 recommended cut-off point after altitude adjustments. A chi-square test was done to find out the association with the categorical variable. Bivariable, multivariable logistic regression was used to analyze the anemia status and associated factors of anemia in WIFAS and Non-WIFAS with 95% CI at 0.05 p-value. Results: The overall prevalence of anemia was 50.43% (CI: 0.45,0.55). While, its prevalence was 44.7% (CI: 37.4%,52.3%) among the WIFAS schools and 56% (CI: 48.5%,63.3%) among non-WIFAS schools. The mean hemoglobin was 12.25±1.67 and 11.25 ±2.38 in WIFAS and non-WIFAS school girls respectively. The use of coffee/tea (AOR=5.967 [CI:1.74,20) and parasite attack history (AOR=7.66 CI: 3.36,17.4) among non-WIFAS school programs whereas VIII poor adherence to the IFAs (AOR=3.69 [CI:1.4,9.6]), poor anemia knowledge (AOR=4.44 [CI: 1.7,11.5]), parasite attack history (AOR=6.94 [CI: 2.86,16.8]), non-vegetarian (AOR=6.614 [CI:(2.4,18.2]) among WIFAS school program was statically significant factors of anemia among adolescents’ girls. Conclusion: In this study, prevalence of anemia among adolescent girls is high. The prevalence of anemia among WIFAS school program adolescents’ girls was less as compared to non-WIFAS school program girls, suggesting the role of the WIFAS program is important to improve the anemia status of adolescent girls. Hence, the WIFAS program should be addressed to other schools as well. The use of tea/coffee and parasite attack history among non-WIFAS school programs whereas poor adherence, poor anemia knowledge, non-vegetarian among WIFAS school programs were the main significant factors for the anemia status among adolescent girls. concurrent health education with the program would be important to strengthen adherence/compliance of adolescent girls with IFAs programs and also to boost the effectiveness of the program among WIFAS school-going adolescent girls