Awareness about Anaemia and Weekly Iron-Folic Acid Supplementation (WIFAS) among School-Going Adolescent Girls and Parents in East Java and East Nusa Tenggara, Indonesia

Health-Related Experiences of Geophagia Among Women of Reproductive Age in Tshwane District, Gauteng Province: An Exploratory Qualitative Study

BACKGROUND/OBJECTIVES

Women of reproductive age are reported to be the largest population that practises geophagia. The short-term and long-term health related conditions originating from the practise of geophagia are often not understood by geophagic women of reproductive age. This study has explored the health-related experiences of geophagia among women of reproductive age of Tshwane District, Gauteng Province.

METHODS

This was a qualitative study design following inductive thematic content analysis. In-depth interviews and focus group discussions were used to collect data using an interview guide and audio record. Data collection took place in 2023.

RESULTS

Mental health disorders, pregnancy complications, appendicitis, cancers, breathing complications, fatigue, premature deaths, worms, piles, and nutrients deficiencies were reported as some of the health-related challenges and diseases experienced by women of reproductive age of Tshwane District, Gauteng Province resulting from the practise of geophagia.

CONCLUSIONS

The practise of geophagia was associated with various negative health outcomes. The reproductive health statuses of women of reproductive age were negatively impacted by the practise of geophagia affecting maternal and childhood mortalities and morbidities.

Comprehensive knowledge and supports from closest relatives are crucial to improve awareness and participation of Indonesian adolescent girls in anemia prevention program

OBJECTIVES

This qualitative study explored perceptions of anemia prevention among adolescent girls from low- to mid-socioeconomic backgrounds to identify educational needs for effective intervention.

METHODS

This qualitative study employed focus group discussions (FGDs) for data collection. Participants were recruited through purposive sampling based on specific criteria, with each FGD comprising 7-9 participants. A total of 3 FGDs were conducted, involving 23 high school female students. The discussions, guided by an interview guide, took place in classrooms at two different schools. Verbatim transcripts were created from the FGD recordings and analyzed using a thematic analysis approach.

RESULTS

The study revealed several information gaps, including an incomplete understanding of anemia, prevention strategies, and its consequences. Comprehensive knowledge about the causes and effects of anemia, along with the importance of iron supplementation, was identified as essential educational needs for adolescent girls. Support from family members and teachers was deemed crucial during the implementation of anemia prevention strategies. The participants recognized anemia as a serious health issue and emphasized the importance of prevention.

CONCLUSIONS

Key aspects of anemia prevention need to be integrated into nutrition education programs for adolescents. Addressing these information gaps can enhance the promotion of anemia prevention strategies and improve adherence among adolescents.

Prevalence of anemia and its associated factors among adolescent girls on Weekly Iron Folic Acid supplementation (WIFAS) implemented and non-implemented schools at Tokha municipality, Kathmandu

Anemia, the prevailing nutritional disorder worldwide, exerts its greatest impact on individuals in developing nations, exhibiting a heightened prevalence among adolescents. There is a window of opportunity for children to improve their nutritional status during their adolescence period. Weekly iron-folic acid supplementation is the preventive measure to break the intergenerational cycle of anemia. The correlation between the consumption of iron folic acid supplements and the prevention of anemia has been firmly established by numerous studies, revealing a statistically significant association. Therefore, this study was undertaken with the aim to assess the difference in the prevalence of anemia and its associated factors among adolescent girls in Weekly Iron Folic Acid Supplementation (WIFAS) implemented and non-implemented schools at Tokha Municipality, Kathmandu. A cross-sectional study was carried out among 602 adolescent girls from grade six to ten equally divided into WIFAS implemented and WIFAS non-implemented schools. Hemoglobin estimation was done using the HemoCue Hb 301 method. The descriptive, univariate and multivariable logistic regression analysis was done using SPSS version 25 to identify a significant association between anemia and its associated variables at p-value<0.05. The overall prevalence of anemia among adolescent girls was found to be 17.4% out of which, 14% and 20.9% from WIFAS-implemented and non-implemented schools respectively. The factors like type of school, fathers' education and dietary diversity were found to be statistically significant with anemia during multivariable logistic regression analysis. Given the findings of this research, proper counseling and promotion of utilization of WIFAS in order to decrease the prevalence of anemia among adolescent girls are recommended.

Fundamental Aspects of the Development of a Model of an Integrated Health Care System for the Prevention of Iron Deficiency Anemia among Adolescent Girls: A Qualitative Study

Iron deficiency anemia (IDA) in adolescent girls is a problem that has not been resolved. This study aimed to explore the critical aspects of an integrated health care system model for preventing IDA in adolescent girls in a rural area of Indonesia. This qualitative research employed a grounded theory approach in order to build a substantive theory. This study used in-depth interviews with adolescents, parents, teachers, health workers, and persons in charge of adolescent programs at the health office, education office, and ministry of religion. Purposive sampling was performed until data saturation was achieved. Codes, categories, and themes were generated through thematic data analysis to develop a substantive theory. Data analysis was performed using MAXQDA 2022 software. A total of 41 people participated in this study. This investigation generated twenty-two categories and seven themes. These themes relate to policymaker commitments, stakeholder governance, quality, adolescents' lifestyles, adolescents' self-factors, adolescents' access to health services, and social support. The themes identified become fundamental aspects of the integrated health care system model for preventing IDA in adolescent girls. The model of the integrated health care system consists of several essential points, which include awareness and efforts from policymakers and adolescent girls, supported by parents, teachers, and the community.

Association of soybean-based food with the prevalence of anaemia among reproductive-aged men and women in rural Central Java, Indonesia

OBJECTIVE

To assess the association between soybean consumption and anaemic status in Central Java, Indonesia.

DESIGN

As part of an overarching sanitation improvement intervention in Central Java, Indonesia, we conducted a cross-sectional study in four rural villages. The study consisted of a 24-h food recall, anthropometric measurements, blood Hb measurement and stool sampling to test for soil-transmitted helminth (STH) infection status. A binary logistic regression model was fitted to test the association between soybean consumption and anaemic status after adjusting for socio-demographic factors, STH infection, dietary diversity and anthropometric status.

SETTING

This study took place in four rural villages of Wonosobo regency, Central Java, Indonesia.

PARTICIPANTS

Participants were rural villagers aged between 15 and 49 years.

RESULTS

A total sample size of 763 was attained, of which 231 were anaemic. The prevalence of anaemia was 30·2 % among men and women of reproductive age, and highest among young males. Consumption of soybean was high (79·8 %). After adjusting for covariates, the protective association between soybean consumption and anaemia was statistically significant (AOR = 0·53, 95 % CI = 0·30, 0·95, P < 0·05). There was a positive association with anaemia among underweight (AOR = 2·75, 95 % CI = 1·13, 6·69, P < 0·05) and those with high diet diversity (AOR = 1·40, 95 % CI = 1·00, 1·97, P < 0·05).

CONCLUSIONS

Our results were consistent with studies from other countries finding a protective association between soybean consumption and anaemia. This association appeared stronger for tofu than for tempeh. The prevalence of anaemia in rural Central Java is relatively consistent with nation-wide statistics indicating that interventions targeting anaemia are still largely required.