An Anemia Monitor hands out Iron Folic Acid (IFA) tablets to girl students at the Sayaji Girls' High School, Vadodara, Gujarat
“I feel very energetic and I am able to concentrate better on my studies after I started taking the red iron tablets being given in my school. My menstrual cycle has become regular too”, said Namrata Dalwadi, a class XI student of Sayaji Girls High School, Vadodara.
A survey amongst adolescent girls in the city of Vadodara in Gujarat state, raised an alarm with 75 percent suffering from anemia. Gujarat is one of the economically better-off states in India. As a result, a pilot intervention was started in 2000 with all school-going adolescent girls being given an Iron & Folic Acid (IFA) tablet once a week to control anemia.
It was for the first time that an anemia control programme was jointly implemented by the Health and Education departments with support from UNICEF. The tablets are administered to students from Class VIII onwards under the supervision of a school teacher. Interestingly, Wednesday was selected as a fixed day for supplementation after long discussions with school teachers, principals and girl students since it is an atypical day when the girls do not generally observe a fast.
Teachers’ training for supervised supplementation has been a crucial component of the programme. About 800 teachers were provided training. Students were also oriented by the trained teachers on the benefits of IFA tablets and dietary sources of iron, etc.
The pilot programme was implemented in 426 schools of Vadodara district, covering 69,000 adolescent girls. Posters, brochures, and a “20 question booklet” were distributed to enhance awareness about anemia control.
Two girl students were appointed as anemia monitors to distribute the IFA tablets every Wednesday and ensure supervised consumption. “This strategy is working very well as the girls feel a part of the programme and has made our task easier too.” says Kalpana Mehta, a school teacher.
Geeta Desai, a teacher in Sayaji Girls High School came out with a unique strategy to motivate the girls to take the IFA tablets. First, she gave a motivating talk on the benefits and necessity of consuming iron tablets and then herself ate the IFA tablets during the school assembly for two days. This had an immense impact on the girls and they started taking IFA tablets willingly. Jigna Patel, a class XI student of Sayaji Girls High School says, “I used to feel weak and giddy during my period. Now I take IFA tablets and feel stronger. My food intake has increased and I sleep better too.”
Princy, a Class VIII student of Baroda High School, explains to her parents the benefits of the Iron Folic Acid supplement programme
After a year and a half of implementing the programme, an impact evaluation, conducted by Government Medical College, Vadodara showed encouraging results. The level of anemia went down by 22% and hemoglobin levels had gone up by 75%. Ami Jhala, a student of class VIII in Baroda High School says, “Earlier, walking a little would make me feel tired. Now, walking or cycling – nothing tires me, thanks to the iron tablets given to me by my teacher for the last six months”.
Parents of the school girls have also appreciated the benefits of the programme. Aarti Sharma, mother of Princy, a class VIII student of Baroda High School says, “Princy would get extremely tired after returning from school and also during her period. But, after regularly taking IFA tablets she has become stronger and does not feel tired. In class VII her result used to be around 50%, now in class VIII it has shot up to 80%”. Convinced of the benefits of IFA tablets, Sangeeta Pattani, mother of Vishakha studying in class XI, has persuaded her younger daughter also to eat IFA tablets given in the school.
The success of this initiative has not only motivated the Government of Gujarat to expand the programme to all the 25 districts of Gujarat, it is also proposed to introduce a package of other interventions like awareness about life skills, menstrual hygiene and prevention of HIV/AIDS in partnership with other organisations. While UNICEF is supporting the programme in 16 districts, covering approximately 750,000 girls, Micronutrient International has joined hands to support 9 districts, covering 200,000 adolescent girls. The programme is seen as a model for replication across India for anemia control among adolescent girls. It is gradually receiving international recognition, with a couple of South Asian nations planning to adopt the same concept.
Gurinder Gulati, Communication Officer, Gujarat