Factors associated with high compliance/feasibility during iron and folic acid supplementation in a tribal area of Madhya Pradesh, India

Abstract

Objective To study the feasibility of iron and folic acid (IFA) supplementation among tribal adolescent girls and identify factors associated with high compliance. Design Intervention study with IFA supplementation among tribal adolescent girls of Bijadandi block, Mandla district, Madhya Pradesh, India. Girls (n 274) from twelve villages randomly selected out of 100 potential villages received daily tablets containing iron (iii) hydroxide polymaltose complex equivalent to 100 mg of elemental Fe and 350 μg of folic acid (commercially available as Feritas tablets, marketed by Intas Pharmaceutical Ltd, India). IFA was given for 100 d and supervised by school teachers and anganwadi workers. Compliance was measured using cards and interviews. Setting Community-based iron supplementation programme. Subjects Tribal adolescent girls aged 12-19 years. Results In total 233 girls completed the study. Prevalence of anaemia was reduced from 94 % at baseline to 69 % after the intervention. Compliance rate (>80 tablets) was 89 %. Minor side-effects were reported by three girls, yet they consumed >80 tablets. Factors associated with compliance included fasting during the local festival (χ 2 = 72·74, df 3; P < 0·0001) and counselling (χ 2 = 72·74, df 3; P < 0·0001). Other qualitative factors like social mobilization, timely supply of tablets, quality of tablets (blister pack) and availability of teachers and anganwadi workers were also associated with the compliance and feasibility. Conclusions High compliance indicates that IFA supplementation with tablets is feasible among the tribal adolescent girls of Bijadandi block, Mandla district. © The Authors 2012.