Effect of School-Based Weekly Iron and Folic Acid Supplementation Program on the Serum Folate Status of Adolescent Girls in Sidama Region, Southern Ethiopia: Comparative Cross-Sectional Study.

Abstract

Background: In Ethiopia, a school-based weekly iron and folic acid supplementation (WIFAS) program is being implemented to reduce burden of anemia in adolescent girls. While the program's impact on iron levels is well-studied, there is limited evidence on its effect on folate status.

Objective: The study was aimed at assessing the effect of the WIFAS on serum folate levels of school adolescent girls in Sidama Region, Southern Ethiopia.

Methods: A school-based cross-sectional study that compared the serum folate concentration among adolescent girls (10-19 years) enrolled in schools with (n = 165) and without (n = 165) the WIFAS program was carried out. Adolescent girls from both groups were sampled using multistage sampling procedure. The serum folate was compared between the 2 groups using mixed effects linear regression model.

Results: The study presented significantly higher mean (±standard deviation) serum folate concentration among girls from schools implementing the WIFAS program (9.76 ± 4.02 ng/mL) than their counterparts (7.38 ± 4.53 ng/mL) (β = 2.28, P < .001). The mean hemoglobin level was also higher in the WIFAS arm (13.07 ± 1.81 g/dL) than the comparator group (12.4 ± 1.93 g/dL (β = 0.86, P = .034).

Conclusion: The school-based WIFAS program showed positive association with serum folate and hemoglobin concentration in adolescent girls. This evidence should be used for advocating the scale-up of the program to areas with high prevalence of anemia and folic acid deficiencies.