Barriers, Facilitators of Iron and Folic Acid Supplementation, and Deworming Program among School-Going Adolescents of Deoghar, Jharkhand, India: A Mixed-Methods Study.

ABSTRACT

BACKGROUND: This study aimed to identify barriers and facilitators of iron and folic acid supplementation and deworming programs among school-going adolescents. METHODS: A mixed-method observational study was conducted among adolescents in the 8th to 10th standards and their teachers across four schools in Deoghar, Jharkhand, India, using simple random sampling. The study included a questionnaire on socio-demographics, knowledge (34 items) (α=0.894), attitudes (2 items) (α=0.711) toward iron deficiency anemia, awareness of the Weekly Iron and Folic Acid Supplementation (WIFS) program and deworming (20 items) (α=0.783), and practices related to iron folic acid supplementation (IFS) and deworming, along with qualitative components. Data were analyzed using jamovi. RESULTS: Compliance rates for IFS and deworming were 27.5% and 67.9%, respectively. The multivariable logistic regression analysis showed that sex, religion, caste, father's educational status, per capita monthly family income (PCMI), diet type, adequate knowledge, and positive attitude toward anemia influenced IFS compliance. Religion, PCMI, and prior information on the importance of deworming facilitate compliance. Implementation barriers included irregular medication supply and a lack of student awareness. CONCLUSION: Periodic evaluation, regular sensitization, and a consistent drug supply are necessary to effectively implement WIFS and deworming programs in the study area.