Objectives
Due to poor program success, iron and folic acid supplementation (IFAS) programs are often neglected. Following program improvements in IFAS coverage and adherence, MI aimed to identify key program activities from policy to behaviour change initiatives (BCI) that led to program success.
Methods
MI worked with governments and partners (2011 -2015) in Kenya, Nigeria, Ethiopia, Senegal, Nepal, Bangladesh, Indonesia, and Afghanistan to improve coverage and adherence of IFAS. Support was prioritised according to the potential to strengthen the enabling environment, IFAS provision and demand, including consumption. Changes in women’s and health workers’ knowledge and practices, policies, supply and quality of IFAS, coverage and adherence of IFAS were monitored and evaluated with pre and post surveys. Following a mapping of program support; key program activities linked with improved outputs were identified, and a model to communicate this approach for IFAS programing was developed.
Results
6 countries aligned their IFAS policies and formulations with WHO guidelines. Across the 8 countries: health worker’s knowledge and skills to effectively counsel women, forecast and monitor IFAS stocks improved following intensive training and the implementation of comprehensive BCI plans. An additional 7M pregnant women received any IFAS; and 2M women reported consuming at least 90 IFAS. An adapted WHO/CDC logic model incorporating the key program activities linked to improved IFAS coverage and adherence was designed for future program planning and advocacy
Conclusions
Investing in and committing to a comprehensive IFAS program approach enables governments to increase program outputs of coverage and adherence to IFA supplements.
