Micronutrient Initiative supported governments of Bangladesh and Indonesia in revitalising IFA as a key component of the ANC package through demonstration of strategies to improve the coverage and adherence of IFA among pregnant women in selected districts with the objective of reducing iron deficiency anaemia.
The program package consisted of strengthening the supply chain of the IFA supplements; capacity building of health staff in monitoring and tracking, behavior Change Interventions for increasing adherence with a focus on improved interpersonal counselling; modifying monitoring system to track coverage and improving supportive supervision. The demonstration projects were implemented in Narsinghdi and Satkhira districts of Bangladesh and in Lebak and Purwakarta districts in Indonesia. The program was assessed by a pre-post intervention study design with comparison areas in Bangladesh and a post intervention study design with comparison areas was adopted in Indonesia. Socio-demographically similar districts were considered as comparison areas.
In both the countries, in the intervention areas, adherence to 90+ IFA tablets was found to be more than 50% and logistic regression showed that among all women interviewed, those who were exposed to improved interpersonal counseling were 2-7 times more likely to consume 90+ IFA in the most recent surveys undertaken [Indonesia: Unadjusted odds ratio (UOR): 2.124 (95% CI:1.386-3.256, p=0.001) and Bangladesh: UOR: 7.560 (95% CI: 3.850-14.486, p=0.000)] .
Considering the positive results of the program package it is being scaled up in four provinces in Indonesia and in 10 low performing districts of Bangladesh with a focus on improved interpersonal counselling.