Anemia and adherence to weekly iron-folic acid supplementation among adolescent girls in a stunting locus of Ambon City, Indonesia

Background: Anemia remains a major public health concern among adolescent girls in Indonesia. To address this, weekly iron-folic acid (IFA) supplementation has been implemented nationwide. This study examined factors associated with anemia and adherence to IFA supplementation among adolescent girls in three senior high schools within the Poka-Rumah Tiga Health Centers' catchment area in Ambon City, Indonesia. Methods: A cross-sectional survey was conducted in August 2022 involving 522 female students from three senior high schools in Ambon City. Factors associated with anemia and adherence to weekly IFA supplementation were examined using logistic regression. Results: A high prevalence of anemia (49.23%) was found among participants. Only 14.75% of participants complied with taking IFA supplements weekly. A reduced odd of anemia was associated with having no previous history of worm infections. The odds of adherence to weekly IFA supplementation increased in those who did not consume green vegetables and knew the rules of taking IFA tablets. The odds of adherence also increased among those who understood the benefits of IFA tablets. The highest odds of adherence were associated with those who knew at least two benefits of taking IFA tablets. Conclusion: Worm infection was associated with anemia, while consumption of green vegetables, as well as awareness about the rules for taking IFA tablets and the benefits of IFA tablets were associated with compliance with weekly IFA supplementation. Worm control measures and health promotion activities benefit the anemia control efforts in Ambon City, Indonesia. Keywords: Low Hb level, Senior high school students, Indonesia