ANEMIA AND ASSOCIATED FACTORS AMONG ADOLESCENT GIRLS IN WEEKLY IRON AND FOLIC ACID SUPPLEMENTATION IMPLEMENTED AND NONIMPLEMENTED SCHOOLS IN GOG AND ABOBO WOREDA, GAMBELLA, SOUTHWEST ETHIOPIA.

Background: Iron deficiency anemia is a significant public health concern among adolescent girls in Ethiopia, affecting their health and development. The Weekly Iron and Folic Acid Supplementation program was implemented to address iron deficiency anemia but its effectiveness in this age group remains unclear. Objective: The aim of this study was to assess anemia and its associated factors among adolescent girls in Gog and Abobo woreda, Gambella Region, Southwest Ethiopia.. Methods: This study employed a comparative cross-sectional design to investigate anemia among high school students in Gambella, Abobo, and Gog woreda. A total of 359 students were randomly selected and surveyed using a pre-tested structured questionnaire. Data analysis was performed using SPSS. Bivariable binary logistic regression was conducted to identify potential predictors of anemia. Variables with a p-value less than 0.25 in the bivariable models were included in the final multivariable logistic regression model. Goodness-of-fit and multicollinearity tests were conducted to ensure the validity of the statistical models. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated to measure the strength of the association. Statistical significance was declared at a p-value less than 0.05. Result: The overall prevalence of anemia among high school students was 28.4% (95% CI: 22.5- 34.1). Significantly higher rates were observed in non-WIFAS schools (33.9%, 95% CI: 28- 34.2) compared to WIFAS schools (22.9%, 95% CI: [17-31.5]). In WIFAS schools, students from households where the father had died were 11.08 times (AOR = 11.08, 95% CI: 1.47-28.33) more likely to be anemic compared to those with living fathers. A history of malaria increased the odds of anemia by 3.62 times (AOR = 3.622, 95% CI: 1.08-12.11). Inadequate knowledge about anemia was associated with a 7.57 times increased risk of anemia (AOR = 7.57, 95% CI: 2.94-19.47). Lack of access to healthcare services increased the odds of anemia by 5.04 times (AOR = 5.04, 95% CI: 1.81-14.09). Students with underweight were 9.30 times (AOR = 9.30, 95% CI: 3.01-28.83) more likely to be anemic compared to their counterparts. In non-WIFAS schools, belonging to larger families increased the odds of anemia by 6.22 times (AOR = 6.22, 95% CI: 2.29-16.82). Low dietary diversity was associated with a 4.02 times increased risk of anemia (AOR = 4.02, 95% CI: 1.52-9.11). Lack of healthcare access increased the risk by 5.11 times (AOR = 5.11, 95% CI: 2.31-12.78). Students with underweight were 2.82 times (AOR = 2.82, 95% CI: 1.05-7.59) more likely to be anemic.This study showed that anemia was a moderate public health problem in this population, with non-WIFAS schools exhibiting higher rates. Deceased father, history of malaria, Inadequate Knowledge on Anemia, lack of healthcare access, underweight were significantly associated with anemia among WIFAS group while large family size, low dietary diversity, lack of health care access, underweight were significantly associated with anemia among non-WIFAS