This PowerPoint is weekly iron folic acid supplementation its origin and how it is implemented in India

1. Weekly Iron and Folic Acid
Supplementation (WIFS)
Dr Nishant Kumar
Assistant Professor
Department of Community Medicine
Madhubani Medical College , Madhubani , Bihar

2. Introduction
What is Anaemia ?
It is a condition in which the number of red blood cells (RBCs) is reduced and
consequently their oxygen-carrying capacity , is insufficient to meet the body’s
physiological needs.
Anemia results from one of the following process
a) Defective red blood cell production
b) Increased red blood cell destruction or blood loss
Iron is important micro mineral necessary for the synthesis of hemoglobin. Iron
deficiency anemia is an most common cause of anemia globally.

3. Adverse effect of Anaemia
Anaemia
Reduced
Physical
Development
Decrease Work Output
Decreased work Capacity
Impaired
Sexual and
reproductive
Development
Irregular Menstruation
Low pre pregnancy iron store
LBW babies and preterm delivery
Reduced
Cognitive
Development
Diminished concentration
Disturbance in perception
Poor Learning ability

4. Classification of Anaemia
Age Group No
Anaemia
Mild Moderate Severe
Children 6-59
months of age
>11 10 - 10.9 7 -9.9 < 7
Children 5- 11 year
of age
>11.5 11 – 11.4 8 – 10.9 < 8
Children 12- 14 year
of age
>12 11- 11.9 8 – 10.9 < 8
Non – pregnant
women (15 year of
age and above)
>12 11 – 11.9 8 – 10.9 < 8
Pregnant women >11 10-10.9 7 -9.9 < 7
Men >13 11- 12.9 8-10.9 < 8

5. Etiology
▪ Iron Deficiency
▪ Vitamin B12 and Folic Acid Deficiencies
▪ Helminthic Infestation
▪ Malaria
▪ Sickle Cell Disease and Thalassemia
▪ Chronic Infection

6. Problem Statement- Global Overview
• WHO Global data base on Anaemia for 1993- 2005 , covering
half of world population shows the estimated prevalence of
anemia worldwide at 25 per cent.
• Nearly 1.62 billion people globally with about 293 million
children of pre school age and 56 million pregnant women and
468 million non – pregnant women are anemic.
• Anaemia is estimate to contribute to 115,000 maternal dead and
591,000 perinatal death globally per year.

7. Problem Statement – Indian Scenario
▪ In India 58% of pregnant women are anemic and it is estimated
it is the underlying cause for 20- 40 percent of maternal death
in India.
Prevalence of anemia among different age group
Age Group Prevalence of anemia(5)
Children (6-35) month 79
Children ( 6- 59) months 69.5
All women (15-49) 55.3
Adolescent Girls 69.7
Pregnant women 58.7
Lactating women 63.2

8. Programme for Anemia Prevention
• National Iron + Initiative
It follows the Life cycle approach
for Iron Deficiency Anaemia
It includes
a) 6 month – 5 years
b) 6- 10 years
c) Adolescents
d) WRA( Women of
reproductive age)
e) PW ( pregnant women)
• Weekly Iron Folic Acid Supplementation
Weekly Iron and folic acid supplementation
for adolescents boys and girls

9. Prevalence of Anaemia among adolescent girls (12-19 years) and
young women (20-29) in India
68.6% 69.7%
55.8% 56.1%
27.0%
47.2%
39.1% 38.5%
20.5% 20.7%
14.9% 16.0%
1.1% 1.0% 1.7% 1.7%
0.0%
20.0%
40.0%
60.0%
80.0%
12-14 years 15-17 years 17- 19 years 20 -29 years
Any anaemia(<12g/dl) Mild anaemia(10.0-11.9g/dl)
Moderate Anemia(7-9.9g/dl Severe Anemia( <7 g/dl)

10. Indian future
80.6
124.2
186
236.6
262
297
0
100
200
300
400
1950 1970 1990 2010 2030 2050
Growth of Indian Adolescent population
Millions

11. WIFS - Introduction
• Started in the Year 2000 as UNICEF initiated a pilot to control
Adolescent Anaemia
• Target – Government school going and out of school adolescent
girls in 20 districts in 5 states
• Platform :
• Government school
• Anganwadi centers ( village level child development
center).
• Channels : Nodal Teachers , Anganwadi workers and peer educators
• Intervention : Weekly IFA + Biannual Deworming + Nutrition
Health Education

12. WIFS Progress
2000-05( Initial
Phase)
• UNICEF pilot in 20
district 5 states
• Expanded to 52
district in 13 state by
2006-2011
Expanded to all
district of 13 states
by 2011
Covering 27.6
million adolescent
girls
2012 Onwards
GOI launched the
nation wide WIFS
programme in 2012
targeting 108 million
adolescent girls and
boys both.

13. WIFS - Objectives
• To reduce the prevalence and severity of nutritional Anaemia in adolescent
population (10-19) years
• Target groups
• School going Girls and Boys ( 6th to 12th class)
• Adolescent girls who are not in school.

14. WIFS - Intervention
• Weekly Blue IFA ( 100m g of elemental iron plus
500microgram folic acid) round the year)
• Deworming ( Albendazole 400mg) every six months
• Screening and Referral Services
• Nutrition and Health Education counselling

15. Thank you