OVERVIEW

Iron deficiency and iron deficiency anemia in adolescence is a major public health issue in Afghanistan, where the prevalence of anemia is among the highest in the world. The Afghan National Nutrition Survey (2013) findings indicate that anemia exists in all age groups and is particularly high among adolescent girls.

Adolescents in general (age 10–19 years) are at high risk of iron deficiency and anemia due to poor dietary intake of iron, high rates of infection, notably from parasites, and adolescent pregnancy which is a result of societal pressures for early marriage. Long-term problems associated with anemia include maternal mortality and complications while giving birth.

The objective of this program is to improve the iron count of adolescent girls both in and out of schools by providing weekly supplements and biannual treatment of parasites. Evidence suggests that a weekly iron and folic acid tablet supplement for adolescent girls is as effective as daily supplements with a much lower rate of side effects. The program will also raise awareness on the prevention of adolescent anemia and document and disseminate best practices for the management and prevention of anemia.

ACTIVITIES

Activities for girls in school

• Build teachers’ knowledge on nutrition, importance of micronutrients, and hygiene and sanitation.
• Develop a system for weekly supplementation within urban and rural schools for adolescent girls.
• Ensure continuous supply of iron and folic acid supplements and deworming tablets to schools.
• Advocate for integration of nutrition, hygiene and sanitation messages into school education programs.

Activities for girls not in school

• Reach out to girls attending the non-formal education system (Accelerated Learning Centers) at the community level for delivery of weekly supplementation.
• Sensitize communities on the importance of nutrition for adolescents, with a particular focus on adolescent girls.
• Train non-governmental organizations and community health workers to provide supplements and parasite treatment for adolescent girls at the community level.

ACCOMPLISHMENTS

• A bilateral Memorandum of Understanding (MOU) was signed between the Ministries of Health and Education with detailed roles and responsibilities of each Ministry that describes the cooperative relationship between the two and acts as the legal agreement between the two parties.
• Protocol, guidelines, handbook, and communication materials of Weekly Iron and Folic acid Supplementation have been developed for teachers, students, parents, and religious leaders.
• A comprehensive plan for training of facilitators was developed, and the core Master Trainers received two full days of Training of Trainers to learn the facilitation techniques. The Training of Trainers for the 14 provinces is completed and training of teachers at the Provinces is going on.
• The supplementation of Iron and Folic Acid for school going adolescent girls has started in Parwan Province and will increase to 14 provinces by the end of 2016.