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Daily versus Weekly Iron Supplementation: Programmatic and Economic Implications for Indonesia

Gross, Rainer, Angeles-Agdeppa, Imelda, Schultink, Werner J., Dillon, Drupadi, Sastroamidjojo, Soemilah
World Health Organization, adolescents, anemia, childhood, developing countries, eating habits, elderly, elementary students, feeding behavior, food fortification, girls, iron, lactating women, nutrient deficiencies, pregnancy, pregnant women, preschool children, Indonesia
Available information on iron deficiency and anaemia among Indonesian population groups was analysed to identify the at-risk groups in Indonesia and to suggest more efficient intervention programmes to reduce its high prevalence. The results showed that the groups with the highest prevalence of anaemia were pregnant women (52.3%), working adult women (27.9%), pre-schoolers (27.1%), adolescent girls (21.1%), the elderly (10.9%), and primary-school children (6.8%). Pre-school children and adolescents need iron supplementation to provide enough iron for growth and cognitive functioning during childhood. Adolescent girls need iron supplementation to develop sufficient iron reserves before pregnancy and to improve working performance. Pregnant and lactating women also need iron supplementation. Strategies to control anaemia include improvement in dietary habits, food fortification, and supplementation. Unless feeding behaviour is changed or food fortification is adapted nationwide, oral iron supplementation remains the mainstay of the prevention and treatment of anaemia. Weekly supplementation has been shown to be an effective and economic method of supplementation. With the current approach of daily supplementation recommended by the World Health Organization, Indonesia would have to spend US$360 million annually, but weekly dosing would require only US$15 million to cover the same target population. Weekly dosing offers a practical and economic means of improving iron status in developing countries.