The document discusses India's Weekly Iron and Folic Acid Supplementation (WIFS) program and National Iron Plus Initiatives (NIPI) which aim to reduce anemia among adolescents and children. The key strategies of the programs include weekly supplementation of IFA tablets through schools and Anganwadi centers, deworming, and nutrition education. Anemia negatively impacts productivity and child development. Proper storage, administration and monitoring of IFA distribution are emphasized to ensure the success of the initiatives.

2. WIFS(weekly iron & folic acid supplementation
programme)
• Content-
• -Evidence
• -Causes of maternal death and contribution of iron deficiency anemia
• -Health economics of micronutrient deficiencies in children
• -Intergenration cycle of Anemia
• -Strategis for prevention of IDA

5. RATIONAL : EVIDENCE
• Anemia is multi- factoral in etiology
• Iron and folate deficiency are common
• Iron deficiency is related to nutritional deficiency, intestinal
helminthic deficiency and folate deficiency due to poor intake and
chronic hemolytic stage.
• Anaemia in pregnant women reduces woman ability to survive
bleeding during and after child birth.
• Besides these, malaria and other chronic diseases like- Tuberculosis,
HIV and Cancers remain as Major contributors to Anemia.

7. #HEALTH ECONOMICS OF
MICRONUTRIENTS DEFICIENCIES IN CHILDREN
• Anemia and other key micronutrient deficiencies can directly
attribute or to
• Depressed cognition
• Inferior school performance
• Reduced future earnings and productivity
• Depressed immunity
• Repeated infection .

9. HEALTH ECONOMICS OF ANEMIA
• □IMPACT ON PRODUCTIVITY.
• In an anemic individual the aerobic capacity endurance and energy
Efficiency are compromised 10-50%.
• Anemia hits hard on productivity with an estimate of 5% deficit
among all “blue collar” jobs to additional 17% loss for heavy manual
labour such as agriculture and construction.

10. IMPACT ON CHILDREN
• Iron deficiency Anaemia severaly affects cognitive performance.
• It also impacts language skill, motor skills and coordination among
infants and young children and a deficit of 5 to 10 points in
intelligence quotient(IQ).
• Anemic children score 0.5 ti 1.5 SD lower intelligence tests where as
iron interventions have similar magnitude of positive impact on
cognitive scores.

12. THE COST IMPLICATION INCLUDE:
• Increased length of hospital stay.
• Expenses related to hospital, transport of cases to hospitals with
pediatric care facilities.
• Cost of incubatars and intensive care.
• Cost of post maternity care.
• # these all result in burdan on state health budget.

14. STRATEGIES FOR PREVENTION OF IDA
• Dietry diversification.
• Food fortification.
• IFA supplementation with biannual deworming.
• Provide improved health services.
• Dietary diversification.

18. OBJECTIVE:
• The ministry of health and family welfare government of India has
launched the weekly iron and folic acid supplementation (WIFS)
programme to reduce the prevalence and severity of nutritional
Anaemia in adolescent population (10-19 years) and NIPI for age
group 6 month to 10 years.

19. Weekly Iron And Folic Acid
Supplemention(WIFS) Programme:
• Will be planned and implemented for the following two target groups
in both rural and urban areas.
• Adolescent girls and boys enrolled in government/government aided/
Municipal schools from 6th To 12th classes.

20. NATIONAL IRON PLUS INTIATIVES:
• Girls and boys enrolled in government/ government aided/ Municipal
schools from 1th to 5th classes.
• 6 month to 60 month children through AWCS.

22. STRATEGY FOR PREVENTION ANAEMIA
IN ADOLESCENTS:
• Fixed day.
• Institutions based.
• Supervised consumption.
• Educating correct dietary practices and increasing iron intake.
• Screening for moderate/severe anemia and referring.
• Annual/ biannual deworming.

24. EDUCATION SYSTEM APPROACHES:
• Weekly supplemention of IFA Tablet’s on fixed day approach to
school going girls and boys in the age group of 10- 19 yrs.
• Supervised consumption of IFA.
• School based deworming programme.
• Nutrition education to increase consumption of iron rich food.

25. ICDS APPROACHES:
• At AWCs these Tablet’s are distributed free of cost to adolescent girls
Who is Out of school.
• For adolescent girls married/ unmarried weekly IFA for 52 weeks in a
year.
• INFORMATION, COUNSELLING AND SUPPORT TO ADOLESCENT
GIRLS ON:
• How to prevent anemia and
• How to minimise the potential undesirable effects of WIFS.
• Referral services for adolescent girls suffering from moderate and
severe anemia.

26. DISTRICT EDUCATION AND ICDS
DEPARTMENT:
• Ensure monitoring of programme with monthly data collection from
block level.
• Ensure uninterrupted supply of IFA tablets at block level ( School and
AWC).
• Ensure complication of training/Orientation sessions of block
officers, teachers, ICDS , supervisors, ANM, AWW, ASHA and MO-
PHC.
• Ensure IEC material display at school and AWC.

27. BLOCK EDUCATION OFFICER AND
CDPO/ICDS OFFICER:
• Consolidated requirement from schools and ICDS Project for block
supply and share with district level.
• Set- up distribution for schools and AWO
• Ensure uninterrupted supply of IFA.
• Consolidated monitoring data and share with District.
• Conduct quarterly meeting to review the programme.

28. ESTIMATION OF IFA
• # EDUCATION:
• IFA tablet for the year =(52×total number of children in 6 to 12th
standard) + ( 52 tablets/ per teacher/ year.) An additional 20% stock
as buffer will be added.
• ICDS
• Estimating IFA tablet supply = (Number of adolescent girls registered
with ICDS × 52 tablets) + ( 52 tablets/year of each AWW + 52 Tablets/
year for ASHA). An additional 20% is yo be added for ensuring
adequate stock supply.

30. WIFS –IFA DRUGS ( STORAGE)
• STORAGE- WIFS-IFA should be kept in cool and dry place. (AVOID EXPOSURE OF SUNLIGHT AND
WATER).
• SELECTION OF PROPER PLACE:-
• Locke and key room.
• Limited access to the store
• KEEP STORE IN GOOD CONDITION:-
• Control the temperature in the store.
• Control the light in the store
• Prevent water damageand Control humidity
• Keep the store free of pests .
• KEEP YOUR STORE CLEAN AND ORGANISED:-
• Clean the store and keep it tidy.
• Store supplies on shelves.

31. WIFS- IFA DRUGS (ADMINISTRATION)
• ADMINISTRATION:- IFA drugs should be administered weekly, school
– Monday, AWCS – Thursday) to adolescent ( 10-19 years) school
going adolescent and out of school adolescent girls after mid day
meal/ poshahaar (NOT EMPTY STOMACH).
• FEFO( First Expiry First Out).
• Check Expiry in Routin.

32. Bibliography
• www.slideshare.com
• http://rajswasthya.Nic.in
• A comprehensive text book of Operational framework: WIFS for
adolescent, Manoj Jhalani, New delhi.
• http:// nhm.gov.in.