Weekly Iron And Folic Acid Supplementation Research Articles

Barriers, Facilitators of Iron and Folic Acid Supplementation, and Deworming Program among School-Going Adolescents of Deoghar, Jharkhand, India: A Mixed-Methods Study.

This study aimed to identify barriers and facilitators of iron and folic acid supplementation and deworming programs among school-going adolescents. A mixed-method observational study was conducted among adolescents in the 8th to 10th standards and their teachers across four schools in Deoghar, Jharkhand, India, using simple random sampling. The study included a questionnaire on socio-demographics, knowledge (34 items) (α=0.894), attitudes (2 items) (α=0.711) toward iron deficiency anemia, awareness of the Weekly Iron and Folic Acid Supplementation (WIFS) program and deworming (20 items) (α=0.783), and practices related to iron folic acid supplementation (IFS) and deworming, along with qualitative components. Data were analyzed using jamovi. Compliance rates for IFS and deworming were 27.5% and 67.9%, respectively. The multivariable logistic regression analysis showed that sex, religion, caste, father's educational status, per capita monthly family income (PCMI), diet type, adequate knowledge, and positive attitude toward anemia influenced IFS compliance. Religion, PCMI, and prior information on the importance of deworming facilitate compliance. Implementation barriers included irregular medication supply and a lack of student awareness. Periodic evaluation, regular sensitization, and a consistent drug supply are necessary to effectively implement WIFS and deworming programs in the study area.

Influence of intermittent iron and folic acid supplementation on cognitive abilities among adolescent girls in northwestern Tanzania.

Iron and folic acid (IFA) supplementation to reduce anemia is key for improving substantial lost disability adjusted life years (DALYs) for adolescent girls. This study assessed the impact of weekly IFA supplementation (WIFAS) on cognitive ability among adolescent girls in the Simiyu Region in northernwestern Tanzania. This cross-sectional comparative evaluation study of 770 adolescent girls (396 -WIFAS supplemented; 374 -not supplemented) evaluated the association between WIFAS and cognitive ability through a face-to-face survey and cognitive ability assessment using standardized tests (Span-forward Test, Span-backward Test and Maze Test). Using a modified Poisson regression, we controlled for the geographic setting (urban vs rural), availability of potable water and feeding programs in schools, age and school level of adolescent girls, parental status, main parental economic activities, and the number of teachers. Participants were between the ages of 11 and 19 years, with more than half (57%) between 12-15 years of age. Those with WIFAS had higher cognitive ability (Span-forward scores, χ2 = 46.34% p <0.001; Span-forward, χ2 = 46.34% p <0.001; and Global Composite Cognitive Performance (GCCP), χ2 = 32.52% p<0.001). Among the IFA supplemented adolescent girls, secondary school level had a significantly higher score with respect to Span-backward (aPR = 1.43, 95% CI = 1.06-1.62); Span-forward ability (aPR = 1.26, 95% CI = 1.04-1.53) and Maze Test ability (aPR = 1.12, 95% CI = 1.01-1.25) as compared to their counterpart in primary school level. Individual adolescent girls with WIFAS and living with both parents performed much better on the Span-backward Test (aPR = 1.22, 95% CI = 1.07-1.68) as compared to those living with relatives and/or orphans. The presence of potable water program among the WIFAS schools resulted in a higher Span-backward ability (aPR = 1.34, 95% CI = 1.03-1.89); and GCCP (aPR = 1.27, 95% CI = 1.03-1.75). Adolescent girls from WIFAS schools with feeding program had higher Span-forward (aPR = 1.38, 95% CI = 1.03-1.63) ability as well as a higher Maze Test (aPR = 1.15, 95% CI = 1.07-1.26) score. The present study provides compelling evidence that WIFAS is positively associated with higher cognitive ability among adolescent girls. Nevertheless, IFA interventions are still rare in communities across Tanzania.

Prevalence of Anaemia among Adolescent Girls on Weekly Iron and Folic Acid Supplementation (WIFS) and Non WIFS Group in Rural Schools of Mangalore, Karnataka; a Comparative Study

Background: Weekly Iron and Folic Acid Supplementation (WIFS) Programme is an initiative to decrease the burden of anaemia among adolescents studying in Government schools.&#x0D; Objective: To assess the difference in prevalence of anaemia among Government school-going adolescents girls on WIFS as compared to private school girls not on WIFS.&#x0D; Methods: Cross-sectional study was conducted among adolescent girls, 7th to 10th standard in Government schools (on WIFS) and private schools (not on WIFS). The sample size in each group was 104, selected by multi-stage sampling. Data was collected using semi-structured questionnaire, clinical examination and haemoglobin estimation. Chi-square test and Unpaired t test used to compare the categorical and continuous variables respectively.&#x0D; Results: The prevalence of anaemia among the school children in government schools was 51% and in the private schools it was 64.4%. The mean haemoglobin was 11.77 ± 1.41 and 11.34 ± 1.49 in government and private school girls, respectively, which was statistically significant (p=0.013).&#x0D; Conclusions: The prevalence of anaemia among the government school girls was lesser as compared to the private schools girls, suggesting the role of WIFS in the reduction of prevalence of anemia. WIFS programme may be extended to private schools as well.

Is ignorance of the weekly iron and folic acid scheme among adolescents the deciding factor for its suboptimal utilization and ineffectiveness? A cross-sectional study.

INTRODUCTION:Targeting the huge burden of adolescent anemia, the Weekly Iron and Folic acid Supplementation (WIFS) was launched by the Government of India. Few studies have been done to assess the effective functioning of the program since its inception. The present study was done to assess the knowledge WIFS among adolescents of Madhya Pradesh and the associated factors.MATERIALS AND METHODS:A cross-sectional study was done in a total of six districts (3 districts where the national adolescent program was implemented and 3 districts where it was not) of Madhya Pradesh. Multistage stratified random sampling technique was used for the enrollment of 3213 adolescent boys and girls, and a prestructured and validated tool was used to collect paperless data. Ethical approval and consent from the participants were obtained. Statistical analysis was performed using SPSS v21.RESULTS:It was observed that the knowledge of WIFS was more among adolescent girls (29.3%) as compared to adolescent boys (14.1%). More of the adolescent girls received Iron and folic acid tablets as compared to adolescent boys (60.8% girls vs. 24.1% boys). Mostly, the adolescents got Iron tablets from school followed by Anganwadi and PHC/CHC. Girls, rural location, literacy, below poverty line status, knowledge of anemia, adolescents who got iron and albendazole tablets, and adequate consumption of iron tablets (>4) were associated with higher knowledge of WIFS.CONCLUSION:The knowledge of WIFS was found to be less in adolescent boys. There is a hint of the fact that effective execution of the program among its beneficiaries leads to an automatic increased knowledge of the program, at least among the beneficiaries. Thus, an indirect but significant indirect finding is that the nationwide WIFS program needs to be put to greater focus among the adolescent boys, apart from its major focus on the female gender among most age groups.

Perspective: Weekly Iron and Folic Acid Supplementation (WIFAS): A Critical Review and Rationale for Inclusion in the Essential Medicines List to Accelerate Anemia and Neural Tube Defects Reduction

ABSTRACTWeekly iron and folic acid supplementation (WIFAS) is among the 8 key effective actions for improving adolescent nutrition included by the WHO in the 2018 guidelines. However, at present WIFAS in the WHO-recommended formulation is not included in the Model Essential Medicines List (MEML), limiting the potential for countries to import, produce, and prioritize this formulation as part of their national supply management and procurement plans for medicines. The WHO WIFAS guideline presents evidence that the formulation reduces anemia, but not that folic acid reduces neural tube defects (NTDs), because sufficient evidence was unavailable at the time of the last review. Recently, a 3-arm, parallel-group, randomized, double-blind, placebo-controlled folic acid efficacy trial on WIFAS was conducted to address this evidence gap. The study population included 331 women (18–45 y old), randomly assigned to 3 treatment groups, including a supplement with 60 mg Fe as ferrous fumarate and either 0 mg, 0.4 mg, or 2.8 mg of folic acid, to be consumed once weekly for 16 wk, followed by a 4-wk washout period. In this article we critically review how the outcomes of this folic acid efficacy trial, and how the evidence generated, could potentially be used to inform WHO WIFAS guidelines for the potential inclusion of this formulation on the MEML, and how this, in turn, may affect product availability. If the new evidence on weekly folic acid is assessed as adequately reducing the risk of NTDs, a guideline revision could be warranted and WIFAS could be presented to the MEML for the dual benefits of anemia reduction and NTD prevention. This inclusion could enable acceleration of implementing policies and programs to contribute to global anemia and NTD reduction efforts.

School Readiness in Weekly Iron Folic Acid Supplementation Program in Urban Area, West Java, Indonesia

Background:School based weekly iron and folic acid supplementation (WIFAS) program was aimed to decrease anemia prevalence and improve the adherence to consume iron tablet.Limited information on the school perspective and their readiness to implement the program.Objectives:To analyze program guidelines, stakeholders’ perspective and school readiness to implement the program which will help evaluate and improve adherence to WIFAS.Methods:Using cross sectional design with mixed method approach to utilize social ecological model and community readiness model.Results: Most of schools received awareness campaign regarding the program,only 38,9% have conducted a drinking together session once a week,only 27,8% recorded their students’ adherence.The average score for the school readiness was 3.36 (SD ±0.82), the school was in the vague awareness stage.There is a correlation between the score of school’s knowledge, attitude toward WIFAS program,City Health Authority and Education Regional Office ‘s support score, the total score of the school readiness, ever got socialization with implementation of WIFAS (r= 0.35, r=0.2, r=0.49, r=0.21, r= 0.66, r= 0.43, p value &lt;0.005).The strongest correlation with implementation of WIFAS at school was the school readiness total score, ever received socialization and score school’s knowledge on WIFAS (p value &lt;0.005) and City health Authority and Education regional office’s support score for WIFAS program as covariant (p &gt;0.05).Conclusions: School readiness is important factor of community and environment which contribute to behavior change.School realize that anemia and schoolgirl adherence to consume WIFAS had to solved but did not know how and assume outside parties can help solve the problem.The City Health Authority and Education Regional Office is expected to help improve the school readiness to implement the program.

Pattern of anaemia, determinants and weekly iron and folic acid supplementation programme among tribal adolescent girls attending a primary health centre in Wayanad, Kerala

Anaemia is a major cause of concern during adolescence particularly among the persons of tribal origin. The objective of the study was to determine the pattern of anaemia, determinants and coverage of the weekly iron and folic acid supplementation (WIFS) programme among adolescent girls in a tribal area. A cross sectional study was conducted among 196 adolescent girls at a primary health care centre in tribal area of Kerala. Every alternate adolescent girl attending the centre was chosen over a period of three months. Assent and informed consent from accompanying parents was obtained. Haemoglobin was estimated by Sahli’s method and peripheral smear prepared. Three fourths of the adolescent girls had iron deficiency anaemia; of which 48.64% had moderate anaemia 5.40% had severe anaemia and 1.6% had sickle cell anaemia. Adolescents belonging to Paniya tribe and those not consuming Iron and folic acid tablets under WIFS programme were three times (OR 2.95 95% CI 1.38,6.28) and two times (OR 2.5 95% CI 1.24, 5.11) respectively were more likely to be anaemic. Most (80%) of the anaemic girls were unaware about WIFS scheme and the intake of the iron supplementation was significantly higher in school going girls. Strengthening the WIFS scheme by targeting the vulnerable adolescent girls of Paniya tribe and out of school girls are of extreme importance in tackling the problem of anaemia among tribal adolescent girls.

Population-level effective coverage of adolescent weekly iron and folic acid supplementation is low in rural West Bengal, India.

To assess the coverage of the adolescent weekly iron and folic acid supplementation (WIFS) programme in rural West Bengal, India. We conducted a population-based cross-sectional survey of intended WIFS programme beneficiaries (in-school adolescent girls and boys and out-of-school adolescent girls). Birbhum Health and Demographic Surveillance System. A total of 4448 adolescents 10-19 years of age participated in the study. The percentage of adolescents who reported taking four WIFS tablets during the last month as intended by the national programme was 9·4 % among in-school girls, 7·1 % for in-school boys and 2·3 % for out-of-school girls. The low effective coverage was due to the combination of large deficits in WIFS provision and poor adherence. A large proportion of adolescents reported they were not provided any WIFS tablets in the last month: 61·7 % of in-school girls, 73·3 % of in-school boys and 97·1 % of out-of-school girls. In terms of adherence, only 41·6 % of in-school girls, 38·1 % of in-school boys and 47·4 % of out-of-school girls reported that they consumed all WIFS tablets they received. Counselling from teachers, administrators and school staff was the primary reason adolescents reported taking WIFS tablets, whereas the major reasons for non-adherence were lack of perceived benefit, peer suggestion not to take WIFS and a reported history of side effects. The effective coverage of the WIFS programme for in-school adolescents and out-of-school adolescent girls is low in rural Birbhum. Integrated supply- and demand-side strategies appear to be necessary to increase the effective coverage and potential benefits of the WIFS programme.

Study of epidemiological determinants of undernutrition among adolescent girls in urban slums of Berhampur, Odisha: a cross-sectional study.

Adolescent girls are vulnerable to many problems, undernutrition being the most common. This results in growth restriction resulting in stunting, wasting, underweight and last but not the least iron-deficiency anaemia. Nutritional needs are high during puberty which later leads to complications during pregnancy and its outcomes. A field based cross-sectional study was carried out to assess the nutritional status of the girls and to determine the various factors responsible for undernutrition. After clearance from the Institution Ethical Committee (IEC) and permission from Child Development Programme Officer (CDPO), the study was conducted in the anganwadi centres (AWC) of urban slums in the field practice area of the Department of Community Medicine from the 1st October 2014 to the 31st October 2016. All the adolescent girls enlisted in the seven anganwadi centres were included as study subjects with their consent. A pre-designed, pre-tested and semi-structured questionnaire was used to collect data on following sections. (a) socio-demographic profile and (b) nutritional status. Dietary intake was taken using the 24-h recall method. Anthropometry was measured and haemoglobin (Hb) was estimated. SPSS version 21 was used for descriptive and analytic statistics. Among the 160 girls 98(61.3%), 69(43.1%), 53(33.1%) were underweight, stunted and wasted, respectively. Anaemia was present among 144(90%) of the girls. Strict monitoring of weekly iron and folic acid supplementation (WIFS) as well as nutrition education are essential measures to solve the problem of undernutrition among adolescent girls.

Iron-deficiency anemia among adolescents: A global public health concern

Iron deficiency Anemia is a global public health concern. We aim to assess a national program for Weekly Iron and Folic-acid Supplementation (WIFS) to address this concern among adolescents in India. A longitudinal interventional community-based study was conducted with 1100 school-going adolescents. A questionnaire regarding socio-demographic profile, anthropometric details, and clinical examination, hemoglobin levels, and WIFS supplementation were conducted to collect information at 0, 3, 6, 9, and 12 months. The mean age of adolescents was 13.7 years. Anemia among students reduced from 95.8% to 75% post-intervention. The mean level of hemoglobin was 9.69 g/dL at 0 months and improved to 11.29 g/dL at 12 months for adolescents. The prevalence of anemia reduced significantly with WIFS over one year. Education and awareness for dietary diversification, increasing bioavailable iron, fortified food for full-term infants and children, and additional supplements are crucial to prevent iron deficiency anemia.

Understanding barriers in implementation and scaling up WIFS from providers perspective: A mixed-method study, Rishikesh, India.

Context:Since the implementation of Weekly Iron and Folic acid Supplementation (WIFS) program in India in 2013, little effort has been made to comprehensively evaluate the program.Aims:This study was carried out to assess the coverage of WIFS among adolescent girls, explore implementation barriers, and suggest solutions to improve WIFS through public schools in Rishikesh, India (2018–19).Methods and Materials:This was a sequential explanatory mixed-methods study. Quantitative component was a community-based cross-sectional survey to determine the prevalence of anemia and coverage of WIFS. Qualitative component added an explanation to understand WIFS implementation through document review and nonparticipant observation of WIFS session. We invited stakeholders for nominal group discussion on barriers and solutions.Statistical Analysis Used:Variables were described as proportion and mean. Group discussion transcript was analyzed using content analysis.Results:Of 400 adolescent girls, 16% (95% CI: 12.4, 19.6) received weekly and 45% ever received iron tablets over the last 3 months and 79% were anemic. From ten schools, one school never implemented WIFS. There was iron-folic acid (IFA) stock out for 10 months last year. Major barriers identified were nonavailability of IFA, and irregularity in submitting IFA consumption report. Suggested solutions were ensuring IFA stock, strengthening supervision, ownership, training, and regular meetings of stakeholders.Conclusions:To conclude, in a setting with high anemia prevalence, WIFS was poorly implemented. Ownership and strengthening supervision is essential for the success of the program.

Assessment of Weekly Iron-Folic Acid Supplementation with and without Health Education on Anemia in Adolescent Girls: A Comparative Study.

Background:Iron deficiency is the most common and widespread nutritional disorder in the world, affecting a large number of children and women in developing countries and constituting a public health condition of epidemic proportions. Weekly iron and folic acid supplementation (WIFS) with health education has been demonstrated to be effective in reducing anemia in adolescent school going girls. We assessed the impact of WIFS with and without health education on anemia in adolescent school girls of Delhi.Methods:This is a school-based intervention study conducted in two government senior secondary schools of Delhi. A total of 210 adolescent school girls from two schools were included in the study. In one school (intervention group), weekly ironfolic acid with health education once a month was given, and in the second school (control group), only WIFS was given for 6 months. Iron–folic acid supplementation containing 100 mg of elemental iron and 0.5 mg of folic acid was given on a weekly basis, and health education was provided once a month for 6 consecutive months. Hemoglobin (Hb) estimation was done at the beginning and the end of the study using the Hemocue method. Mean Hb change after intervention between the control and experimental groups was compared using a t test. Pre and post differences within the control and experimental groups were assessed using a paired-t test.Results:After intervention, there was a significant decline in prevalence of anemia in both the intervention (54.7 percentage points decline) and the control (26 percentage points decline) groups (P < 0.001).Conclusions:WIFS with once a month health education can be effective in reducing the prevalence of anemia in adolescent school girls.

Assessment of Anemia status among school going adolescent of Raipur and Jashpur district of Chhattisgarh

Background: According to WHO, adolescence is the population of 10-19 years of age. According to NFHS III, in Chhattisgarh, 58.7% adolescent girls and 34.6% adolescent boys aged between 15-19 years were anemic. So, to combat anemia MoHFW launched weekly iron and folic acid supplementation (WIFS) programme with the objectives to reduce the prevalence. Thus the present study was in attempts with the objective to assess anemia status among school going adolescent of Raipur and Jashpur districts of Chhattisgarh.Methods: It was a school based cross-sectional study conducted in the two districts of Chhattisgarh during 2017-18 among the students aged between 12-19 years and the sample size was 480. By using simple random sampling method, four schools from each district and from each school total 60 students i.e. 10 students from each class 7th -12th were selected by using systematic random sampling method. Permission from DEO of the respective district followed by permission from the principal of each schools and consent from parents of the student was taken and then study was proceeded.Results: In the present study, the mean age of the students in Raipur and Jashpur district was 15.1±1.8 years and 15.2±1.8 years respectively. Out of all the students, in Raipur district, 101 (42.1%) students were found to be anemic and mean Hemoglobin level was 12.5±1.9 gm/dl. In Jashpur district about two third 147 (61.2%) of the students were anemic and mean Hemoglobin level was 11.9±1.9 gm/dl.Conclusions: This study concluded that anemia is still high among adolescent boys and girls.

Incidence of Side-effects After Weekly Iron and Folic Acid Consumption Among School-going Indian Adolescents

To estimate incidence of side effects after weekly iron and folic acid supplementation (WIFS) in Delhi and Haryana. In this cross-sectional school-based study, data were collected from 4,183 adolescents on WIFS consumption and side effects experienced first time of receipt of WIFS (week 1), and in last two consecutive weeks (week 2,3). Week 3 was 48 hours preceding the survey. WIFS consumption in week 1, 2 and 3 was 85%, 63% and 52%, respectively. Side effects reported were highest in first week (25%) and reduced to 7% (week 2) and 5% (week 3). Side effects most reported were abdominal pain (80%) and nausea (10%). Adolescents (45%) who faced a side-effect in week 1 did not consume WIFS in subsequent week. Incidence of side effects was low, but it affected compliance. Positive reinforcement to students who face side effects requires strengthening by teachers.

India steps ahead to curb anemia: Anemia Mukt Bharat

Anemia is a major public health problem in India affecting over half of population in almost all age groups. It has devastating effect on human health and affects the socio-economic development. Government has devised several programs like National Nutritional Anemia Control Program (NNACP), Weekly Iron and Folic Acid Supplementation (WIFS), National Iron Plus Initiative (NIPI) etc to combat anemia. The facts remain that in spite of all the programs, no marked improvement has been noticed in the magnitude of anemia. A holistic approach is required with special emphasis on community awareness about consequences of anaemia and benefits of Iron Folic Acid (IFA) supplementation, uninterrupted supply availability of Iron folic Acid tablets and syrups, hard to reach areas and monitoring and review system to find out adequacy in terms of participation and frequency of meetings and problem-solving in NIPI

Knowledge about iron rich foods and its consumption pattern among adolescent girls in an urban slum of Kolar

Background: Adolescent anemia is a long standing public health problem in India. According to NFHS-3 almost 56% of adolescent girls aged 15-19 years suffer from some form of anaemia. This study was conducted to assess the knowledge and consumption practices of iron rich foods and also to estimate the haemoglobin levels among adolescent girls in urban slum of Kolar. Methods: Around 170 adolescent girls in the age group of 10-19 years in Gandhinagar area of Kolar town were included and administered the interview questionnaire. They were invited to Anganwadi centres on a fixed day for estimation of haemoglobin. 92 girls attended the screening and were given awareness by distributing hand out. Results: The mean age of the girls was 15.06±2.230. The mean age at menarche was 13.38±1.158. Majority of girls 58.8% were in 15-19 year age group, 94.1% were aware about iron rich foods and 66.5% were aware of weekly iron and folic acid supplementation (WIFS). Around 92 (54.1%) girls were screened for haemoglobin levels and 32 (34.8%) were found to have anaemia. The factors associated with anaemia among adolescent girls included attaining menarche and no toilet usage which was statistically significant (p value &lt;0.05). Conclusions: The supplementation of iron and folic acid tablets alone is not sufficient and it has to be effectively combined with improving the awareness about iron rich foods and its consumption practices to reduce the prevalence of anaemia.

A Study on Weekly Iron and Folic Acid Supplementation (WIFS) Programme in a School at Rural Area of West Bengal, India

A Study on Weekly Iron and Folic Acid Supplementation (WIFS) Programme in a School at Rural Area of West Bengal, India

Evaluation of Weekly Iron and Folic Acid Supplementation Programme for adolescents in rural schools of Kannur, North Kerala, India: A cross-sectional study

Background: Iron deficiency is the major cause for anemia and widespread nutritional deficiency disorder in India. In 2013, Ministry of Health and Family Welfare has launched the Weekly Iron and Folic Acid Supplementation (WIFS) Programme to reduce the prevalence and severity of nutritional anemia in adolescent population. Since it is a relatively new program, we conducted this survey to evaluate current status of the program implementation in the schools, Kannur, India. Objective: To evaluate the current status of WIFS Programme implementation in the schools of Kannur, north Kerala, India. Materials and Methods: It was a cross-sectional study carried out in schools under the rural field practice area of Community Medicine Department, Kannur Medical College, Kannur. Two schools were selected randomly for the data collection and a sample of 524 students and 39 teachers were studied for a period of 1 month. A pretested, semi-structured, self-administered questionnaire was administered and descriptive statistics and associations were analyzed. Results: Out of the 524 students, 50.4% were males and 49.6% females, 77.3% of them had not consumed iron and folic acid (IFA) tablets regularly—main reasons were feeling healthy and parent’s resistance. Awareness about anemia and its symptoms was good but significant difference existed between the schools. Twenty-three percent had side effects after IFA tablets intake and common side effect was stomach pain. All 39 teachers opined WIFS Programme was useful and 90% teachers counseled the students. Fifty percent teachers told they faced resistance from parents. Conclusion: Awareness about anemia was good but WIFS implementation in schools was not regular. There is a need to strengthen the program by giving proper training to the teachers and by giving health education to the parents and students about the benefits of WIFS.

Demonstrating Effectiveness of Delivering Weekly Iron and Folic Acid Supplementation (WIFS) through Government Systems in Chhattisgarh, India

Demonstrating Effectiveness of Delivering Weekly Iron and Folic Acid Supplementation (WIFS) through Government Systems in Chhattisgarh, India

Evaluation of Weekly Iron and Folic Acid Supplementation program for adolescents in rural Pondicherry, India

Background: Weekly Iron and Folic Acid Supplementation (WIFS) program is a newly initiated program in Pondicherry. It was considered crucial to explore the compliance and “for and against” forces for it so as to facilitate its future implementation in a community setting. Objectives: To evaluate the recently initiated WIFS program for government school children. Materials and Methods: It was a mixed-methods study design, where quantitative (survey of students) and qualitative (key informant interviews of teacher in charge of WIFS, health assistants, and auxiliary nurse midwife) methods were used. Results: Out of the 345 participants of quantitative survey, there were 110 boys and 235 girls. Majority (85.8%) of the students reported to consume four tablets of Iron folic acid (IFA) in the past 4 weeks. The major reasons for noncompliance reported were absenteeism (55.1%), powdery tablet (22.4%), and side effects (22.5%). Most motivating role in taking IFA tablet regularly was played by the teacher. The percentage of students who correctly reported at least three iron-rich food was 40%. Significantly girls had better knowledge about symptoms of anemia and iron-rich diet than boys. Major positive factors for the program reported by the students and key informants were benefits such as an improved sense of well-being, motivation by parents, teachers, and friends, heath education by the local medical officer and health staff, regular supply of tablets, and demand from private schools for IFA tablets. Major negative factors for the program reported were fear of adverse effects such as nausea, attribution of abdominal pain due to other causes of IFA tablets, and extra workload on teachers. Conclusion: We found a good compliance to IFA tablet consumption. In order to improve the program further, awareness about side effects on IFA tablet consumption and health education about iron-rich diet should be strengthened.