ABSTRAK
Female adolescents are vulnerable to iron deficiency anemia (IDA) and if it persists into their reproductive years has serious implications not only for the health of their offsprings but for their own as well. An iron supplementation is warranted in order to provide sufficient iron stores prior to pregnancy and to effect desirable birth outcomes. A communication component of the supplementation is regarded as essential for improving compliance. Therefore, an experimental community trial involving adolescent female students in two public high schools in Metro Manila was conducted between October-December 1997. The objective of the study was to asses the effect of communication on compliance to weekly iron supplementation. The students were assigned to three groups: iron plus communication (FeC group, n = 82), iron (Fe group, n = 89), and control group (n=78). The FeC and Fe groups received iron tablets containing 60 mg. Elemental iron and 250 mcg. Folic acid while the control group received placebo tablets from Physical Education Health and Music (PEHM) teachers once a week of eight subsequent weeks. Teachers assigned to the FeC group were trained communication. Comparison were made between the three groups on compliance as communication. Comparisons were made between the three groups on compliace as measured by attendance to tablet distribution and actual ingestion through stool test, record on index card and interview. Additionally, levels and prevalence of anemia were measured before and after intervention and a pre and post test about knowledge on IDA and possible causes and treatments were included. Data about side-effects, reaction from students, parents and teachers about the supplementation-communication activities and suggestions for futher improvements in conductiong such future undertaking were obtained from focus group discussions (FGDs). Comparisons of actual tablet ingestion between the three groups showed significantly higher compliance in the FeC group (P<0.001) than in the other two group as measured by record on index card and interview desoite more side effects felt. Changes from pre to post-test knowledge scores o iron were significantly greater for the FeC group (p<0.001) than in the Fe and control groups. However, hemoglobin levels improved significantly in the Fe group (p<0.05) but not in the FeC group and remained the same in the control group. Reactions obtained through focus group discussions from parent (as reported by students), teachers and the participants found the program beneficial and feasible for implementation on a larger scale. Compliance enhancing strategies and motivational approaches for adolescent female students must consider the potential influence of family, fiends and teachers as revealed by the Venn diagram in planning iron supplementation programs with communication for this target group.