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Abstrak :
ABSTRACT
An experimental community trial study was conducted to observe the influence of communication program on weekly iron supplementation in Tanzanian adolescent school girls.

A sample of 237 school-going adolescent girls aged 14 -17 years was randomly recruited from 5 schools in Darus-Salaam and placed into 3 groups. One group received 65 mg elementary iron with 0.25 mg folic acid on a weekly dose along with communication sessions. The second group received the same dose of iron tablets and no communication sessions. No intervention was made to the control group.

A VENN Diagram to assess the most closer person whom the girls would listen to was drawn prior to study. Three Focus Group Discussions at different stages with the adolescents and teachers were conducted. Anthropometrics in-dices were done once at baseline. Supplementation and communication strategies lasted for 8 weeks.

Measurements of Hemoglobin levels to obtain a general picture about the nutritional status of the participants were carried out before and after the intervention. Hemoglobin increased in school 1&2, (iron supplementation plus communication schools), (p<0.001); and anemia dropped significantly (p<0.001). School 3 (iron without communication) had zero anemia decrease; while school 4 (control); had anemia rates unchanged. To the contrary; anemia levels increased significantly in control school 5; (p>0.05).

Knowledge test was carried out before and after intervention; and an in-crease in test scores of school 1&2 was observed (p<0.001). Compliance was checked through stool examination (observed compliance) and iron pill distribution record (reported compliance). The results as indicated by two positive stool tests, were 94% and 75% in school 1 and 2 respectively; in school 3 (iron supplementation only) it was 50%. Reported compliance was 89% for school I&2 each, and 48% for school 3.

It was concluded that, carefully planned communication strategies can influence ingestion of iron supplementation; and, as anemia in adolescents in Tanzania is high, therefore a National Iron Supplementation Program was recommended.

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.