Knowledge, Attitude, and Practices Regarding Iron Folic Acid Tablets and Coverage of the Weekly Iron Folic Acid Supplementation Programme Among Rural Adolescent Girls in Nagpur District: A Cross-Sectional Study

Despite years of programmatic efforts, anemia among adolescent girls in India remains a significant public health challenge. This study aimed to assess awareness, practices related to iron and folic acid (IFA) tablet consumption, and coverage of the Weekly Iron and Folic Acid Supplementation (WIFS) program among adolescent girls in rural areas of Nagpur district, Maharashtra.A cross-sectional design was employed to gather socio-demographic data and assess knowledge (five questions), attitude (three questions), and practices (nine questions) related to government-recommended IFA tablet consumption.Among 221 randomly selected adolescent girls, 90.5% were aware of IFA tablets, primarily informed by school teachers. Over half knew the purpose of IFA supplementation. Although 94% reported having received IFA tablets in the past, only 88% consumed them. While most did not report adverse effects, one-third did not believe IFA consumption was beneficial. Common barriers to adherence included the bitter taste of the tablets, forgetfulness, and symptoms like nausea or vomiting. The recent coverage of WIFS was observed to be low. In 2017 and 2018 the program coverage was above 75% but dropped below 60% in other years. Only 9% of participants had received an IFA tablet in the past 14 days; of these, 60% consumed two tablets. The primary reason for non-consumption was non-receipt from schools (89%).The study highlights inadequate knowledge of IFA benefits despite high awareness and suboptimal coverage of the WIFS program. Strengthening program delivery and addressing barriers to IFA consumption are essential to improve adherence and reduce anemia among adolescent girls in rural India.