SUPPLEMENTATION STRATEGIES TO ALLEVIATE IRON-DEFICIENCY - EXPERIENCESFROM INDONESIA

Anemia, mainly caused by iron deficiency, is common in Indonesia, espe cially among pregnant women and infants. In pregnancy iron deficiency anemia is associated with undesirable birth outcome, and in infants wi th reduced mental and motor development. Iron status can be improved t hrough dietary changes, food fortification, antehelminthic treatment, and supplementation. Supplementation offers the best chance for improv ement on short term, although reported effectiveness of large scale pr ograms is often limited. In Indonesia supplementation programs exist f or pregnant women, female factory workers, and under-five children fro m poor families. Effectiveness of the programs is limited by tablet su pply, program coverage, compliance and a possibly by a low vitamin A s tatus, and the following changes should be considered to improve effec tiveness. Tablets should also be distributed through channels other th an the health sector, such as through traditional birth attendants. In order to decrease the iron deficiency prevalence during pregnancy you ng women/adolescent girls should be supplemented before they get pregn ant. Infants should also be targeted by programs. Supplementation on a weekly in stead of daily basis should be considered especially under conditions where supplementation can be supervised such as in schools or factories. Since intake of vitamin A and zinc are also frequently d eficient, a multi-supplementation should be strived for. (C) 1998 Else vier Science Inc.