Weekly Iron Folic Acid

Supplementation
(WIFA)
Date & Venue: _____________________________________________

Presented by:
 Learning Objectives
At the end of this session, participants should be able
to:

1. describe the extent of iron and folic acid deficiency

affecting at-risk populations especially among
female adolescents in the country.

2. explain the guidelines of the program to address

iron and folic acid deficiency among female
adolescents enrolled in public high schools and in
the Alternative Learning System (ALS).
 Learning Objectives
At the end of this session, participants should be able to:

3. identify implementing mechanism and discuss the roles

and functions of key players in the implementation of
the weekly iron folic acid (WIFA) supplementation for
female adolescents enrolled in public high schools.

4. explain why WIFA matters among female adolescents.

5. Discuss possible issues, needs, and concerns related to

program implementation
 Outline of Presentation
I. Defining the problem
II. The Program and Its Guidelines
- Legal Basis
- Scope and Coverage
- General Guidelines
- Schedule of Administration
- Roles and Responsibilities of key players
- Additional Guidelines
- Monitoring and Reporting
III. Why WIFA matters
IV. Facing Challenges
 I. Defining the problem
• Iron deficiency anemia (IDA) was considered
to be the most important contributing factors
to the global burden of disease (WHO, 2002)
- affects 1.62 billion people globally;
with preschool-age children as the
most at-risk (47.4%), while men
presented the lowest prevalence
(12.7%) (WHO, 2008)
 I. Defining the problem

• It is estimated that 41.8% of

pregnant women worldwide are
anemic. At least half of this
anemia burden is assumed to
be due to iron deficiency.
(WHO Guideline on Intermittent Iron and Folic Acid
Supplementation in Non-anemic Women, 2012)
 I. Defining the problem
•Anemia is a global public health problem affecting
both developing and developed countries with
major consequences for human health, as well as
social & economic developments
- occurs at all stages of life cycle, but
more prevalent in pregnant women
(25.2%) and young children 6 mos – <1
year old ( 39.4%)
Source: FOOD AND NUTRITION RESEARCH INSTITUTE
Department of Science and Technology
Source: FOOD AND NUTRITION RESEARCH INSTITUTE
Department of Science and Technology
 I. Defining the problem
• A special study in the National
Capital Region (FNRI 2013) revealed
that folate deficiency is also high.
Folic Acid or folate is a B vitamin
(B9) which cannot be stored in the
body and needs to be continuously
supplied from the daily diet.
FOOD AND NUTRITION RESEARCH INSTITUTE
Department of Science and Technology
II. The Program and Its Guidelines

Weekly Iron Folic Acid

(WIFA)
Supplementation for
Female Adolescents
 Implementing
Mechanism
Department of Health

Department of Education

Local Government Units

(Provincial/City/Rural Health Units)
 LEGAL BASIS
• DOH AO No. 2010-0010 “Revised Policy on
Micronutrient Supplementation to Support
Achievement of 2015 MDG Targets to
Reduce Under-Five and Maternal Deaths
and Address Micronutrient Needs of Other
Population Groups”
LEGAL BASIS
 SCOPE AND COVERAGE
• WIFA Supplementation is a nationwide
effort targeting all non-pregnant women
10-49 years old, which includes the
adolescents.

• In public high schools, the priority

target beneficiaries for the WIFA are
Grades 7 to 10 female learners and
those in the Alternative Learning System
(ALS) nationwide.
 SCOPE AND COVERAGE
• Female adolescents enrolled in private
high schools and those who are out of
school are encouraged to access the
WIFA supplementation through the
nearest public health centers in their
localities.

• The WIFA shall be done simultaneously

in all public high schools covering
female adolescents in grades 7 to 10
and in the ALS.
 General Guidelines
• All public high schools and ALS shall
secure consent from
parents/guardians for WIFA
Supplementation. Only learners with
consent shall be administered with
IFA. Learners with no consent will still
be included in the master list but will
not be provided with IFA tablets.
 Schedule of Administration
1. Intermittent WIFA supplementation based on the
World Health Organization (WHO) recommendation
will be given in two rounds.

- The first round is going to be every July-

September, after which there is going to
be a three-month rest (October to
December) to be followed by the second
round every January to March for each
school year.
 Schedule of Administration
2. Each female learner shall be provided by the
school nurse and/or the classroom teacher with
one tablet of 60 mg elemental iron with 400 ug
folic acid to be given once a week every Monday
for a total of 24 weeks in a given school year.

3. In case the beneficiary is absent on the day of

WIFA administration, the supplement for the week
shall be given on the day she returns to school.
 Schedule of Administration
4. In case the beneficiary is absent for the whole week,
the supplement for the previous week shall be given
on the day she returns and the current week’s
supplement 1-2 days after.

5. Iron folic acid (IFA) supplements shall be

administered on a full stomach to avoid gastric
discomfort.

6. For ALS, administration of iron folic acid shall be as

per agreed schedule between the ALS coordinator
and the learners.
 Roles and Responsibilities

DepEd Division/Districts

1. Distribute IFA supplements

provided by DOH-CO and DepEd
Regional Offices to Districts/Schools
making sure that they are enough to
cover all eligible learners and
teachers.
 Roles and Responsibilities
DepEd Division/Districts

2. DepEd Division/Districts to prepare

implementation and monitoring
plan for WIFA supplementation in
public high schools

3. DepEd Division/Districts to reproduce

WIFA recording and reporting forms
and secure other necessary supplies
 Roles and Responsibilities
Schools

1. Each school to designate point person

responsible for coordination of WIFA
supplementation activities and to
collect and consolidate school reports

2. Ensure that the required IFA

supplements and other supplies,
including clean water, are available
 Roles and Responsibilities

Schools

3. All female learners enrolled in Grades 7

to 10 in public high schools and eligible
school personnel shall be simultaneously
given IFA supplements starting July to
September for the first round and
January to March for the second round.
 Roles and Responsibilities
Schools

3.1 For ALS female learners they will

be given IFA supplements every
week on an agreed schedule set
by the ALS coordinator following
the same schedule for the first
and second rounds
 Roles and Responsibilities

Schools

4. Prior to administration of IFA

supplement, the female learners and
eligible school personnel shall be
screened by the school nurse/classroom
teacher if they have been dewormed,
within the last six months.
 Roles and Responsibilities
Schools

5. In the event that the learner was only given

for WIFA supplementation but not for
deworming, the parent/s of the female
learner shall be encouraged by the
nurse/classroom teacher to likewise give
consent for deworming as the benefits of
WIFA supplementation will be maximized
only if the learner has been dewormed first.
 Roles and Responsibilities
Schools

6. The nurse/classroom teacher will administer the

IFA supplements every Monday making sure that
clean water is available at the school during that
day.
7. The nurse/classroom teacher shall administer Iron
and Folic Acid tablet containing 60 mg elemental
iron and 400 mcg folic acid and should ensure that
the learner swallowed the tablet
 Roles and Responsibilities

Schools

8. The names of the learners who are

absent should be recorded by the
classroom teacher and should be
given IFA supplement when they
return to school.
 Roles and Responsibilities
Schools
9. Generally, IFA supplements have no known
adverse effects except for some gastric
discomfort, constipation and blackening of
stool.
These side effects, are mild and not life
threatening, however, the learner may report
any of these side effects, if experienced, to the
classroom teacher and/or the school nurse for
management and appropriate action.
 Roles and Responsibilities

Schools

10. If symptoms persist, the school nurse

may refer the affected learner to the
Rural Health Unit for further evaluation
and management.
 Roles and Responsibilities
Rural Health Units

1. Rural Health Units (RHUs) to provide WIFA to

Grades 7 to 10 in private high schools, out-of-
school adolescents and women 10-49 years old
not covered by the WIFA supplementation in
public high schools.

2. RHUs to also assist the school health personnel in

information dissemination among parents and in
management of persistent side effects like
constipation, gastric discomfort and blackening
of stool.
 Additional Guidelines
• In case the learner has been previously
diagnosed with anemia and receiving
therapeutic doses of iron, IFA shall NO
longer be given.

Once the therapeutic treatment has been

completed, WIFA supplementation shall
be started to prevent recurrence of
anemia following the WIFA
recommended schedule.
 Additional Guidelines
• In case the learner has been screened
positive for glucose-6-phosphate
dehydrogenase (G-6-PD), the learner shall
be given the IFA tablet as it is not a
contraindication for iron supplementation.

• For ALS, administration of iron folic acid

shall be as per agreed schedule between
the ALS coordinator and the learners.
 Monitoring and Reporting
DepEd Districts/Division
1. Monitor consistent implementation of the
WIFA supplementation in schools for the
first and second rounds.

2. Ensure that records and reports are

properly filled up and submitted
following the agreed schedule for
reporting.
 Monitoring and Reporting
Schools

1. The class adviser shall make sure that all

female learners listed in the master list
were given IFA supplements
2. WIFA supplementation point person to
collate and submit report using
prescribed forms and following agreed
schedules.
 Monitoring and Reporting
Rural Health Units

1. In coordination with DepEd, monitor the

consistent implementation of the WIFA
supplementation in schools.

2. Secure copies of the District consolidated

report for inclusion in the municipal
FHSIS report for WIFA supplementation
among 10-49 years old.
 Flow of Recording and Reporting
WIFA
Reports DepEd- BLSS
DOH Central Office
(DPCB-WMCHDD)

DepEd Regional DOH Regional

Coordinator Coordinator
Schools Division
Superintendent PHO/CHO

District Supervisor
MHO

High School Principal

Grade Level Chairperson

Class Adviser
Monitoring and Reporting
Monitoring Indicators

• The number of female learners in

Grades 7-10 and ALS given WIFA for
2 rounds/ total female enrolment x
100

• Number of public high schools that

implemented WIFA/ total number of
public high schools per division
III. Why WIFA Matters
 III. Why WIFA Matters
• Consequences of iron deficiency
- the cognitive performance, behavior, and
physical growth of infants, preschool and
school-aged children
• Iron deficiency adversely affects:
- the immune status and morbidity from
infections of all age groups
- the use of energy sources by muscles
and thus the physical capacity and work
performance of adolescents and adults
of all age groups
III. Why WIFA Matters
Iron is needed for:

• the formation of hemoglobin in

red blood cells;
• transport of oxygen in the body;
• production of energy;
• function of the immune system;
• normal cognitive function;
• reduction of tiredness and fatigue;
• cell division.
 III. Why WIFA Matters
Iron (Ferrous Sulfate)
• Teenage girls and women of
childbearing age need more iron
than males of the same age.

• Almost half of teenage girls do

not consume enough iron and
intakes are also low in a large
proportion of young women.
III. Why WIFA Matters
Folate (Folic Acid)

• Assists in protein metabolism

• Promotes red blood cell formation
• Prevents birth defects of spine and
brain
• lowers homocysteine levels
 III. Why WIFA Matters
Vitamin C (Ascorbic Acid)
• Involves in collagen formation
• Facilitates wound healing
• Assists in maintaining blood vessels, bones and teeth
• Necessary for the absorption of calcium, iron, and
folic acid
• Stimulates production of brain hormones and immune
factors
• Anti oxidant action
 IV. Challenges
• Delayed delivery of logistics

• Refusal due to Dengvaxia scare

• Lack of social preparation of both

teachers and parents

• Error in reporting

• Inventory of logistics

• Need for more media advocacy

 In Summary
• Iron Deficiency Anemia (IDA) is a micronutrient
malnutrition that affects not only pregnant women
and young children but many female adolescents as
well.

• DOH, DepEd, and LGUs work together to address

the problem and prevent increase in the prevalence
of IDA.

• WIFA Supplementation prioritizes Grades 7 to 10

female learners and those in the ALS nationwide.
 In Summary
• The school nurse and/or classroom teacher shall
provide each female learner with one tablet of 60
mg elemental iron with 400 ug folic acid once a
week every Monday for a total of 24 weeks in a
given school year and for the ALS to be scheduled
with their Coordinator. This will be administered
on full stomach to prevent any gastric discomfort.

• Female learners should have been dewormed

within the last six months prior to the
administration of IFA supplement.
 In Summary
• Iron supplementation increases school/work
performance and productivity for both learners and
teachers.

• Iron/folic acid supplementation lowers the risk of

deaths during childbearing by preventing severe
anemia which is highly associated with severe
bleeding.

• Folate/folic acid is important for the development of

neural tube during fetal development.
 Knowledge Check
The two rounds of WIFA Supplementation for
female adolescents in public high schools
should be given during these periods except

A. July – September
B. October – December
C. January – March
D. A & C
 Knowledge Check
The two rounds of WIFA Supplementation for
female adolescents in public high schools
should be given during these periods except

A. July – September
B. October – December
C. January – March
D. A & B
E. A & C
 Knowledge Check
Iron/Folic acid supplementation prevents
neural tube defects among women of
reproductive age beginning from

A. one month prior to conception

B. conception to nine months of pregnancy
C. 20th week of pregnancy
D. First 1000 Days
 Knowledge Check
Iron/Folic acid supplementation prevents
neural tube defects among women of
reproductive age beginning from
A. one month prior to conception
B. conception to nine months of pregnancy
C. 20th week of pregnancy
D. First 1000 Days in life
 LET’S PUSH WIFA
FOR
PINK AND HEALTHY
ADOLESCENTS..

THANK YOU!
Slides courtesy of MAS Arroyo, RND