Perceived Barriers and Enablers for Taking Iron–Folic Acid Supplementation Regularly Among Adolescent Girls in Indonesia: A Pilot Study

Abstract

Non-compliance with iron and folic acid (IFA) supplementation is a significant contribution to the high prevalence of anemia among adolescent girls in Indonesia. This pilot study aims to explore the perceived barriers and enablers to regular IFA supplement consumption among adolescent girls. Using a qualitative approach, data were collected through focus group discussions (FGDs) conducted in Makassar and Padang City. The FGD involved 32 grade eight and nine students from four junior high schools. In-depth interviews were also conducted with health workers, teachers, and parents to triangulate the findings. A thematic analysis was performed using a social cognitive theory framework. The average age of the informants was 13.6 ± 0.6 years. Despite receiving IFA supplements at school, only 47% of informants reported consuming them regularly. Key barriers to regular supplementation included dislike of the taste and smell, parental prohibition, negative experience consuming IFA supplements, the belief that IFA supplements increase menstrual blood flow and volume, and forgetfulness factors. Enablers include self-awareness of the supplement's benefits, trust in school-provided supplements, and positive support from parents and peers. The findings highlight that both barriers and enablers play a crucial role in influencing IFA supplementation adherence. Addressing these factors is essential for improving compliance and reducing anemia rates among adolescent girls. Given the small sample size and convenience sampling method, this study serves as a pilot, and further research is needed to validate these findings on a larger scale.

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