1.Longitudinal changes in haemoglobin levels following supervised weekly iron-folic acid supplementation among adolescent girls: A school-based study in Indonesia
Desi Rusmiati ; Irwan Budiono ; Arum Siwiendrayanti ; Dwi Wahyuni ; Petrus Geroda Beda Ama
Malaysian Journal of Nutrition 2026;32(No. 2):159-170
Introduction: Anaemia remains a significant public health concern among adolescent
girls in Indonesia. Weekly iron-folic acid supplementation is widely implemented; however,
evidence from supervised school-based settings is limited. This study aimed to examine
changes in haemoglobin levels following supervised weekly supplementation. Methods: A
quasi-experimental study with repeated measurements was conducted among adolescent
girls in one junior high school. Participants received weekly ferrous fumarate (60 mg
iron and 400 µg folic acid) for 12 weeks under school supervision. Haemoglobin levels
were measured at baseline and follow-up. Data were analysed using General Linear
Model Repeated Measures (GLM-RM), with additional analysis of covariance (ANCOVA) to
adjust for baseline differences. Results: A total of 47 participants completed the study.
Haemoglobin levels increased in the intervention group (10.8 to 13.2 g/dL), while minimal
change was observed in the comparison group (12.4 to 12.9 g/dL). GLM-RM showed a
significant effect of time (p<0.001) and time–group interaction (p=0.001). However, after
baseline adjustment using ANCOVA, the difference between groups was not statistically
significant (p=0.296). Conclusion: Supervised weekly iron-folic acid supplementation was
associated with improved haemoglobin levels over time. However, baseline differences may
have influenced the observed effects. Strengthening school-based programmes through
structured supervision and adherence monitoring may improve implementation. Further
research using baseline-adjusted designs is needed to better estimate the true effect of
supplementation.


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