Browsing by Author "Mhango, Memory"

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    Determinants of non-compliance to iron and folic acid supplementation among adolescent girls in schools of Salima district
    (Kamuzu University of Health Sciences, 2022-09-09) Mhango, Memory
    Executive Summary Type of the study This will be a school-based quantitative cross-sectional study aiming at assessing the determinants of non-compliance to iron and folic acid supplementation among adolescent girls in selected schools in Salima district. Problem In Malawi, the prevalence of anaemia among adolescent girls is unacceptably high. The Malawi demographic health survey (MDHS) 2015-2016 indicated the anaemia prevalence of 35.3% among adolescent girls. World health organization (WHO) recommends iron and folic acid supplementation to adolescent girls in a country with prevalence of more than 20%. The recommendation is based on evidence that Iron and Folic Acid Supplementation (IFAS) has been proved cost effective way of improving iron status especially in developing countries. Considering this, the ministry of health, in collaboration with the ministry of education and other partners in 2019 launched the weekly IFAS program for adolescent girls aged 10 to 19 years to mitigate the 35.3% prevalence of anemia among adolescent girls in the country. The program was piloted in six districts of Mangochi, Dedza, Salima Lilongwe, Dowa, and Machinga, and later rolled out to other districts. However, since the implementation started in Salima district, compliance rates have been disappointingly low below the national requirement of 100% for the past 3 years of implementation. According to Salima Health Information and Management System (HMIS) data for school platform, from July to December 2019, the program had a coverage of 79% with a compliance rate of 61%. In 2020, the same duration, 69% IFAS coverage was achieved with a compliance rate of 14%, and from July to December 2021, 82% IFAS coverage was achieved with a 21% compliance rate. Yet, the reasons behind the low compliance remain unknown due to limited literature and being a new intervention among adolescent girls in Malawi. Hence the need for this study. Broad Objective The aim of the study is to assess determinants of non-compliance to Iron and Folic Acid supplementation among adolescent girls enrolled in selected schools in Salima district. Specific Objectives (1) To determine the adolescent girlsā€˜ level of knowledge of Iron deficiency anaemia and IFAS program in selected schools in Salima district. (2) To identify individual factors affecting compliance with IFAS among adolescent girls enrolled in selected schools in Salima district. (3) To examine modifying factors affecting compliance to IFAS among adolescent girls enrolled in selected schools in Salima district. Methodology The study will be conducted in randomly selected primary schools and is targeting adolescent girls (10 to 19 years) with a sample size of 106 calculated using Cochran's formula. Sampling will be done in stages (multi stage sampling) to select the health facilities, schools, and adolescent girls (responded). The data will be collected through face to face interviews using a structured questionnaire and analyzed using SPSS version 22. Descriptive statistics will be used to present the data in figures and tables. And then, logistic regression analysis will be carried out to identify determinants of IFAS non-compliance. The ethical approval to conduct this study will be sort from college of medicine research and ethics committee (COMREC) and institution clearance was obtained from Salima district council, education department. Expected findings The study findings will document determinants of non-compliance to IFAS among adolescent girls. This will give evidence that will serve as a basis for recommendation to policymakers, program managers, advocators and service providers to formulate policies and improve IFAS program strategies by including interventions that will promote compliance among the girls hence reducing the prevalence of iron deficiency anemia. Dissemination of the results The findings will be presented to schools and district nutrition coordinating committee (DNCC) in Salima, COMREC, and ministry of health, department of nutrition and HIV Aids (DNHA). The study findings will be published in a reputable peer review journals and presentedat a conference. A copy of thesis will be in Kamuzu University of health sciences (KUHES) library.