Evaluation of the management of iron tablet supplementation program for adolescent girls in Indonesia: a scoping review
Abstract
Purpose: This study aimed to analyze the evaluation of the management of iron and folic acid supplementation programs for adolescent girls in Indonesia using the input–process–output–outcome (IPOO) framework.
Methods: This scoping review followed PRISMA-ScR guidance. Six information sources, including Google Scholar, PubMed, ScienceDirect, Semantic Scholar, Taylor & Francis Online, and Wiley Online Library, were searched for studies published up to 2025 using terms related to program management, iron supplementation, adolescent girls, and Indonesia. Eligibility criteria were structured using the JBI Population–Concept –Context (PCC) framework, with adolescent girls aged 10–19 years as the population, iron supplementation program management as the concept, and Indonesia as the context. Studies published in English or Indonesian were eligible, while reviews, editorials, and commentaries were excluded.
Results: Of 2,692 records identified, 28 reports were sought for retrieval, 24 underwent full-text assessment, and seven studies met the eligibility criteria, comprising six qualitative studies and one mixed-methods study. The IPOO synthesis identified limited human resources and program resources as key input constraints, while weak monitoring, irregular supervision, and untimely distribution represented major process barriers. These implementation challenges contributed to inadequate program coverage, poor adherence to iron supplementation, and limited knowledge among adolescent girls.
Conclusion: Iron supplementation programs showed inconsistent effectiveness due to persistent implementation barriers. Strengthening program management, resource capacity, super- vision, health education, monitoring and reporting systems, and cross- sectoral collaboration between health services and schools is essential to improve adherence and ensure that program outputs translate into sustain- ed behavioral and health outcomes.
References
WHO. Global nutrition targets 2025: anaemia policy brief (WHO/NMH/NHD/14.4). Geneva: World Health Organization; 2014. Available from: [Website]
WHO. Anaemia. Geneva: World Health Organiza- tion; 2025. Available from: [Website]
Ministry of Health of the Republic of Indonesia. Indonesian Health Survey 2023. Jakarta: Health Development Policy Agency; 2024. Available from: [Website]
Ministry of Health of the Republic of Indonesia. Laporan Nasional Riskesdas 2018. Jakarta: National Institute of Health Research and Development, Ministry of Health RI; 2019. Available from: [Website]
Ministry of Health of The Republic of Indonesia. Laporan Nasional Riskesdas 2013. Jakarta: Ministry of Health of The Republic of Indonesia; 2013.
Sigit FS, Ilmi FB, Desfiandi P, Saputri D, Fajarini ND, Susianti A et al. Factors influencing the prevalence of anaemia in female adolescents: A population-based study of rural setting in Karanganyar, Indonesia. Clinical Epidemiology and Global Health. 2024;25:101500.
Mulianingsih M, Suriah S, Hidayanty H, Amiruddin R, Hadju V, Salmah AU, et al. Nutritional deficiency anemia status among adolescent girls in North Lombok District, West Nusa Tenggara, Indonesia. The Open Public Health Journal. 2024;1–7.
WHO. Guideline: intermittent iron and folic acid supplementation in menstruating women. Geneva: World Health Organization; 2011. Available from: [Website]
WHO. Guideline: daily iron supplementation in adult women and adolescent girls. Geneva: World Health Organization; 2016. Geneva; 2016. Available from: [Website]
Scott S, Lahiri A, Sethi V, de Wagt A, Menon P, Yadav K, et al. Anaemia in Indians aged 10-19 years: Prevalence, burden and associated factors at national and regional levels. Maternal and Child Nutrition. 2022;18(4):e13391.
Ghimire M, Bhandari S, Rajbanshi M. Prevalence of anemia and its associated factors among school-going adolescent girls in schools of Dhankuta municipality, Nepal. PLoS Global Public Health. 2024;4(9):e0003684.
Bhardwaj A, Murage L, Sharma S, Dipo D, Makena C, Roche M, et al. Weekly iron and folic acid supplementation and nutrition education for adolescent girls in Africa and Asia. Oxford: Emergency Nutrition Network (ENN); 2021. Available from: [Website]
Roche ML, Bury L, Yusadiredjai IN, Asri EK, Purwanti TS, Kusyuniati S, et al. Adolescent girls’ nutrition and prevention of anaemia: A school based multisectoral collaboration in Indonesia. BMJ. 2018;363:k4541.
Helmyati S, Syarifa CA, Rizana NA, Sitorus NL, Pratiwi D. Acceptance of Iron Supplementation Program among Adolescent Girls in Indonesia: A Literature Review. Amerta Nutrition. 2024;7(3SP): 50–61.
Silitonga HTH, Salim LA, Nurmala I. A systematic review of iron supplementation’s effects on adolescent girls. Jurnal Gizi Indonesia. 2024;12(2): 60–9.
Khomsan A, Riyadi H, Prasetya G. Anaemia : female youth’s knowledge and supplementation program management. International Journal of Public Health Science (IJPHS). 2025;14(1):257–65.
Tricco AC, Lillie E, Zarin W, Brien KKO, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals of Internal Medicine. 2018;169(7):467–73.
Yanti RF, Kiswanto K, Alamsyah A. Evaluation of the program for giving iron supplementary tablets to young girls in schools at the work area of the Kunto Darussalam Public Health Center in 2022. Riwayat: Educational Journal of History and Humanities. 2023;6(3): 1628–36.
Susanti S, Sulastri D, Desmawati D. Evaluasi pemberian tablet tambah darah pada remaja putri. Jurnal Kesehatan. 2021;12(1):115–26.
Ningrum AAA. Evaluasi program pemberian tablet tambah darah pada remaja putri di wilayah kerja Puskesmas Kebonsari Kabupaten Madiun. Jurnal Ilmu Kesehatan dan Gizi. 2025;3(1):107–22.
Nurcahyanti WO, Lisnawaty L, Muchtar F. Analisis pelaksanaan program pemberian tablet tambah darah pada remaja putri di wilayah kerja Puskesmas Usuku Kabupaten Wakatobi tahun 2021. Jurnal Gizi dan Kesehatan Indonesia. 2022;2(4): 134–42.
Yanti MR, Anwar S. Peran lintas sektor dalam pengawasan pemberian tablet tambah darah Fe bagi remaja putri di Kecamatan Simpang Jaya Kabupaten Nagan Raya. Jurnal Biology Education. 2022;10(2):33–44.
Yudina MK, Fayasari A. Evaluation of iron tablet supplementation program of female adolescent in East Jakarta. Jurnal Ilmiah Kesehatan (JIKA). 2020;2 (3):147–58.
WHO. Accelerating anaemia reduction: a comprehensive framework for action. Geneva: World Health Organization; 2023. Available from: [Website]
Khapre M, Shewade HD, Kishore S, Ramaswamy G, Dongre AR. Understanding barriers in implementation and scaling up WIFS from providers perspective: A mixed-method study, Rishikesh, India. Journal of Family Medicine and Primary Care. 2020;9(3):1497.
WHO. A guide to implementation research in the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2016. Available from: [Website]
Sudfeld CR, Rai RK, Barik A, Valadez JJ, Fawzi WW. Population-level effective coverage of adolescent weekly iron and folic acid supplementation is low in rural West Bengal, India. Public Health Nutrition. 2020;23(15):2819–23.
Gosdin L, Sharma AJ, Tripp K, Amoaful EF, Mahama AB, Selenje L, et al. A school-based weekly iron and folic acid supplementation program effectively reduces anemia in a prospective cohort of Ghanaian adolescent girls. The Journal of Nutrition. 2021;151 (6):1646–55.
Singh M, Rajoura OP, Honnakamble RA. Assessment of weekly iron–folic acid supplementation with and without health education on anemia in adolescent girls: A comparative study. International Journal of Preventive Medicine. 2020;11(203).
Copyright (c) 2026 Noerfitri Noerfitri, Rohayati Rohayati, Nanda Aula Rumana, Erni Astutik, Ahmad Muhaimin
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
