Anemia status and associated factors among adolescent girls under weekly iron and folic acid supplementation (WIFAS) and non-WIFAS programs in public schools in Janamora district, Northwest Ethiopia 2023; a comparative cross-sectional study

Background Anemia is the most common nutritional problem in impoverished countries, particularly among adolescents. Adolescents have a unique opportunity to enhance their nutritional status. Weekly iron-folic acid supplementation can halt the intergenerational cycle of anemia. Numerous studies have revealed a statistically significant link between taking iron folic acid supplements and preventing anemia. Therefore, this study aimed to compare the differences in the prevalence of anemia and associated factors among adolescent girls in public schools that implemented weekly iron folic acid supplementation (WIFAS) and those that did not in Janamora district, Northwest Ethiopia, in 2023. Methods A school-based comparative cross-sectional study was conducted among (361) adolescent girls on (180) WIFAS and (181) non-WIFAS schools Programme. We selected the participants via simple random multistage sampling techniques. Data were collected using an interviewer-based questionnaire, anthropometric measurements, and a hemoglobin level test. Hemoglobin estimation was performed by using the HemoCue Hb 301 machine. Descriptive and multivariate logistic regression analyses was performed via STATA Version 17 to identify a significant association between anemia and its associated variables at a p-value < 0.05. Results The overall prevalence of anemia was 50.43% (CI: 45%, 55%). However, its prevalence was 44.7% (CI: 37.4%, 52.3%) among the WIFAS schools and 56% (CI: 48.5%, 63.3%) among the non-WIFAS schools, with statistically significant differences at p < 0.05. The habit of drinking coffee/teas [AOR = 5.9] and secondary school girls [AOR = 2.5] among non-WIFAS school programs, whereas poor adherence to the IFAs [AOR = 3.6], poor anemia knowledge [AOR = 4.4], and non-vegetarian status [AOR = 2.8] among WIFAS school programs. Furthermore, parasite attack history [AOR = 6.9, and 7.6] for each program was a statistically significant factor among adolescent girls. Conclusion Anemia was less prevalent in the WIFAS school Programme than in the non-WIFAS school Programme. This indicates that the WIFAS has an important function in improving anemic status. As a result, it is recommended that the WIFAS program be extended to more schools. The WIFAS program is more effective when health education is delivered concurrently with it.