Keeping Anaemia at Bay

With schools closed during the COVID-19 pandemic, peer supporters in West Lombok are bringing iron folic acid tablets directly to adolescent girls at risk of anaemia

UNICEF
Nurjawanis and her classmates
UNICEF/2020/Blandina Rosalina Bait
28 July 2020

“I am so excited with this task. Not only do I have an opportunity to help my friends stay healthy during the pandemic, but I am also able to see them, if only for a few minutes,” said Nurjawanis.  

The 14-year old junior high school student is helping to prevent anaemia by handing out iron folic acid (IFA) tablets to her friends as a peer supporter for adolescent nutrition in West Lombok. Because her school is closed due to the COVID-19 pandemic, Nurjawanis is now making home visits to 10 adolescent girls who live in her neighbourhood. 

Around 22.7 per cent of Indonesian females aged between 14 and 18 are anaemic a condition in which the blood does not have enough healthy red blood cells to carry oxygen around the body1. It is most commonly caused by micronutrient deficiencies and poor nutrition and can lead to fatigue, shortness of breath, difficulty focusing and reduced cognitive performance. 

Anaemic adolescent girls are more likely to become anaemic mothers. During pregnancy, they have an elevated risk of postpartum haemorrhage and giving birth to low-birthweight, premature or stillborn babies who are likely to grow stunted, perpetuating the vicious cycle of malnutrition. 

Nurjawanis delivers IFA tablets
UNICEF/2020/Blandina Rosalina Bait
Nurjawanis delivers IFA tablets to another adolescent girl in her neighbourhood in West Lombok, West Nusa Tenggara Province.

“I learned in school that anaemia is often experienced by adolescent girls, especially when they have their monthly period. That’s why IFA tablets are very important to prevent adolescent girls from becoming anaemic, and to help increase blood circulation which enables them to concentrate and live a healthy life,” said Nurjawanis enthusiastically. 

The 186 peer support groups in 48 schools in West Lombok are part of AKSI BERGIZI, a multisectoral programme aimed at tackling the triple burden of malnutrition – undernutrition, anaemia and obesity. In 2019, AKSI BERGIZI reached over 60,000 adolescent girls in West Lombok with IFA tablets, 4,000 of whom were reached by peer supporters like Nurjawanis.  

However, a recent UNICEF online survey of more than 6,000 young people in Indonesia found that nearly 90% of adolescent girls have stopped consuming IFA tablets during the pandemic. 

“The COVID-19 pandemic has caused interruptions in essential nutrition services for adolescents in Indonesia, which has a profound impact on their nutritional status,” said UNICEF Nutrition Chief Jee Hyun Rah. “Innovative measures, such as the engagement of peer volunteers, are needed to safeguard and promote access to essential nutrition services for adolescents.” 

An adolescent girl takes an IFA tablet
UNICEF/2020/Blandina Rosalina Bait
An adolescent girl takes an IFA tablet after receiving it from Nurjawanis.

Since the onset of the pandemic, Nurjawanis has had to adapt and take new precautionary measures to protect her own health and the health of her peers. Before going to distribute the IFA tablets, she contacts her friends and makes an appointment. When visiting their homes, she makes sure to always wear a mask, keep her distance of at least 1.5 metres and meet outside in their terrace or yard.  

“Distributing the IFA tablets does not mean that my mission is accomplished,” she said. “I also need to send them a reminder to take it.”  

Nurjawanis herself also keeps taking IFA tablets once a week. 

“I have to lead by example, although I feel sad and lonely when taking IFA tablets at home alone instead of taking them together with my friends at school,” she said with a deep breath. “What makes me sad about this pandemic is that I can no longer hold hands and hug my best friends until a vaccine is discovered,” she continued with tears in her eyes.  

“I like to sing, so when I feel sad that I can't go to school, meet friends and do fun activities together, I will sing a song. Singing makes me calm and happy again,” she added with smile.