{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T22:13:08Z","timestamp":1791238388935,"version":"4.1.0"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"unspecified","delay-in-days":331,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Nutr Sci"],"published-print":{"date-parts":[[2025]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The weekly iron and folic acid supplementation (WIFAS) programme is a school-based initiative designed to reduce iron and folate deficiency anaemia among adolescent girls. In Ethiopia, donor-supported pilot programmes are implementing WIFAS in schools, but evaluations of its demand- and supply-side barriers and facilitators remain limited. This study aimed to explore these barriers and facilitators in the Sidama Region of Ethiopia. An exploratory qualitative study collected data from ten WIFAS-targeted schools using key informant interviews (KIIs) and focus group discussions (FGDs). Participants included purposively selected school directors, WIFAS-trained teachers, health centre heads, district health and education office nutrition focal points, and regional health and education bureau delegates. Ten FGDs were conducted with adolescent girls and their mothers. Thematic analysis was performed using Open Code software to identify emerging themes. This study identified low awareness of iron and folic acid (IFA) tablets, negative community perceptions, fear of side effects, supplementation interruptions due to school closures, and inadequate coverage as key barriers. Structural barriers included poor programme coordination, weak supply chain management, and water scarcity. Facilitators included free IFA tablet distribution, health extension workers\u2019 involvement in awareness campaigns, positive testimonials, local leader support, training, and regular supervision. The WIFAS programme implemented in schools of the Sidama Region faces programmatic and structural barriers. However, facilitators like free IFA distribution, health extension worker involvement, and community support offer opportunities for improvement. These findings highlight the need for addressing barriers while leveraging existing facilitators for enhancing programme success.<\/jats:p>","DOI":"10.1017\/jns.2025.10055","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T10:40:21Z","timestamp":1764326421000},"source":"Crossref","is-referenced-by-count":1,"title":["Demand- and supply-side barriers and facilitators of the weekly iron and folic acid supplementation programme in Sidama Region, Ethiopia"],"prefix":"10.1017","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1233-8899","authenticated-orcid":false,"given":"Amelo","family":"Bolka","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04r15fz20","id-type":"ROR","asserted-by":"publisher"}],"name":"Hawassa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tafese","family":"Bosha","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/04r15fz20","id-type":"ROR","asserted-by":"publisher"}],"name":"Hawassa University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samson","family":"Gebremedhin","sequence":"additional","affiliation":[{"name":"Addis Ababa University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"S2048679025100554_ref20","doi-asserted-by":"publisher","DOI":"10.1080\/23311932.2023.2197167"},{"key":"S2048679025100554_ref30","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/8242896"},{"key":"S2048679025100554_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzab094"},{"key":"S2048679025100554_ref34","doi-asserted-by":"crossref","first-page":"89","DOI":"10.33545\/26641658.2022.v4.i1b.104","article-title":"Utilization and compliance of weekly iron and folic acid supplementation programme among school dropout adolescent girls in rural areas of Odisha, India","volume":"4","author":"Nikita","year":"2022","journal-title":"Int J Adv Res Commun Health Nursing."},{"key":"S2048679025100554_ref23","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0279827"},{"key":"S2048679025100554_ref10","doi-asserted-by":"publisher","DOI":"10.1177\/11786329211036303"},{"key":"S2048679025100554_ref21","first-page":"274","article-title":"Barriers, facilitators of iron and folic acid supplementation, and deworming program among school-going adolescents of Deoghar, Jharkhand, India: a mixed-methods study","volume":"45","author":"Biswas","year":"2024","journal-title":"n.a. J Fam Med."},{"key":"S2048679025100554_ref31","doi-asserted-by":"publisher","DOI":"10.1166\/asl.2018.12718"},{"key":"S2048679025100554_ref15","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-60800-5"},{"key":"S2048679025100554_ref27","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-020-08574-z"},{"key":"S2048679025100554_ref3","unstructured":"3. CSA, ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF. 2016."},{"key":"S2048679025100554_ref33","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.2625"},{"key":"S2048679025100554_ref14","unstructured":"14. FDRE. National Food and Nutrition Strategy of Ethiopia 2021. https:\/\/faolex.fao.org\/docs\/pdf\/eth211936.pdf."},{"key":"S2048679025100554_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3026(23)00160-6"},{"key":"S2048679025100554_ref16","doi-asserted-by":"publisher","DOI":"10.1177\/03795721241304475"},{"key":"S2048679025100554_ref17","unstructured":"17. SRHB. Sidama National Regional State Health Bureau 2023\/2024 Indicative Plan. 2023."},{"key":"S2048679025100554_ref22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0210634"},{"key":"S2048679025100554_ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0232076"},{"key":"S2048679025100554_ref11","first-page":"CD009218","article-title":"Intermittent iron supplementation for reducing anaemia and its associated impairments in adolescent and adult menstruating women","volume":"1","author":"Fernandez-Gaxiola","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"S2048679025100554_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-018-0490-y"},{"key":"S2048679025100554_ref12","unstructured":"12. WHO. Guideline: Daily supplementation of iron and folic acid in adult women and adolescent girls 2016. Accessed July 19, 2023 http:\/\/apps.who.int\/iris\/bitstream\/10665\/204761\/1\/9789241510196eng.pdf?ua=1&ua=1."},{"key":"S2048679025100554_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-20685-5"},{"key":"S2048679025100554_ref1","unstructured":"1. WHO. Weekly iron and folic acid supplementation as an anaemia-prevention strategy in women and adolescent girls: lessons learnt from implementation of programmes among non-pregnant women of reproductive age: (WHO\/NMH\/NHD\/18.8). Licence: CC BY-NC-SA 3.0 IGO. 2018."},{"key":"S2048679025100554_ref19","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzab094"},{"key":"S2048679025100554_ref8","unstructured":"8. EPHI. Ethiopia National Micronutrient Survey 2016."},{"key":"S2048679025100554_ref4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0264063"},{"key":"S2048679025100554_ref6","first-page":"62","article-title":"Anaemia and nutritional status of adolescent girls in Babile District, Eastern Ethiopia","volume":"24","author":"Teji","year":"2016","journal-title":"Pan Afr Med J."},{"key":"S2048679025100554_ref18","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzaa135"},{"key":"S2048679025100554_ref29","doi-asserted-by":"publisher","DOI":"10.1093\/cdn\/nzaa135"},{"key":"S2048679025100554_ref13","unstructured":"13. EMOH. Ethiopia National Nutrition Program 2016-2020. https:\/\/www.google.com\/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwi06L-Ot9SKAxWRBdsEHaWzALMQFnoECBQQAQ&url=https%3A%2F%2Fwww.nipn.ephi.gov.et%2Fsites%2Fdefault%2Ffiles%2F2020-05%2FNNP2_pdf.pdf&usg=AOvVaw1S7QyZcwpo74G5vtWI9NED&opi=89978449. 2016."},{"key":"S2048679025100554_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0224514"},{"key":"S2048679025100554_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4135-8"},{"key":"S2048679025100554_ref24","article-title":"Successes and challenges of the home-grown school feeding program in Sidama Region, Southern Ethiopia: a qualitative study","volume":"11","author":"Desalegn","year":"2022","journal-title":"J Nutr Sci"},{"key":"S2048679025100554_ref5","doi-asserted-by":"publisher","DOI":"10.1186\/s13690-018-0324-y"}],"container-title":["Journal of Nutritional Science"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2048679025100554","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T10:40:24Z","timestamp":1764326424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2048679025100554\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":34,"alternative-id":["S2048679025100554"],"URL":"https:\/\/doi.org\/10.1017\/jns.2025.10055","relation":{},"ISSN":["2048-6790"],"issn-type":[{"value":"2048-6790","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025]]},"article-number":"e85"}}