Knowledge Attitude and Practices of Iron-Folic Acid Supplementation and Deworming Among Mothers of 6 Months – 60 Months Children Attending an Urban Primary Health Care Centre Field Practice Area in Pudupet – A Cross Sectional Study


Authors : Jenica Muthuvel Jayachandran; Manoj Kumar K; Hasna Haridas; Hema Pandian; Kanimozhi M; Keerthana; Koushik G; Melvin Anto; Abhilekshmi AM; Priyadharshini S; Savitha S; Kavitha V; Rajesh J; Arun Murugan S

Volume/Issue : Volume 10 - 2025, Issue 5 - May


Google Scholar : https://tinyurl.com/3dkk9ha3

DOI : https://doi.org/10.38124/ijisrt/25may1378

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background: Iron deficiency anemia (IDA) is a significant global health burden, especially in children under six. India combats childhood anemia via the National Iron Plus Initiative (IFA supplementation) and biannual deworming. NFHS 5 (2019- 2021) reported anemia in 67.1% of Indian children under five, and 57.4% in Tamil Nadu.  Methods: This two-month cross-sectional study (August-September 2022) surveyed 194 mothers of children aged 6-60 months at an urban primary health center in Pudupet. Data was collected using a semi-structured questionnaire.  Results: Knowledge of IFA supplementation was 40.2% (78/194 mothers), while deworming knowledge was 69.6% (135/194). IFA supplementation was practiced by 52.6% (102/194) of mothers, and deworming by 67.5% (131/194). Although 65.6% (86/131) of deworming practices aligned with WHO guidelines (twice yearly), only 34.3% (35/102) of IFA supplementation was weekly and 35.3% (36/102) monthly, despite a twice-weekly recommendation. Key reasons for non-adherence included lack of awareness and perceived side effects like black stools for IFA (62.7%) and abdominal cramps for deworming (48.1%). Binary logistic regression showed maternal age above 30 positively influenced IFA adherence, while lower-middle-class status and working mothers correlated with reduced IFA practice. For deworming, working mothers demonstrated significantly improved practices, and mothers with one child showed marginal significance. Both IFA and deworming practices were significantly associated with maternal occupation and socioeconomic status. Conclusion: Deworming showed better knowledge, attitude, and practice than IFA supplementation. However, both interventions had less than 50% performance across knowledge, attitude, and practice indicators. With rising childhood anemia, increased awareness and practice of IFA supplementation and deworming are crucial for improving child well-being.

References :

  1. https://www.who.int/data/nutrition/nlis/info/anaemia
  2. NFHS 5 Tamil Nadu data http://rchiips.org/nfhs/NFHS-5_FCTS/Tamil_Nadu.pdf
  3. Fentaw W, Belachew T, Andargie A. Anemia and associated factors among 6 to 59 months age children attending health facilities in Kombolcha town, Northeast Ethiopia: a facility-based cross-sectional study 
  4. National Iron Plus Initiative programme dosage and regimen https://www.nhp.gov.in/national-iron-plus-initiative-for-anemia-control_pg
  5. Target for the year 2022 Anaemia Mukt Bharath https://anemiamuktbharat.info/home/target/ 
  6. Anaemia Mukt Bharath Quarterly Progress Report (cumulative) https://anemiamuktbharat.info/quarterly-progress-report
  7. https://rchiips.org/nfhs/pdf/NFHS4/India.pdf
  8. Anaemia Mukt Bharath Quarterly Progress Report (cumulative) https://anemiamuktbharat.info/quarterly-progress-report
  9. Mohan, Reenaa; Vaishnavi, B Sowbarnika; Premanandh, Kandasamy. Coverage evaluation of Iron folic acid and vitamin A supplementation among children in rural Puducherry—A Mixed method study. Journal of Family Medicine and Primary Care 13(9):p 3753-3758, September 2024. | DOI: 10.4103/jfmpc.jfmpc_30_24
  10. Pasricha, Sant-Rayn & Biggs, Beverley-Ann & N Srinivas, Prashanth & Sudarshan, Hanumappa & Moodie, Rob & Black, James & Shet, Arun. (2011). Factors Influencing Receipt of Iron Supplementation by Young Children and their Mothers in Rural India: Local and National Cross-Sectional Studies. BMC public health. 11. 617. 10.1186/1471-2458-11-617.
  11. V. D, M. V, J. K. Assessment of deworming practice among mothers of under five children in Kancheepuram district. Int J Community Med Public Health [Internet]. 2018 May 22 [cited 2025 May 2];5(6):2580-4. Available from: https://www.ijcmph.com/index.php/ijcmph/article/view/3017
  12. Bahago NI, Oyewole EO. Knowledge, Perception and Practice of Deworming Among Mothers of Under-Five Children in Rural Communities of Lafia Lga, North Central Nigeria. North Central Nigeria. 2022.
  13. Priya, SHema & Datta, Shib Sekhar & Bahurupi, Yogesh & K A, Narayan & N., Nishanthini & R., Ramya. (2016). Factors influencing weekly iron folic acid supplementation programme among school children: Where to focus our attention?. Saudi Journal for Health Sciences. 5. 28. 10.4103/2278-0521.182863.

Background: Iron deficiency anemia (IDA) is a significant global health burden, especially in children under six. India combats childhood anemia via the National Iron Plus Initiative (IFA supplementation) and biannual deworming. NFHS 5 (2019- 2021) reported anemia in 67.1% of Indian children under five, and 57.4% in Tamil Nadu.  Methods: This two-month cross-sectional study (August-September 2022) surveyed 194 mothers of children aged 6-60 months at an urban primary health center in Pudupet. Data was collected using a semi-structured questionnaire.  Results: Knowledge of IFA supplementation was 40.2% (78/194 mothers), while deworming knowledge was 69.6% (135/194). IFA supplementation was practiced by 52.6% (102/194) of mothers, and deworming by 67.5% (131/194). Although 65.6% (86/131) of deworming practices aligned with WHO guidelines (twice yearly), only 34.3% (35/102) of IFA supplementation was weekly and 35.3% (36/102) monthly, despite a twice-weekly recommendation. Key reasons for non-adherence included lack of awareness and perceived side effects like black stools for IFA (62.7%) and abdominal cramps for deworming (48.1%). Binary logistic regression showed maternal age above 30 positively influenced IFA adherence, while lower-middle-class status and working mothers correlated with reduced IFA practice. For deworming, working mothers demonstrated significantly improved practices, and mothers with one child showed marginal significance. Both IFA and deworming practices were significantly associated with maternal occupation and socioeconomic status. Conclusion: Deworming showed better knowledge, attitude, and practice than IFA supplementation. However, both interventions had less than 50% performance across knowledge, attitude, and practice indicators. With rising childhood anemia, increased awareness and practice of IFA supplementation and deworming are crucial for improving child well-being.

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