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"Female adolescents are vulnerable to iron deficiency anemia (IDA) and if it persists into their reproductive years has serious implications not only for the health of their offsprings but for their own as well. An iron supplementation is warranted in order to provide sufficient iron stores prior to pregnancy and to effect desirable birth outcomes. A communication component of the supplementation is regarded as essential for improving compliance. Therefore, an experimental community trial involving adolescent female students in two public high schools in Metro Manila was conducted between October-December 1997. The objective of the study was to asses the effect of communication on compliance to weekly iron supplementation. The students were assigned to three groups: iron plus communication (FeC group, n = 82), iron (Fe group, n = 89), and control group (n=78). The FeC and Fe groups received iron tablets containing 60 mg. Elemental iron and 250 mcg. Folic acid while the control group received placebo tablets from Physical Education Health and Music (PEHM) teachers once a week of eight subsequent weeks. Teachers assigned to the FeC group were trained communication. Comparison were made between the three groups on compliance as communication. Comparisons were made between the three groups on compliace as measured by attendance to tablet distribution and actual ingestion through stool test, record on index card and interview. Additionally, levels and prevalence of anemia were measured before and after intervention and a pre and post test about knowledge on IDA and possible causes and treatments were included. Data about side-effects, reaction from students, parents and teachers about the supplementation-communication activities and suggestions for futher improvements in conductiong such future undertaking were obtained from focus group discussions (FGDs). Comparisons of actual tablet ingestion between the three groups showed significantly higher compliance in the FeC group (P<0.001) than in the other two group as measured by record on index card and interview desoite more side effects felt. Changes from pre to post-test knowledge scores o iron were significantly greater for the FeC group (p<0.001) than in the Fe and control groups. However, hemoglobin levels improved significantly in the Fe group (p<0.05) but not in the FeC group and remained the same in the control group. Reactions obtained through focus group discussions from parent (as reported by students), teachers and the participants found the program beneficial and feasible for implementation on a larger scale. Compliance enhancing strategies and motivational approaches for adolescent female students must consider the potential influence of family, fiends and teachers as revealed by the Venn diagram in planning iron supplementation programs with communication for this target group."

"Although iron is the most abundant element ¡n the universe , anemia is still the most prevalent nutritional disorders worldwide including in Indonesia. Among other approaches of combating iron deficiency anemia, iron supplementation is known to be the simplest and most effective way in improving iron status. This study is aimed to investigate the effect of iron supplementation given during menstruation as compared with weekly administration using the same dosage and number of iron tablets. The findings of this study are reported in three parts. Part I contains introduction which consists of background, problem statement and rationale, literature review, causal model, hypotheses, objectives, variables and indicators. This part supports the idea of the study. Manuscript for publication that covers main methods and findings of this study ¡s presented in part Il. The last part is appendices which comprise questionnaires, detailed methodology, detailed results, informed consent and ethical approval, references, Asia Pacific Journal of Chnical Nutrition?s guidelines for contributors, and curriculum vitae."

"ABSTRACTAn experimental community trial study was conducted to observe the influence of communication program on weekly iron supplementation in Tanzanian adolescent school girls. A sample of 237 school-going adolescent girls aged 14 -17 years was randomly recruited from 5 schools in Darus-Salaam and placed into 3 groups. One group received 65 mg elementary iron with 0.25 mg folic acid on a weekly dose along with communication sessions. The second group received the same dose of iron tablets and no communication sessions. No intervention was made to the control group. A VENN Diagram to assess the most closer person whom the girls would listen to was drawn prior to study. Three Focus Group Discussions at different stages with the adolescents and teachers were conducted. Anthropometrics in-dices were done once at baseline. Supplementation and communication strategies lasted for 8 weeks. Measurements of Hemoglobin levels to obtain a general picture about the nutritional status of the participants were carried out before and after the intervention. Hemoglobin increased in school 1&2, (iron supplementation plus communication schools), (p<0.001); and anemia dropped significantly (p<0.001). School 3 (iron without communication) had zero anemia decrease; while school 4 (control); had anemia rates unchanged. To the contrary; anemia levels increased significantly in control school 5; (p>0.05). Knowledge test was carried out before and after intervention; and an in-crease in test scores of school 1&2 was observed (p<0.001). Compliance was checked through stool examination (observed compliance) and iron pill distribution record (reported compliance). The results as indicated by two positive stool tests, were 94% and 75% in school 1 and 2 respectively; in school 3 (iron supplementation only) it was 50%. Reported compliance was 89% for school I&2 each, and 48% for school 3.It was concluded that, carefully planned communication strategies can influence ingestion of iron supplementation; and, as anemia in adolescents in Tanzania is high, therefore a National Iron Supplementation Program was recommended."

"ABSTRACTAlthough iron supplementation exists for pregnant women, the prevalence of anemia during pregnancy remains high. The lack of compliance of the target group is one of the reasons which may reduce the efficacy of the supplementation program.Recent studies in preschool children and non pregnant women has been reported that the administration of intermittent iron supplement was equally effective in improving the iron status as daily supplement.This research was to investigate whether a weekly dose of 120 mg iron supplementation would improve the iron status in the same way as a daily dose of 60 mg iron supplementation in pregnant women.The effect of daily vs weekly iron supplementation was studied in pregnant women in non randomized experimental community trial. The subjects were pregnant women who attended the selected Health Centers for the first time in their current pregnancy. Of the 176 pregnant women enrolled, a complete data set were available for 139 (79 %). Duration of supplementation was 8 - 20 weeks.Three health centers each, matched with socioeconomic condition were allocated for control group and treatment group. Daily group served as control received 60 mg Fe + 0.25 mg folic acid daily (68 pregnant women), while weekly group received 120 mg Fe + 0.50 mg folic acid weekly (71 pregnant women).Hemoglobin concentration in both group increased significantly after supplementation (p < 0.001). Improvement of hemoglobin was influenced by initial hemoglobin level (p < 0.001), and hookworm infestation (p < 0.05).Serum ferritin level decreased in daily and weekly group (p > 0.05). Serum ferritin change was not influenced by initial hemoglobin level (p ] 0.05), however was influenced by hookworm infestation (p < 0.001).The duration of supplementation had no effect on hemoglobin changes (p > 0.05), but it influenced serum ferritin changes (p < 0.05).It was concluded that supplementation with 120 mg elemental iron on weekly basis had similar effects as daily dose of 60 mg on hematological status, but was not enough to improve iron stores in pregnant women. "

"Anemia has long been recognized as a serious public health problem in many developing countries. WHO reported at an INACG meeting and estimated that 2 billion people were anemic. Based on the public health viewpoint, most cases of anemia are nutritional anemia and defined in the year 1968 WHO technical report as a condition in which the hemoglobin content of the blood is lower than normal as a result of a deficiency of one or more essential nutrients, regardless ofthe cause of such deficiency.The causal relationship between iron deficiency and physical work capacity is evaluated through a systematic review of research literature, including animal and human studies. The presumed mechanism for this effect is the reduced oxygen transport associated with anemia; tissue iron deficiency may also play a role through reduced cellular oxidative capacity.The effects of anemia on physical activities and work performance have been studied in several countries such as Indonesia and China. A study in Indonesia found a significantly lower output of anemic Indonesian rubber plantation workers than the non-anemic workers. The Vietnam national survey in anemia l995 revealed that the prevalence of anemia was 40.2 % among non-pregnant women; it was also high among males around 20 %), whereas the prevalence of iron deficiency among non pregnant women was not very high (33.3 %). Therefore, multivitamin supplementation may reduce the anemia prevalence among Vietnamese non pregnant workers. Some main problems of an anemia control program (in scale of 113 districts of Vietnam) were side effects and the unpleasant taste of iron tablets; it caused the low compliance of iron tablet consumption. On the other hand, multi vitamin tablets have no side effect and have a palatable taste, thus it may be well accepted."

"The effect of weekly iron supplementation and deworming on the hemoglobin level was studied among 289 children aged 2 to 5 years in a randomized double-masked placebo controlled community trial. Subjects were allocated into 3 groups which respectively received iron supplements and deworming, iron supplements only and placebos. Iron supplementation for 8 weeks using 30 mg elemental iron as ferrous sulphate syrup once per week, led to a significant reduction in the prevalence of anemia from 37.2%. to 16.2%. Using unsupervised distribution by mothers, hemoglobin concentration increased significantly in both groups which received iron (p<0.001) and also in the placebo group (p<0.05), but the changes in both treatment groups were significantly higher than the placebo group (p<0.001). No significant difference in hemoglobin changes was found between those who received additional deworming and those who received iron supplement only. Positive iron in stool were confirmed in 68.2% of the children who were reported received iron supplements (n=66). It is concluded that weekly iron supplementation is effective to reduce the prevalence of anemia among preschoolers."

"Anemia is the main micronutrient deficiency problem among adolescent school girls in Indonesia. Anemia due to iron deficiency often coexists with zine deficiency. Iron and zinc have anlagonistic interaction. Therefore, it was appropriate ratio of iron-zinc supplementation. Objective The study was aimed to investigate the different ratios of iron-zinc supplementation Fe: Zn = 2: 1 and Fe: Zn = 4: 1 on improving the iron and zinc status and eventually reduction of the morbidity of anemic adolescent school girls compared to iron supplementation alone. Methodology randomized, double blind community trial was conducted among anemic adolescent school girls (10-12 years old). Selection of subjects was conduted in two steps. Firstly, 238 girls (out of 1358 girls), with hemoglobin concentration level < 115 g/L using Hemocue were recruited and given antihelminthic drug (500 mg mebendazole as a single dose). Secondly, those who had hemoglobin concentration < 120 g/L using Cell Dyn from venous blood one week after deworming (n+133) were enrolled into the study. The 133 subjects were assigned randomly to one of the three groups for daily iron-zinc supplementation for 12 weeks with: Group 1 (n=45): iron (60 mg/day), Group 2 (n=45): iron and zinc (30 mg and 15 mg/day) or group 3 (n=43): iron and zinc (60 mg and 15 mg/day).Supplement intake was supervised at base line, weight and height were measured and the available iron and zinc intake from diet was estimated using a model modified from WHO/FAO and Murphy, based on the data 24-hour Food Recall and Food Frequency Questionnare. Iron (hemoglobin/Hb, serum ferritin/SF, serum transferrin receptor/TfR, zinc protoporphyrin/ZPP, Mean Corpuscular Volume/MCV, Red-cell Distribution Width/RDW, body iron/BI) and zinc (serum zinc/SZ) status and supplementation. Morbidity status of diarrhea and Acule Respiratory Infection (ARI) were recorded weekly. The phagocytes cell and Cell-Mediated Immunity were measured only for 50% of the subjects. Results and Discussion By the end of the supplementation, most indicators of iron status were increased significantly in all subjects both they took iron supplementation with or without zinc, and the proportion of iron deficiency anemia reduced. Iron supplementation alone or iron-zinc improved zinc status. The proportion of zinc deficiency was sinificantly reduced only among subjects who took iron-zinc supplementation with the ratio of Fe: Zn =2: 1. which was significantly lower compared to the other two groups at the end of supplementation. In iron/zinc 2 : 1 group, no subject had iron deficiency anemia and zinc deficiency after 12 weeks of supplementation, which suggested that iron-zinc supplementation with the ration of Fe: Zn = 2 : 1 had reduced both iron deficiency anemia and zinc deficiency. In this study, iron deficiency among anemic school girls was due to insufficiency of iron in red blood cell, and iron or iron-zinc supplementation for 12 weeks had less benefit to increase iron status. The possibility; of hemoglobinopathies such as thalassemia trait affecting adolescent girls in this study should be considered as several studies indicated that the prevalence of tlinlassemia trait among the same population in Indonesia is high. Iron deficiency also occurred at the storage level, which increased and reached the normal value with iron or iron-zinc supplementation. At the end of supplementation, the mean value of most indicators of iron status in all groups did not reach the normal value (such as Hb < 120 g/L, ZPP > 40 umol/mol heme, MCV <2 80 fL, RDW > l4%), perhaps the 12-weeks of iron supplementation was not long enough to fulfill iron for the 120 erythrocyte life cycle. lt seems, that the competition between iron and zinc occurred both at the storage level and the erythrocyte formation, and iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction as the improvement of both iron and zinc status was higher compared to the other groups. Most anemic adolescent school girls in this study had low available iron and zinc intake from the diet, with low intake of enhancers and high intake of inhibitors, which is not enough to promote either iron or zinc absorption from the supplements. The reduction of the proportion ol' subjects suffering from ARI was the highest among subjects who took either iron alone (3l.1% to 6.7%) compared to those who took iron- zinc supplement with ratio 2: 1 (1 7.3% to l1.l%) or iron-zinc supplement with ratio 4: 1(16.3 % to l4%), indicating that iron alone reduced morbidity status in tenn of Acute Respiratory Infection (ARI). However, adding zinc to iron supplements with ratio 2: 1 scents to improve the specific immune response of anemic adolescent school girls, as shown that the ratio of CD-4/CD-S was slightly increased among subjects who took iron- zinc supplement with the ratio of Fe: Zn= 2: 1 Conclusions and Recommendations lt was concluded, that both iron deficiency anemia (22%) and zinc deficiency (15.8%) were problems in the study area. Iron deficiency and hemoglobinopathies such as that assemia trait might be the causes of anemia among adolescent school girls. A daily 30 mg iron and 15 mg zinc supplementation among anemic adolescent schools girls for 12 weeks improved iron and zinc status and reduced iron deficiency anemia and zinc deficiency. Iron supplementation alone increased iron status, while adding zinc to iron supplementation protected the adverse effect of iron on decreasing zinc status. The competition between iron and zinc might occur in the role of both nutrients for erythrocytes formation as well-as at storage level, and supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction on improving bot.h iron and zinc status. As most of the anemic adolescent school girls had inadequate iron and zinc intake from the diet, the deficiencies of other micronutrients such as; vitamin A, folic acid and vitamin B12 should also be considered as the causes of anemia. Combined iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 was appropriate on reducing the risk of anemic adolescent school girls suffering from Acute Respiratory Infection, however the mechanism of both iron and zinc on enhancing immune system could not clearly be shown from the results of this study. It is recommended to establish an iron-zinc supplementation program with ratio of 2: 1 through the existing channel of school health program to alleviate iron de iciency anemia and zinc deficiency 'among adolescent girls. Research cum action prioritized is to explain the contribution of bioavailability iron and zinc intake from the diet including increase the enhancers and minimize the inhibitors to the absorption of iron-zinc supplementation with ratio of Fe: Zn = 2: 1. The possibility of hemoglobinopathies such as thalassemia trait, as the cause of anemia needs further investigations."

"Anemia is the main micronutrient deficiency problem among adolescent school girls in Indonesia. Anemia due to iron deficiency often coexists with zine deficiency. Iron and zinc have anlagonistic interaction. Therefore, it was appropriate ratio of iron-zinc supplementation.ObjectiveThe study was aimed to investigate the different ratios of iron-zinc supplementation Fe: Zn = 2: 1 and Fe: Zn = 4: 1 on improving the iron and zinc status and eventually reduction of the morbidity of anemic adolescent school girls compared to iron supplementation alone.MethodologyA randomized, double blind community trial was conducted among anemic adolescent school girls (10-12 years old). Selection of subjects was conduted in two steps. Firstly, 238 girls (out of 1358 girls), with hemoglobin concentration level < 115 g/L using Hemocue were recruited and given antihelminthic drug (500 mg mebendazole as a single dose). Secondly, those who had hemoglobin concentration < 120 g/L using Cell Dyn from venous blood one week after deworming (n+133) were enrolled into the study.The 133 subjects were assigned randomly to one of the three groups for daily iron-zinc supplementation for 12 weeks with: Group 1 (n=45): iron (60 mg/day), Group 2 (n=45): iron and zinc (30 mg and 15 mg/day) or group 3 (n=43): iron and zinc (60 mg and 15 mg/day).Supplement intake was supervised at base line, weight and height were measured and the available iron and zinc intake from diet was estimated using a model modified from WHO/FAO and Murphy, based on the data 24-hour Food Recall and Food Frequency Questionnare. Iron (hemoglobin/Hb, serum ferritin/SF, serum transferrin receptor/TfR, zinc protoporphyrin/ZPP, Mean Corpuscular Volume/MCV, Red-cell Distribution Width/RDW, body iron/BI) and zinc (serum zinc/SZ) status and supplementation. Morbidity status of diarrhea and Acule Respiratory Infection (ARI) were recorded weekly. The phagocytes cell and Cell-Mediated Immunity were measured only for 50% of the subjects.Results and DiscussionBy the end of the supplementation, most indicators of iron status were increased significantly in all subjects both they took iron supplementation with or without zinc, and the proportion of iron deficiency anemia reduced. Iron supplementation alone or iron-zinc improved zinc status. The proportion of zinc deficiency was sinificantly reduced only among subjects who took iron-zinc supplementation with the ratio of Fe: Zn =2: 1. which was significantly lower compared to the other two groups at the end of supplementation. In iron/zinc 2 : 1 group, no subject had iron deficiency anemia and zinc deficiency after 12 weeks of supplementation, which suggested that iron-zinc supplementation with the ration of Fe: Zn = 2 : 1 had reduced both iron deficiency anemia and zinc deficiency.In this study, iron deficiency among anemic school girls was due to insufficiency of iron in red blood cell, and iron or iron-zinc supplementation for 12 weeks had less benefit to increase iron status. The possibility; of hemoglobinopathies such as thalassemia trait affecting adolescent girls in this study should be considered as several studies indicated that the prevalence of tlinlassemia trait among the same population in Indonesia is high.Iron deficiency also occurred at the storage level, which increased and reached the normal value with iron or iron-zinc supplementation. At the end of supplementation, the mean value of most indicators of iron status in all groups did not reach the normal value (such as Hb < 120 g/L, ZPP > 40 umol/mol heme, MCV <2 80 fL, RDW > l4%), perhaps the 12-weeks of iron supplementation was not long enough to fulfill iron for the 120 erythrocyte life cycle.lt seems, that the competition between iron and zinc occurred both at the storage level and the erythrocyte formation, and iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction as the improvement of both iron and zinc status was higher compared to the other groups. Most anemic adolescent school girls in this study had low available iron and zinc intake from the diet, with low intake of enhancers and high intake of inhibitors, which is not enough to promote either iron or zinc absorption from the supplements.The reduction of the proportion ol' subjects suffering from ARI was the highest among subjects who took either iron alone (3l.1% to 6.7%) compared to those who took iron- zinc supplement with ratio 2: 1 (1 7.3% to l1.l%) or iron-zinc supplement with ratio 4: 1(16.3 % to l4%), indicating that iron alone reduced morbidity status in tenn of Acute Respiratory Infection (ARI). However, adding zinc to iron supplements with ratio 2: 1 scents to improve the specific immune response of anemic adolescent school girls, as shown that the ratio of CD-4/CD-S was slightly increased among subjects who took iron-zinc supplement with the ratio of Fe: Zn= 2: 1.Conclusions and Recommendationslt was concluded, that both iron deficiency anemia (22%) and zinc deficiency (15.8%) were problems in the study area. Iron deficiency and hemoglobinopathies such as that assemia trait might be the causes of anemia among adolescent school girls. A daily 30 mg iron and 15 mg zinc supplementation among anemic adolescent schools girls for 12 weeks improved iron and zinc status and reduced iron deficiency anemia and zinc deficiency. Iron supplementation alone increased iron status, while adding zinc to iron supplementation protected the adverse effect of iron on decreasing zinc status.The competition between iron and zinc might occur in the role of both nutrients for erythrocytes formation as well-as at storage level, and supplementation with the ratio of Fe: Zn = 2: 1 had minimal interaction on improving bot.h iron and zinc status. As most of the anemic adolescent school girls had inadequate iron and zinc intake from the diet, the deficiencies of other micronutrients such as; vitamin A, folic acid and vitamin B12 should also be considered as the causes of anemia.Combined iron-zinc supplementation with the ratio of Fe: Zn = 2: 1 was appropriate on reducing the risk of anemic adolescent school girls suffering from Acute Respiratory Infection, however the mechanism of both iron and zinc on enhancing immune system could not clearly be shown from the results of this study.It is recommended to establish an iron-zinc supplementation program with ratio of 2: 1 through the existing channel of school health program to alleviate iron de iciency anemia and zinc deficiency 'among adolescent girls. Research cum action prioritized is to explain the contribution of bioavailability iron and zinc intake from the diet including increase the enhancers and minimize the inhibitors to the absorption of iron-zinc supplementation with ratio of Fe: Zn = 2: 1. The possibility of hemoglobinopathies such as thalassemia trait, as the cause of anemia needs further investigations."

"Iron deficiency anemia is the most common nutritional disorder in developing countries and the most at risk population are women of reproductive age, pregnant women and children (DeMaeyer, 1989). UNICEF reported in 1998 that, nearly two billion people are estimated to be anemic, the majority of them were women.

The anemia prevalence in Indonesia is still high and considered as a public health problem. According to the data fiom the National Household Survey (SKRT) in 1995, the average prevalence of iron deficiency anemia among females aged 15-44 years and pregnant women were 48.9 % and 50.9%, respectively. Whereas based on data from the Directorate of Community Nutrition in 1997, 30%-40% among female factory workers as one segment of women at reproductive age suffered &om anemia (Kodyat, 1997)- The study carried out by I-Iusaini et. al (1981) in West Java, Scholz et. al (1997) in Jakarta and Untoro et. al (1998) in Kudus District, Central Java Province showed, that the anemia prevalence among female workers ranged hom 35.5%-50%.;Iron deficiency anemia is the most common nutritional disorder in developing countries and the most at risk population are women of reproductive age, pregnant women and children (DeMaeyer, 1989). UNICEF reported in 1998 that, nearly two billion people are estimated to be anemic, the majority of them were women.

The anemia prevalence in Indonesia is still high and considered as a public health problem. According to the data fiom the National Household Survey (SKRT) in 1995, the average prevalence of iron deficiency anemia among females aged 15-44 years and pregnant women were 48.9 % and 50.9%, respectively. Whereas based on data from the Directorate of Community Nutrition in 1997, 30%-40% among female factory workers as one segment of women at reproductive age suffered &om anemia (Kodyat, 1997)- The study carried out by I-Iusaini et. al (1981) in West Java, Scholz et. al (1997) in Jakarta and Untoro et. al (1998) in Kudus District, Central Java Province showed, that the anemia prevalence among female workers ranged hom 35.5%-50%.;;Iron deficiency anemia is the most common nutritional disorder in developing countries and the most at risk population are women of reproductive age, pregnant women and children (DeMaeyer, 1989). UNICEF reported in 1998 that, nearly two billion people are estimated to be anemic, the majority of them were women.

The anemia prevalence in Indonesia is still high and considered as a public health problem. According to the data fiom the National Household Survey (SKRT) in 1995, the average prevalence of iron deficiency anemia among females aged 15-44 years and pregnant women were 48.9 % and 50.9%, respectively. Whereas based on data from the Directorate of Community Nutrition in 1997, 30%-40% among female factory workers as one segment of women at reproductive age suffered &om anemia (Kodyat, 1997)- The study carried out by I-Iusaini et. al (1981) in West Java, Scholz et. al (1997) in Jakarta and Untoro et. al (1998) in Kudus District, Central Java Province showed, that the anemia prevalence among female workers ranged hom 35.5%-50%."

"Masalah anemia gizi besi (AGB) pada remaja putri saat ini masih tinggi. Faktanya pengetahuan, sikap dan tindakan remaja putri dalam pencegahan anemia masih kurang. Hal tersebut menunjukkan bahwa pelaksanaan edukasi kesehatan masih belum dilakukan secara optimal. Edukasi kesehatan adalah usaha untuk meningkatkan pengetahuan, sikap dan tindakan sesorang. Tujuan penelitian adalah mengetahui pengaruh edukasi kesehatan interaktif dalam jaringan terhadap perilaku pencegahan anemia gizi besi pada remaja putri.Penelitian menggunakan rancangan quasi experiment dengan control group. Jumlah sampel terdiri dari 41 responden kelompok intervensi dan 41 responden kelompok kontrol. Instrumen penelitian menggunakan kuisioner. Analisa data yang digunakan yaitu paired t test dan pooled t test. Hasil penelitian menunjukkan edukasi kesehatan interaktif dalam jaringan berpengaruh secara signifikan terhadap pengetahuan (p= 0,000), sikap (p=0,000), dan tindakan (p=0,022) pencegahan anemia gizi besi pada remaja putri. Edukasi kesehatan interaktif dalam jaringan dapat diterapkan sebagai upaya peningkatan perilaku pencegahan anemia gizi besi pada remaja putri yang dapat diintegrasikan dalam pelayanan keperawatan di sekolah.

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The problem of anaemia iron deficiency in female adolescent is still high. In the fact, adolescent’s knowledge, attitude and practice about anaemia prevention is still lack. This showed that health education intervention was not optimal. Health education is an effort to improve knowledge, attitude and practice of adolescent about anaemia iron deficiency prevention. This study aimed to determine the effect of online interactive health education on behavior of iron deficiency anaemia prevention in female adolescent. The research was quasi experiment with two groups involving 41 female adolescent as the intervention group and 41 in control group. Instrument used a questionnaire. Data were analyzed using a unpaired and paired t-test. The results showed that online interactive health education significantly effected on knowledge (p=0,000), attitude (p=0,000), and skill (p=0,022) of anaemia iron deficiency prevention in female adolescent. The online interactive health education could be applied as an effort to enhance the anaemia iron deficiency preventive behavior of female adolescent which could be integrated in the school nursing service."