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"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%."

"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."

"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."

"Iron deficiency anemia among under live children is highly prevalent in Indonesia and is considered as a public health problem. Iron supplementation seems to be the most appropriate way to control iron deficiency in relatively short period of time. Children consume less food than adult and their diet often consists of foods with little iron content and poor iron bioavailability. Additional iron to food for children is therefore necessary. One possible food chosen as alternative vehicle to prevent iron deficiency among children is bread. This study gave iron supplementation using bread as vehicle which provided 25% of daily iron requirement of preschoolers to address iron deficiency problem in relatively short period of time.The study report is arranged and divided into three parts- Part I includes the background of the study, problem statement, rationale of the study, literature review, hypotheses, objectives and variable-indicator matrix.Part 2 is the manuscripts for publication. The manuscript ?The efficacy of iron supplementation using bread as vehicle of preschoolers in Surabaya, East Java? is written for submission to Asia Pasific Journal. This pan consists of abstract, introduction, materials and methods including study and subjects, sample size, study design, data collection, statistical analysis, ethical consideration, results, discussion, conclusion and references.Part 3 describes the questionnaire used for 'the data collection, detailed methodology and important results that have not been presented in the manuscript, ethical consideration, grant approval, references and curriculum vitae."

"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."

"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."

"A study to investigate the effect of iron supplementation program among underfive children in North Central 'Timor, East Nusa Tenggara, Indonesia was conducted. The study was comprised into two parts: a cross-sectional study to investigate the impact of the ongoing government of Indonesia iron supplementation program and a intervention trial aiming to investigate the effect of daily compared to weekly iron supplementation. Hemoglobin, weight, height and compliance assessment were performed.The cross-sectional study involved 127 underfive children from four health centers. The average of age, weight and height of the recruited subjects was 36.6 months, 10.4 kg and 84.5 cm respectively. The result of this study showed that the prevalence of anemia among 127 underfive children where iron supplementation program has been implemented was still high, (81.5%), although 75.6% of the subjects claimed to take all the iron syrup.The intervention study recruited 160 preschool children and were divided into two groups: for 10 week one group received a daily supplement of 30 mg Fe, while the other group received 30 mg Fe per week A complete data set was obtained from 75 children in the group supplemented daily and 73 children in the group supplemented weekly. Th average age, weight and height of the subjects for daily group were 43.7 months, 12.1 kg and 91.0 cm respectively while 41.8 months, 11.7 kg and 90.3 cm for the weekly group.The result of this study showed a significant hemoglobin increase in both groups (p<0.001) which reduced the prevalence of anemia from 42.3 to 7 % in daily group and from 55.9% to 27.9% in weekly group. Although the weekly group had higher compliance (100%) compared to daily group (42.1%), it is concluded that daily group resulted in a better effect in reducing anemia prevalence among the preschool children."

"the research incorporates a generational study with an emphasis onthe opinions, attitudes and beliefs of the female respondents themselves, whichare compared and contrasted with those of their mothers. In essence theresearch explores the impacts of industrialization on the culturally groundedstatus of women in West Java and around Bonjoran in 1996/97. Status ofwomen is analyzed in terms of decision making power in the household, control of income, control of young women's human resource (factory labour) andwithin the reaim of gender relation in Banjarun, both in the household and thevillage. The 'social' and economic' impacts and outcomes of industrialdevelopment upon cultural values, attitudes and traditional employment ofwomen are important to the demographic impacts apparent in the findings ofthis paper."