National Iron Plus Initiative
Overview of Programme
Orientation of DEO/BEO/ABEO
The National Iron Plus Initiative (NIPI) is
an attempt to look at the Iron Deficiency
Anaemia comprehensively across all life
stages including adolescents and women
in reproductive age group who are not
pregnant or lactating.
Implementation of Iron plus Initiative in
State NHM PIP
Activities to be taken Up
Age group
2014-15 2015-16 2016-17
Children (6 months- 5 years) through AWC and ASHA: √ √ √
Children (5 years -10 years) through schools √ √ √
Children (5 years -10 years) out of school - - √
Adolescents (10- 19 years) through schools √ √ √
Adolescents (10- 19 years) through AWC √ √ √
Pregnant and lactating woman through VHNDs √ √ √
Woman of reproductive age group - - √
National Iron Plus Initiative is the broader umbrella which encompasses all the
programmes for all the categories of population for addressing anemia holistically.
This programme shall cover following age groups & categories in a phased approach
IFA supplementation programme & service delivery
Age Group Intervention/Dose Regime Service delivery
6 – 60 1ml of IFA syrup Biweekly throughout the Through ASHA
months containing 20mg of period 6-60months of age & Inclusion in MCP Card
elemental iron & deworming for children
100mcg of folic acid 12months & above
5 – 10 years Tablets of 45mg Weekly throughout the In school through teachers
elemental iron & period 5-10 years of age &
400mcg of folic acid biannual de-worming
10 -19 years 100mg elemental Weekly throughout the In school through teachers
iron & 500mcg of period 10-19yrs of age & & for out of school
folic acid biannual de-worming children through AWC
Pregnant & 100mg elemental 1 tablet daily for 180 days, ANC/ANM/ASHA
Lactating iron & 500mcg of starting after the first
women folic acid trimester, at 14-16 weeks of Inclusion in MCP Card
gestation. To be repeated for
180 days post-partum
Women in 100mg elemental Weekly throughout the Through ASHA during
reproductiv iron & 500mcg of reproductive period house visit for
e age group folic acid contraceptive distribution
Known Side Effects of IFA
1. Epigastric discomfort
Nausea, diarrhoea or constipation
2. Dark stools
Body excretes the iron it does not need
3. Metallic taste
These effects gradually reduce when IFA is
taken on full stomach and taken regularly.
Side effects of IFA
1. Not Universal
Does not occur to everybody
2. Not Frequent
Circumstances in which you consume it
determine whether it occurs–first time,
empty stomach
3. Not a serious adverse event
Has never caused disability or death
To reduce/avoid side effects what?
Do’s and Dont’s
How to take IFA tablet –Do’s and Don’ts
Dos Don’ts
Take single tablet Don’t chew
Swallow the tablet Don’t crush
Eat on full stomach Don’t break
Take one glass of Don’t take on empty
water after having the stomach
tablet Don’t take with milk
Administration IFA syrup –Do’s and Don’ts
Do’s Don’ts
ANM should give first dose Do not give on empty stomach
under supervision during VHND Do not give to SAM children with
after counseling MUAC less than 11.5 CM
Always administer on full Do not give to ill children (with fever,
stomach diarrhea, vomiting, ARI or any other
Administer syrup half an hour illness)
after food Don’t administer IFA syrup immediately
Keep the bottle in cool & dark after feeding milk/food
place away from reach of Expired IFA syrup should never be
children distributed for consumption
Counsel parents on minor side Do not give IFA to Children with family
effects history of sickle cell anaemia/
Keep the lid of bottle tightly thalassaemia
closed after supplementation
What is Emergency Response System (ERS):
A system to prepare the institutions for handling
or responding to the adverse events following IFA
or Albendazole supplementation
ERS Implementing Body
STATE LEVEL DISTRICT LEVEL BLOCK LEVEL
Director Family Welfare CDMO MO/IC (Convener)
Additional Dir.-Child Health / ADMO, FW (Convener) BPM, NHM
JD-CH
Joint Director-Tech, NHM DPM, NHM LHV
DD, Nutrition (Convener) DMRCH, NHM PHEO
Nodal Officer, MDM DPHCO BEO (S&ME Dept.)
DD IE, OPEPA DEO (S&ME Dept.) CDPO (ICDS,WCD Dept)
Nodal Officer, WCD DPC (S&ME Dept.) WEO (ST&SC Dev.)
Nodal Officer, ST&SC Dev DSWO (WCD Dept.)
Consultant-Adolescent DWO (ST&SC Dev.)
Health, NHM
Consultant, NIPI (UNICEF)
Flow chart for the management of adverse
event following IFA supplementation &
Deworming:
Child with side effects following IFA supplementation / Albendazole ingestion
At Home At AWC At School
Class teacher
Parents AWW
ASHA / AWW / ANM
HM/Principal
Health staff in charge – ANM/LHV/MO-IC
Parents
ERS Team –Block/ District In-charge
Hospital CDMO
