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Submitted
June 21, 2020
Accepted
December 31, 2021
Published
December 31, 2021
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Abstract

Micronutrients play a significant role in metabolism reaction although this only needs a few micronutrients such as iron (Fe) and folic acid as folate substitutes. Fortification and supplementation program aims to meet the requirement of micronutrients by providing synthetic formula. The Indonesian government has applied iron-folic acid fortification (IFA) in flour. Moreover, the IFA supplementation program was given to vulnerable groups, pregnant mothers and women at reproductive age, including adolescent girls. The program has been applied for almost five decades, but the micronutrients deficiencies remain high. This study aims to review effects of the supplementation and fortification to vulnerable groups in Indonesia. This is necessary to  to determine their effectiveness within a specified period since the program has been applied for decades and to assess whether an additional program is needed or not. The data of this study were collected from verified international journal articles in the National Centre for Biotechnology Information (NCBI)/PubMed and Cochrane Library website. 11 articles related to the program were obtained. The program has been conducted for an extended period, yet its effectiveness should be reinforced to diminish the micronutrient deficiencies. It is mandatory to reformulate an additional program to strengthen the program. Nutrition education program, campaign for a healthy and balanced diet, protein consumption based local resources can be designated to assist the eradication of micronutrient deficiencies.

Keywords

supplementation fortification Fe folic acid deficiency

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How to Cite
Octavia, L., & Harlan, J. (2021). Supplementation and fortification program in eradicating micronutrient deficiencies in Indonesia. JKKI : Jurnal Kedokteran Dan Kesehatan Indonesia, 12(3), 276–284. https://doi.org/10.20885/JKKI.Vol12.Iss3.art11
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References

  1. Titaley CR, Dibley, M. J., Roberts, C. L., Hall, J., Agho, K. Iron and folic acid supplements and reduced early neonatal deaths in Indonesia. Bull World Health Organ. 2010;88(7):500-508.
  2. FAO W. Guidelines on food fortification with micronutrients. 2006.
  3. Crider KS, Bailey LB, Berry RJ. Folic acid food fortification-its history, effect, concerns, and future directions. Nutrients. 2011;3(3):370-384.
  4. Ami N, Bernstein, M., Boucher, F., Rieder,M., Parker, L., Society CP. Folate and neural tube defects: The role of supplements and food fortification. In: Society CP, ed. Canada2016.
  5. Balarajan Y, Subramanian, S.V and Fawzi, W.W. Maternal Iron and Folic Acid Supplementation Is Associated with Lower Risk of Low Birth Weight in India. J Nutr. 2013;143:1309-1315.
  6. Rahman MM, Abe SK, Rahman MS, et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: systematic review and meta-analysis. Am J Clin Nutr. 2016;103(2):495-504.
  7. Karakochuk CD, Whitfield, K.C., Green, T.J., Kraemer, K. The Biology of the first 1,000 days Boca Raton, Florida: CRC Press Taylor & Francis Group; 2018.
  8. Diana R, Khomsan, A., Anwar, F., Christianti, D. F., Kusuma, R., Rachmayanti, R. D. Dietary Quantity and Diversity among Anemic Pregnant Women in Madura Island, Indonesia. J Nutr Metab. 2019;2019:2647230.
  9. Zahhura S, Nilan,P., Germov, J. Food Restrictions during Pregnancy among Indigenous Temiar Women in Peninsular Malaysia Mal J Nutr 2012;18(2):243-253.
  10. Soekarjo DDR, A., Thow, A. M., Li, M., Rah, J. H. Strengthening Nutrition-Specific Policies for Adolescents in Indonesia: A Qualitative Policy Analysis. Food Nutr Bull. 2018;39(3):475-486.
  11. Dijkhuizen MA, Wieringa, F.T., Soekarjo, D., Van, K.T., Laillou, A. Legal framework for food fortification: Examples from Vietnam and Indonesia. Food and Nutrition Bulletin. 2013;34:S112-S123.
  12. Berger J, Roos, N., Greffeuille, V., Dijkhuizen, M., Wieringa, F. Driving Policy Change to Improve Micronutrient Status in Women of Reproductive Age and Children in Southeast Asia: The SMILING Project. Matern Child Health J. 2019;23(Suppl 1):79-85.
  13. Aguayo VM, Paintal K, Singh G. The Adolescent Girls' Anaemia Control Programme: a decade of programming experience to break the inter-generational cycle of malnutrition in India. Public Health Nutr. 2013;16(9):1667-1676.
  14. Htet MK, Dillon, D., Rosida, A., Timan, I., Fahmida, U., and Thurnham, D.I. Hepcidin profile of anemic adolescent schoolgirls in Indonesia at the end of 12 weeks of iron supplementation. Food and Nutrition Bulletin. 2014;35 no 2 160-166.
  15. Cortes F, Mellado C, Pardo RA, Villarroel LA, Hertrampf E. Wheat flour fortification with folic acid: changes in neural tube defects rates in Chile. Am J Med Genet A. 2012;158A(8):1885-1890.
  16. Keum N, Giovannucci EL. Folic acid fortification and colorectal cancer risk. Am J Prev Med. 2014;46(3 Suppl 1):S65-72.
  17. Choi JH, Yates, Z., Veysey, M., Heo, Y. R., Lucock, M. Contemporary issues surrounding folic Acid fortification initiatives. Prev Nutr Food Sci. 2014;19(4):247-260.
  18. MoH. Basic Health Research. In. Jakarta: Ministry of Health; 2013.
  19. MoH. Basic Health Research 2018. In. Jakarta: Ministry of Health; 2018.
  20. Oy S, Witjaksono, F., Mustafa, A., Setyobudi, S. I., Fahmida, U. Problem Nutrients in Adolescent Girls With Anemia Versus Nonanemic Adolescent Girls and the Optimized Food-Based Recommendations to Meet Adequacy of These Nutrients in Adolescent School Girls in East Java, Indonesia. Food Nutr Bull. 2019;40(3):295-307.
  21. Barkley JS, Kendrick, K. L., Codling, K., Muslimatun, S., Pachon, H. Anaemia prevalence over time in Indonesia: estimates from the 1997, 2000, and 2008 Indonesia Family Life Surveys. Asia Pac J Clin Nutr. 2015;24(3):452-455.
  22. Haider BAO, I., Wang, M., Spiegelman, D., Ezzati, M., Fawzi, W. W. Anaemia, prenatal iron use, and risk of adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. 2013;346:f3443.
  23. Imdad A, Bhutta ZA. Routine iron/folate supplementation during pregnancy: effect on maternal anaemia and birth outcomes. Paediatr Perinat Epidemiol. 2012;26 Suppl 1:168-177.
  24. Tulchinsky TH. Micronutrient Deficiency Conditions: Global Health Issues. Public Health Reviews. 2017;32, no.1 243-255.
  25. Haider BA, Yakoob, M.Y., Bhutta, Z.A. Effect of multiple micronutrient supplementation during pregnancy on maternal and birth outcomes. BMC Public Health 2011;11(Suppl 3):1-9.
  26. Hovdenak N, Haram, K. Influence of mineral and vitamin supplements on pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2012;164(2):127-132.
  27. Zerfu TA, Ayele, H. T. Micronutrients and pregnancy; effect of supplementation on pregnancy and pregnancy outcomes: a systematic review. Nutr J. 2013;12:20.
  28. Titaley CR, Dibley MJ. Antenatal iron/folic acid supplements, but not postnatal care, prevents neonatal deaths in Indonesia: analysis of Indonesia Demographic and Health Surveys 2002/2003-2007 (a retrospective cohort study). BMJ Open. 2012;2(6).
  29. Titaley CR, Dibley MJ. Factors associated with not using antenatal iron/folic acid supplements in Indonesia: the 2002/2003 and 2007 Indonesia Demographic and Health Survey. Asia Pac J Clin Nutr. 2015;24(1):162-176.
  30. Triharini M, Nursalam, Sulistyono, A., Adriani, M., Armini, N. K. A., Nastiti, A. A. Adherence to iron supplementation amongst pregnant mothers in Surabaya, Indonesia: Perceived benefits, barriers and family support. Int J Nurs Sci. 2018;5(3):243-248.
  31. Wiradnyani LA, Khusun, H., Achadi, E. L., Ocviyanti, D., Shankar, A. H. Role of family support and women's knowledge on pregnancy-related risks in adherence to maternal iron-folic acid supplementation in Indonesia. Public Health Nutr. 2016;19(15):2818-2828.
  32. Siekmans K, Roche, M., Kung'u, J. K., Desrochers, R. E., De-Regil, L. M. Barriers and enablers for iron folic acid (IFA) supplementation in pregnant women. Matern Child Nutr. 2018;14 Suppl 5:e12532.
  33. WHO. WHO recommendation on antenatal care for a positive pregnancy outcome. 2016.
  34. MoH. Ministry of Health Decree no 88 year 2014. In:2014.
  35. Czeizel AE, Dudas,I. Prevention of the first occurence of neural tube defects by periconceptional vitamin supplementation. The New Engl and Journal of Medicine. 1992;327:1832-1835.
  36. Czeizel AE. Periconceptional folic acid and multivitamin supplementation for the prevention of neural tube defects and other congenital abnormalities. Birth Defects Res A Clin Mol Teratol. 2009;85(4):260-268.
  37. Czeizel AE. Periconceptional folic acid-containing multivitamin supplementation for the prevention of neural tube defects and cardiovascular malformations. Ann Nutr Metab. 2011;59(1):38-40.
  38. Shankar AV, Asrilla, Z., Kadha, J.K., Sebayang, S., Apriatni, M., Sulastri, A., Sunarsih, E. and Shankar, A.H., on behalf of the SUMMIT Study Group. Programmatic effects of a large-scale multiplemicronutrient supplementation trial in Indonesia: Using community facilitators as intermediaries for behavior change. Food and Nutrition Bulletin. 2009;30 no 2.
  39. Widyawati W, Jans, S., Bor, H., Siswishanto, R.. van Dillen, J., Lagro-Janssen, A. L. A randomised controlled trial on the Four Pillars Approach in managing pregnant women with anaemia in Yogyakarta-Indonesia: a study protocol. BMC Pregnancy Childbirth. 2014;14:163.
  40. WHO. Daily iron and folic acid supplementation in pregnant women. 2012.
  41. Widyawati W, Jans, S., Utomo, S., van Dillen, J., Janssen, A. L. A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives. BMC Pregnancy Childbirth. 2015;15:47.
  42. Goh C. Combating iodine deficiency: Lessons from China, Indonesia, and Madagasca. Food and Nutrition Bulletin. 2002;23 no 3:280-290.
  43. MoH. Minister of Health Decree on flour fortification program. In. Ministry of Health: Jakarta; 2003.
  44. Jaques PF, Selhub, J., Bostom, A.G., Wilson, P.W.F., Rosenberg, I.H. The effet of folic acid fortification on plasma folate and total homocysteine concentrations. The New Engl and Journal of Medicine. 1999;340, No 19:1449-1454.
  45. Amresh A, Sinha M, Birr R, Salla R. Interactive Cause and Effect Comic-book Storytelling for Improving Nutrition Outcomes in Children. Proceedings of the 5th International Conference on Digital Health 2015 - DH '15; 2015.
  46. Bert F, Giacometti M, Gualano MR, Siliquini R. Smartphones and health promotion: a review of the evidence. J Med Syst. 2014;38(1):9995.