Despite being hesitant, Debora tries to routinely consume the tablets every week based on the Health Ministry's recommendation.
However, consuming this supplement routinely turns out to be a major challenge, Public Empowerment and Mobility Work Team Chief at the ministry Dwi Adi Maryandi stated.
Apart from the boredom of consuming the blood supplement tablets, teenage girls, who received them, also did not like their taste and frequently forgot to consume them, he noted.
This is reason behind only 1.4 percent out of the 76 percent of teenage girls, who received the tablets at schools, having consumed the blood supplement tablets according to the recommendation.
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This is despite the fact that iron consumption, including through supplementation, is necessary, especially for teenage girls diagnosed with iron deficiency.
This aims to prevent them from developing anemia that can eventually result in them giving birth to children with stunting.
Stunting is a form of growth failure in the body and brain of children due to the lack of nutrition for long periods of time.
Data from the 2018 Basic Health Research (Riskesdas) shows that 23 percent of children were born with stunting, thereby necessitating intervention before infants are born and since girls become teenagers.
Children, who suffer from stunting, will have impeded physical growth and brain and intellectual development as well as impacted body metabolism.
In the long term, the IQ of these children will be lower as compared to their peers of the same age, who do not suffer from stunting and experience various degenerative diseases, such as diabetes and stroke.
The Health Ministry strives to sever the stunting chain, including through anemia prevention and mitigation. One step involves encouraging the consumption of blood supplement tablets in schools, especially among middle school and high school students.
Blood supplement tablets are distributed to schools through all public health centers (puskesmas) in Indonesia.
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Schools will then distribute these tablets to female students and ensure that they consume them at least once a week. Moreover, these girls are then encouraged to exercise routinely and to have breakfast.
In addition to teenagers, pregnant women were prioritized in the efforts to prevent stunting.
The ministry's data in 2022 on specific intervention achievement showed that 2.8 million from around 4.9 million pregnant mothers do not check their pregnancy at least six times.
Pregnant women, especially those with blood deficiency, should be encouraged to consume at least 90 blood supplement tablets during pregnancy and visit the doctor at least six times.
Anemia remains one of the health problems that the government is currently focusing on, Maryandi stated.
The Basic Health Research (Riskesdas) showed that the prevalence of anemia rose, from 21.7 percent in 2013 to 23.7 percent in 2018 from the total population in Indonesia.
In 2018, three out of 10 Indonesian teenagers suffered from anemia and 62.6 percent of anemia cases were caused by iron deficiency.
The Indonesian Society of Hematology & Blood Transfusion's (PHTDI's) Chairperson Djumhana Atmakusuma explained that iron deficiency anemia can actually affect anyone.
However, children, parents, and women in their reproductive age that experience menstruation and pregnancy are the most vulnerable groups.
Moreover, conditions, such as pregnancy, hemorrhaging, excessive menstruation, hemorrhoids, and gastritis, can cause the body to experience iron deficiency and, if they are not treated, it can turn into anemia.
Lack of iron can restrict oxygen delivery to cells, cause frequent exhaustion, and reduce body immunity.
Several symptoms can indicate iron deficiency anemia, such as hair loss, fatigue, lack of energy, shortness of breath, irregular heartbeats, and pale skin.
"There are also respiratory disturbances, difficulty in concentrating, dizziness due to the lack of oxygen, and sleeping difficulty due to insufficient tissue oxygenation," Atmakusuma stated.
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Benefit of iron
In terms of benefit, iron forms hemoglobin within the red blood cells that deliver oxygen to the entire body. Around 70 percent of the iron is found in red blood cells and muscles.
It also helps the enzymatic metabolism process to absorb nutrition from food that produces energy and helps to maximize the function of the brain that affects concentration and focus.
Moreover, iron is beneficial to maximize muscle function, support body immunity against infection, expedite the recovery process, and help ensure healthy pregnancy to meet fetal and placental requirements.
According to Atmakusuma, iron consumption is very important as one of the methods to handle anemia. This can be done by consuming foods that contain iron from animal and non-animal sources and iron supplements.
Provision of iron supplements can be undertaken as symptomatic therapy if iron deficient anemia diagnosis has been upheld. However, searching and handling the cause of anemia itself should still be done.
Iron can also be delivered through injection administered to patients, who cannot ingest them orally due to pregnancy and nausea.
"It should not be given to patients with thalassemia, chronic inflammation, HIV, and lupus. Thus, I recommend consulting with doctors first," he remarked.
However, this supplement can also cause constipation. Hence, health experts have recommended that people drink more water to reduce the side effect.
Other side effects of the intake of iron supplement include ulcers, stomach cramps, diarrhea, and loss of appetite. However, according to the Cleveland Clinic, these side effects are usually temporary in nature.
Despite these drawbacks, the provision of iron supplements is necessary to prevent anemia and to produce a golden generation in the future.
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