Interprovincial Disparities in Iron–Folic Acid Tablet Consumption and Anemia among Indonesian Adolescent Girls in 2024

Abstract

Capacity, and health status before the reproductive years. Indonesia has implemented a national iron-folic acid Background: Anaemia among adolescent girls has implications for learning capacity, productivity, and future reproductive health. Indonesia implements a school-linked iron-folic acid (IFA) tablet programme as a preventive strategy. To quantify interprovincial disparities in 2024 IFA tablet coverage and contextualise them against the national anaemia burden among young people. A quantitative secondary analysis was conducted using 38 provinces as ecological units. Provincial IFA coverage was obtained from the 2024 Indonesia Health Profile, while anaemia burden was contextualised using the 2023 Indonesian Health Survey (SKI), published in national reports in 2024. Descriptive statistics included the mean, median, standard deviation, range, interquartile range, coefficient of variation, Gini index, provincial ranking, and a sensitivity analysis excluding administrative coverage values above 100%. Nationally, 11,368,315 of 12,534,824 girls aged 12-18 years were recorded as receiving IFA tablets (90.69%). The unweighted provincial mean was 76.28%, median 88.97%, SD 31.93, IQR 23.71, and coefficient of variation 41.85%. Coverage ranged from 2.01% in Papua Pegunungan to 106.27% in West Sumatra, a 104.26-percentage-point gap. Four provinces reported values above 100%, indicating denominator or administrative reconciliation issues. Six provinces had coverage below 20%, all in the Papua region. SKI 2023 reported anaemia prevalence of 15.5% among people aged 15-24 years, indicating continuing anaemia burden despite high national programme coverage. National IFA coverage was high, but marked geographic inequity remained. Programme monitoring should distinguish distribution coverage from actual consumption and adherence, strengthen denominator quality, and link supplementation records with haemoglobin screening.