Ferrous sulfate program coverage and compliance in Brazilian children
What it found
In children aged six to 18 months in Florianopolis, Brazil, only 6.3% were covered by the national ferrous sulfate supplement program, and just 2.4% received it as recommended.
The data came from health records, not from new measurements in people.
What they found
Studies in people
Low program coverage
Only 6.3% of children aged six to 18 months were registered in the ferrous sulfate supplementation program. The authors note this is far below the 60% coverage expected by the Brazilian Ministry of Health for that year.
Poor compliance with guidelines
Just 2.4% of enrolled children started supplementation at the recommended age and received bottles at the recommended frequency. In 90.2% of cases, compliance was inadequate.
Late start and infrequent bottles
Less than half of the children began supplementation by six months of age, and more than 80% received bottles at intervals longer than six months. Only 7.3% got a bottle every three months as the program directs.
No link to sociodemographics
Compliance was not associated with the child's gender, mother's education level, mother's skin color, or distance from home to the health center. Only the health district where the center was located showed a link.
What the authors conclude
“This study showed low coverage and inadequate compliance with the PNSF directions. Measures to improve this strategy are urgent.”
Also in their conclusions
- They say the study showed low coverage and inadequate compliance with the program's directions, and that measures to improve this strategy are urgent.
- They suggest that the problems are related to distribution and/or lack of prescription by healthcare professionals, and that the program needs better training and awareness strategies for these professionals.
- They note that community health workers should be involved as essential elements for families to adhere to the program.
How it was done
Iron-deficiency anemia affects many young children in Brazil, and prophylactic iron supplementation is a key prevention strategy. The authors wanted to check whether the National Program of Iron Supplementation was actually reaching children and being used as intended.
They looked at health records for all 13,197 children aged six to 18 months registered at 35 public health centers in Florianopolis in 2010. Of these, 834 were enrolled in the iron supplementation program. They checked the age when children first received ferrous sulfate and how often they got new bottles.
What it can’t tell you
- This study used existing health records, so it can only show what was recorded, not why coverage or compliance was low.
- It cannot prove that improving coverage or compliance would reduce anemia, because the study did not measure health outcomes like hemoglobin levels.
Who paid
- Conflicts
- Conflito de interesse: nada a declarar
The paper
- Title
- Coverage and adequacy of ferrous sulfate supplementation in the prevention of anemia among children treated at health centers of Florianopolis, Santa Catarina
- Type
- Study
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Cembranel F, Corso AC, González-Chica DA (2013). Coverage and adequacy of ferrous sulfate supplementation in the prevention of anemia among children treated at health centers of Florianopolis, Santa Catarina. Revista paulista de pediatria. doi:10.1590/S0103-05822013000300007Free full textPubMed 24142313DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error