Sarina Sariman
Management and Science University, Malaysia

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School Context as an Independent Factor Associated with Anemia among Adolescent Girls: A Cross-Sectional Study in Banawa, Donggala, Indonesia Nasrul Nasrul; Taqwin Taqwin; Fahmi Hafid; Sri Rahayu; Hikmah Hikmah; Risma Risma; Sarina Sariman
Journal of Nutrition Explorations Vol. 4 No. 3 (2026): August
Publisher : Politeknik Kesehatan Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/jone.v4i3.779

Abstract

Anemia among adolescent girls remains a major public health problem, yet prevention often emphasizes individual nutritional factors while overlooking the influence of the school environment. This study aimed to determine whether school context, operationalized as school origin, is independently associated with anemia among adolescent girls in Banawa, Donggala, Indonesia, after adjustment for individual-level factors. An observational analytic study with a cross-sectional design was conducted among 189 adolescent girls recruited through total sampling of all eligible female students in two purposively selected schools, SMP Negeri 3 Banawa (junior secondary) and SMK Negeri 2 Banawa (vocational senior secondary). Hemoglobin was measured by point-of-care testing, with anemia defined as hemoglobin below 12 g/dL. Anthropometry, a semi-quantitative food frequency questionnaire, and self-reported iron tablet consumption were assessed. Data were analyzed using the chi-square test and multivariable binary logistic regression, with model fit evaluated by the Hosmer–Lemeshow test. The overall prevalence of anemia was 41.3%. In the adjusted model, school origin remained independently associated with anemia: students from SMK Negeri 2 Banawa had higher odds than those from SMP Negeri 3 Banawa (adjusted odds ratio 2.47; 95% confidence interval 1.31–4.65; p=0.005), whereas individual nutritional variables were not significant. Because the design is cross-sectional and school context was not measured directly, the findings represent an association rather than causation. Strengthening school-based nutrition education, screening, and supportive environments may complement individual supplementation in adolescent anemia prevention.