To evaluate the efficacy of prophylactic biweekly Iron and Folic acid (IFA) supplementation (National Iron Plus Initiative) in maintaining iron status in under-five children with iron sufficiency.

Consecutive healthy children screened for normal iron status (normal hemoglobin and serum ferritin) were started on iron prophylaxis as one mL syrup containing 20 mg elemental iron and 100 µg folic acid biweekly for six months. The pre- and post-supplementation hemoglobin and serum ferritin levels were compared.

Out of 573 children screened, none were receiving IFA prophylaxis routinely. A total of 173 out of 200 eligible children completed the intervention with a significant increase in the mean (SD) hemoglobin [11.7 (0.5)–11.9 (0.5) g/dL] and serum ferritin [54.5 (23.5)– 63.6 (21.1) µg/L] at six months (P < 0.001).

Biweekly iron and folic acid supplementation improved iron status in children aged 1 to 5 years with iron sufficiency.