Adolescent Nutrition & Neurodevelopment in Ghana
This project, supported by the Bill & Melinda Gates Foundation, examines whether iron and folic acid supplementation during adolescence is associated with improved neurodevelopmental outcomes in girls. While iron–folic acid supplementation is widely recommended to improve maternal and child health outcomes in the context of future pregnancies, far less is known about its direct benefits for adolescent brain development, particularly in low-resource settings.
The intervention is implemented through a school-based supplementation program in the greater Accra region of Ghana, where schools provide weekly, directly observed iron and folic acid supplementation. This approach ensures consistent exposure while embedding the intervention within existing educational infrastructure. However, despite the public health rationale, many families and schools do not perceive clear individual benefits for adolescent girls, particularly when pregnancies are unintended or hypothetical.
Our formative research revealed important cultural context shaping uptake and acceptability. Families consistently reported that regular use of pills or supplements is typically associated with serious illness, such as sickle cell disease, rather than with health promotion or prevention. These perceptions highlight a critical gap between public health recommendations and lived experience, underscoring the importance of generating evidence that speaks directly to adolescent health and development.
To address this gap, we are comparing neuroimaging outcomes between two groups of adolescents: those who receive regular iron and folic acid supplementation through the school-based program and those who do not. By integrating neuroimaging with developmental and contextual measures, this work aims to clarify whether nutritional supplementation during adolescence supports brain development in ways that are meaningful, measurable, and relevant to families, schools, and policymakers.