Hamadan University of Medical Sciences Journal of Research in Health Sciences 2228-7795 25 3 2025 06 10 Effect of Interventions on Iron-Deficiency Anemia Among School-Going Children in India: A Systematic Review and Network Meta-Analysis e00651 e00651 10.34172/jrhs.8985 EN Flemin Felix https://orcid.org/0009-0009-5980-8681 Kalesh Mappilakudy Karun https://orcid.org/0000-0002-9940-8764 Chandan Nagendraswamy Deepthy Melepurakkal Sadanandan Yadu Damodaran Manish Barvaliya Subarna Roy REVIEW 10.34172/jrhs.8985 2025 01 21 2025 04 27 Background: The prevalence of iron-deficiency anemia (IDA) among school-aged children in India varies from 27% to 90%. There is no evidence of the comparative effects of various available interventions. Thus, this study aimed to quantify and rank the effects of different interventions on IDA among school-going children. Study Design: Systematic review and Meta-analysis. Methods: To this end, PubMed, Scopus, and ScienceDirect databases were searched, and randomized controlled trials (RCTs) evaluating the comparative effects of various interventions on hemoglobin (Hb) and serum ferritin against a control were included in this study. The random-effect model was conducted for Hb, and the fixed-effects model was performed for ferritin to estimate the mean difference (MD) and 95% confidence interval (CI) of the effect of interventions of outcomes based on the heterogeneity (I2 ). Results: Eight RCTs (including 2534 participants) investigating the effects of 12 interventions for IDA treatment among school-going children in India were obtained. The results of reference-based forest plots and P score indicated that iron-rich fish powder was the most effective intervention for increasing Hb levels (MD: 2.07 g/dL, 95% CI: 0.68–3.47, P score=0.8656), followed by iron and folic acid (IFA) given twice weekly (MD: 1.47 g/dL, 95% CI: -0.31–3.25, P score=0.7209). Additionally, IFA supplementation twice weekly was found to be highly effective in increasing serum ferritin levels among anemic school children (MD: 0.80 ng/mL, 95% CI: 0.33–1.27, P score=0.9148). Conclusion: It seems that iron-rich fish powder and intermittent IFA supplementation were the most effective interventions, but further research is needed to confirm these results and assess their public health implications. Protocol Registration: PROSPERO registration number was CRD42024541802.