Food Provision Quality and Anemia Risk Among Female Adolescents in Islamic Boarding Schools: A Descriptive Mixed-Methods Study

Background: Anemia in adolescent girls remains an enduring public health concern, affecting populations across the world, with Indonesia being no exception. Female students living in Islamic boarding schools are particularly vulnerable because their daily food intake largely depends on institution-provided meals. Objective: This study aimed to assess nutritional gaps in pesantren dietary patterns and identify food-related factors associated with anemia risk among adolescent girls. Methods: A descriptive mixed-methods study was conducted in three Islamic boarding schools in Tasikmalaya, West Java, Indonesia. Seven-day menus were analyzed and compared with the 2019 Indonesian Recommended Dietary Allowances (RDA) for girls aged 13–18 years. In-depth interviews with kitchen managers and focus group discussions (FGDs) with female students were conducted, and qualitative data were analyzed thematically. Results: The protein, iron, and vitamin C levels in all of the menus were less than 80% of the recommended dietary allowances. Iron and vitamin C were found to be the most important nutritional gaps linked to a higher risk of anemia. Qualitative findings revealed limited food budgets, the absence of nutrition professionals, and routine menu-planning practices. Although students generally perceived the meals as adequate, they reported limited variety and repetitive menus. Conclusions: Food provision in the studied pesantren was insufficient to meet the nutritional needs of adolescent girls, particularly for iron and vitamin C. Strengthening nutrition-sensitive menu planning, involving nutrition professionals, and increasing the use of locally available nutrient-rich foods may help prevent anemia in Islamic boarding school settings.