The National Vitamin A program

Описание: The National Vitamin A Program (NVAP) was established by the Ministry of Health and Population in 1993 and expanded to all 75 of Nepal's districts by 2003.The program receives financial and technical support from USAID, UNICEF and AusAIDS, and has been recognized as a model for successful multi-donor cooperation in Nepal.

Under this program, all children 6 months to 5 years of age are eligible to receive high-dose vitamin A supplementation twice a year -- in April and October (Baisakh and Kartik). At a cost of 2 cents per capsule, vitamin A supplementation is one of the most cost-effective child health interventions available anywhere. Surveys conducted after each supplementation round have found coverage rates over 90 percent since the beginning of the program. This remarkably high coverage can be attributed, in particular, to the dedication and ability of Female Community Health Volunteers (FCHVs) who identify eligible children and provide them with vitamin A during each 2-day supplementation round throughout the country. FCHVs also conduct nutrition education to promote the consumption of vitamin A-rich foods, helping to reduce vitamin A deficiency in older children and in women of childbearing age, and to sustain the impact of capsule supplementation for younger children.

Two large, independent studies conducted in Jumla and Sarlahi Districts in the late 1980s found that mortality was nearly 30% lower in children who received high-dose vitamin A capsule supplementation than in those who did not. Based on these research findings, and the consistently high coverage being achieved, USAID estimates that this intervention alone averts about 15,000 child deaths each year.

Vitamin A supplementation is considered to be a major factor contributing to the remarkable 45 percent decline in under-five mortality observed in Nepal from 1996 to 2006 (DHS 2006 preliminary report).The doses of vitamin A being provided to children under the National Vitamin A Program are consistent with WHO global recommendations. In sixteen rounds over eight years, with more than 3 million children now receiving vitamin A during each round and with intensive monitoring during and after each round, no significant adverse effects have been detected. Deworming medication has been added to the vitamin A rounds for children age 2 to 4 throughout Nepal and produces a substantial decline in childhood anemia.