title: The role of expanded coverage of the national vitamin A program in preventing morbidity and mortality among preschool children in India.
abstract: Higher food prices increase the risk of vitamin A deficiency among preschool children in poor families, because a larger part of the household food budget is spent on grain foods and less on vitamin A-rich foods. Vitamin A supplementation is an important source of vitamin A for children. Our objective was to characterize coverage of the India national vitamin A program for preschool children and identify risk factors for not receiving vitamin A. Anthropometric and demographic data were examined in 23,008 children aged 12-59 mo in the India National Family Health Survey, 2005-2006. Within the last 6 mo, 20.2% of children received vitamin A supplementation. The prevalence of stunting, severe stunting, underweight, and severe underweight was higher among children who did not receive vitamin A compared with those who received vitamin A (P < 0.0001). In families with a child who did and did not receive vitamin A, respectively, the proportion with a history of under-5 child mortality was 8.4 vs. 11.4% (P < 0.0001). By state, vitamin A program coverage was inversely proportional to the under-5 child mortality rate (r = -0.51; P = 0.004). Maternal education of > or =10 y [odds ratio (OR) 2.22; 95% CI 1.69-2.91], 7-9 y (OR 1.99; 95% CI 1.57-2.53), or 1-6 y (OR 1.65; 95% CI 1.28-2.13) compared with no education was an important factor related to receipt of vitamin A. Poor coverage of the vitamin A supplementation program in India has serious implications in the face of rising food prices. Expanded coverage of the vitamin A program in India will help protect children from morbidity, mortality, and blindness.
authors: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. rdsemba@jhmi.edu
authors: Richard D
authors: RD
authors: Semba
authors: Saskia
authors: S
authors: de Pee
authors: Kai
authors: K
authors: Sun
authors: Martin W
authors: MW
authors: Bloem
authors: V K
authors: VK
authors: Raju
mesh_terms: D046688:Child Mortality; D002675:Child, Preschool; D019587:Dietary Supplements; D005502:Food / Q000191:economics; D006130:Growth Disorders / Q000517:prevention & control; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D009313:National Health Programs; D011203:Poverty; D013851:Thinness; D014801:Vitamin A / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000188:drug therapy* / Q000517:prevention & control*
chemical_list: D014801:Vitamin A