title: Coverage of the vitamin A supplementation programme for child survival in Nepal: success and challenges.
abstract: BACKGROUND
  Nepal's national vitamin A programme, which began in 1993 and continues twice yearly, targets pre-school-aged children in all districts of the country in an effort to reduce morbidity, mortality and nutritional blindness.
  
  
  OBJECTIVE
  To characterize the coverage of the Nepal National Vitamin A Programme (NVAP) for pre-school-aged children in Nepal and to identify risk factors for failure to receive vitamin A supplementation.
  
  
  METHODS
  The relationship between receipt of a vitamin A capsule and demographic and health indicators was examined in a cross-sectional study of 4013 children aged 12-59 months and their families who participated in the 2011 Nepal Demographic and Health Survey (NDHS), a nationally representative survey. Coverage of the vitamin A programme was compared with coverage estimates from surveys in 2001 and 2006.
  
  
  RESULTS
  Coverage estimates of the national vitamin A programme for children aged 12-59 months as assessed by the 2001, 2006 and 2011 NDHS were 84.3%, 96.6% and 92.1%, respectively. Children who missed a vitamin A capsule were more likely to be younger and anaemic, have less educated parents, live in rural areas, and have higher child and infant mortality in the family.
  
  
  CONCLUSIONS
  The national vitamin A supplementation programme in Nepal has relatively high coverage of children aged 12-59 months but still misses children in families with high child mortality. Further measures might be needed to sustain a high level of programme coverage.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: A M
authors.initials: AM
authors.lastname: Nguyen
authors.forename: D S
authors.initials: DS
authors.lastname: Grover
authors.forename: K
authors.initials: K
authors.lastname: Sun
authors.forename: V K
authors.initials: VK
authors.lastname: Raju
authors.forename: R D
authors.initials: RD
authors.lastname: Semba
authors.forename: D A
authors.initials: DA
authors.lastname: Schaumerg
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet / Q000379:methods*; D005260:Female; D006302:Health Services Research; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009313:National Health Programs; D009390:Nepal; D012307:Risk Factors; D016019:Survival Analysis; D014801:Vitamin A / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D014801:Vitamin A