title: Vitamin A Supplementation Programs and Country-Level Evidence of Vitamin A Deficiency.
abstract: Vitamin A supplementation (VAS) programs targeted at children aged 6-59 months are implemented in many countries. By improving immune function, vitamin A (VA) reduces mortality associated with measles, diarrhea, and other illnesses. There is currently a debate regarding the relevance of VAS, but amidst the debate, researchers acknowledge that the majority of nationally-representative data on VA status is outdated. To address this data gap and contribute to the debate, we examined data from 82 countries implementing VAS programs, identified other VA programs, and assessed the recentness of national VA deficiency (VAD) data. We found that two-thirds of the countries explored either have no VAD data or data that were >10 years old (i.e., measured before 2006), which included twenty countries with VAS coverage ≥70%. Fifty-one VAS programs were implemented in parallel with at least one other VA intervention, and of these, 27 countries either had no VAD data or data collected in 2005 or earlier. To fill these gaps in VAD data, countries implementing VAS and other VA interventions should measure VA status in children at least every 10 years. At the same time, the coverage of VA interventions can also be measured. We identified three countries that have scaled down VAS, but given the lack of VA deficiency data, this would be a premature undertaking in most countries without appropriate status assessment. While the global debate about VAS is important, more attention should be directed towards individual countries where programmatic decisions are made.
authors.affiliation: GroundWork, 7306 Fläsch, Switzerland. james@groundworkhealth.org.
authors.forename: James P
authors.initials: JP
authors.lastname: Wirth
authors.affiliation: GroundWork, 7306 Fläsch, Switzerland. nico@groundworkhealth.org.
authors.forename: Nicolai
authors.initials: N
authors.lastname: Petry
authors.affiliation: Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA. sherry@nutrisci.wisc.edu.
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Tanumihardjo
authors.affiliation: Department of Nutrition for Health and Development, World Health Organization, 1207 Geneva, Switzerland. rogersl@who.int.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Rogers
authors.affiliation: UNICEF Headquarters, New York, NY 10017, USA. emclean@unicef.org.
authors.forename: Erin
authors.initials: E
authors.lastname: McLean
authors.affiliation: Infant and Young Child Nutrition, Micronutrient Initiative, Ottawa, ON K2P 2K3, Canada. agreig@micronutrient.org.
authors.forename: Alison
authors.initials: A
authors.lastname: Greig
authors.affiliation: Global Alliance for Improved Nutrition, 1202 Geneva, Switzerland. ggarrett@gainhealth.org.
authors.forename: Greg S
authors.initials: GS
authors.lastname: Garrett
authors.affiliation: Helen Keller International, New York, NY 10010, USA. rklemm@hki.org.|Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. rklemm@hki.org.
authors.forename: Rolf D W
authors.initials: RD
authors.lastname: Klemm
authors.affiliation: GroundWork, 7306 Fläsch, Switzerland. fabian@groundworkhealth.org.
authors.forename: Fabian
authors.initials: F
authors.lastname: Rohner
mesh_terms: D002675:Child, Preschool; D003906:Developing Countries; D019587:Dietary Supplements; D005527:Food, Fortified; D006801:Humans; D007223:Infant; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D014480:United Nations; D014801:Vitamin A / Q000008:administration & dosage*; D014802:Vitamin A Deficiency / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D014801:Vitamin A
keywords: MNPs; biofortification; deficiency; fortification; programs; supplementation; vitamin A