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Coverage of the vitamin A supplementation programme for child survival in Nepal: success and challenges
A M Nguyen1, D S Grover, K Sun
1Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Insights
Nepal
Area of Science:
- Public Health
- Nutritional Epidemiology
- Child Health Interventions
Background:
- Nepal's national vitamin A program, initiated in 1993, aims to reduce child morbidity, mortality, and blindness.
- The program targets pre-school-aged children semi-annually across all districts.
Purpose of the Study:
- To assess the coverage of Nepal's National Vitamin A Programme (NVAP).
- To identify risk factors associated with children not receiving vitamin A supplementation.
Main Methods:
- Cross-sectional study utilizing data from 4013 children (12-59 months) and their families from the 2011 Nepal Demographic and Health Survey (NDHS).
- Comparison of NVAP coverage with estimates from the 2001 and 2006 NDHS.
Main Results:
- Coverage for children aged 12-59 months was 84.3% (2001), 96.6% (2006), and 92.1% (2011).
- Children missing supplementation were more likely to be younger, anemic, have less educated parents, reside in rural areas, and belong to families with higher child/infant mortality.
Conclusions:
- Nepal's vitamin A supplementation program demonstrates high coverage but still misses vulnerable children.
- Targeted interventions may be necessary to ensure sustained high program coverage, particularly for children in high-mortality families.
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.
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