To see, hear, and live: 25 years of the vitamin A programme in Nepal
Abstract Nepal has a rich history of vitamin A research and a national, biannual preschool vitamin A supplementation (VAS) programme that has sustained high coverage for 25 years despite many challenges, including conflict. Key elements of programme success have included (a) evidence of a 26–30% red...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Maternal and Child Nutrition |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/mcn.12954 |
| _version_ | 1828126486408724480 |
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| author | Andrew L. Thorne‐Lyman Kedar Parajuli Naveen Paudyal Stanley Chitekwe Ram Shrestha Dibya Laxmi Manandhar Keith P. West Jr |
| author_facet | Andrew L. Thorne‐Lyman Kedar Parajuli Naveen Paudyal Stanley Chitekwe Ram Shrestha Dibya Laxmi Manandhar Keith P. West Jr |
| author_sort | Andrew L. Thorne‐Lyman |
| collection | DOAJ |
| description | Abstract Nepal has a rich history of vitamin A research and a national, biannual preschool vitamin A supplementation (VAS) programme that has sustained high coverage for 25 years despite many challenges, including conflict. Key elements of programme success have included (a) evidence of a 26–30% reduction in child mortality from two, in‐country randomized trials; (b) strong political and donor support; (c) positioning local female community health volunteers as key operatives; (d) nationwide community mobilization and demand creation for the programme; and (e) gradual expansion of the programme over a period of several years, conducting and integrating delivery research, and monitoring to allow new approaches to be tested and adapted to available resources. The VAS network has served as a platform for delivering other services, including anthelmintic treatment and screening for acute malnutrition. We estimate that VAS has saved over 45,000 young lives over the past 15 years of attained national coverage. Consumption of vitamin A‐ and carotenoid‐rich foods by children and women nationally remains low, indicating that supplementation is still needed. Current challenges and opportunities to improving vitamin A status include lower VAS coverage among younger children (infants 6–11 months of age), finding ways to increase availability and access to dietary vitamin A sources, and ensuring local programme investments given the recent decentralization of the government. |
| first_indexed | 2024-04-11T15:36:14Z |
| format | Article |
| id | doaj.art-e12c27bbf751465bab976864d296db41 |
| institution | Directory Open Access Journal |
| issn | 1740-8695 1740-8709 |
| language | English |
| last_indexed | 2024-04-11T15:36:14Z |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Maternal and Child Nutrition |
| spelling | doaj.art-e12c27bbf751465bab976864d296db412022-12-22T04:15:58ZengWileyMaternal and Child Nutrition1740-86951740-87092022-01-0118S1n/an/a10.1111/mcn.12954To see, hear, and live: 25 years of the vitamin A programme in NepalAndrew L. Thorne‐Lyman0Kedar Parajuli1Naveen Paudyal2Stanley Chitekwe3Ram Shrestha4Dibya Laxmi Manandhar5Keith P. West Jr6Center for Human Nutrition, Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MarylandNutrition Section, Family Welfare Division Ministry of Health and Population Nepal Kathmandu NepalUNICEF Nepal Kathmandu NepalUNICEF Nepal Kathmandu NepalNepali Technical Assistance Group Kathmandu NepalUNICEF Nepal Kathmandu NepalCenter for Human Nutrition, Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore MarylandAbstract Nepal has a rich history of vitamin A research and a national, biannual preschool vitamin A supplementation (VAS) programme that has sustained high coverage for 25 years despite many challenges, including conflict. Key elements of programme success have included (a) evidence of a 26–30% reduction in child mortality from two, in‐country randomized trials; (b) strong political and donor support; (c) positioning local female community health volunteers as key operatives; (d) nationwide community mobilization and demand creation for the programme; and (e) gradual expansion of the programme over a period of several years, conducting and integrating delivery research, and monitoring to allow new approaches to be tested and adapted to available resources. The VAS network has served as a platform for delivering other services, including anthelmintic treatment and screening for acute malnutrition. We estimate that VAS has saved over 45,000 young lives over the past 15 years of attained national coverage. Consumption of vitamin A‐ and carotenoid‐rich foods by children and women nationally remains low, indicating that supplementation is still needed. Current challenges and opportunities to improving vitamin A status include lower VAS coverage among younger children (infants 6–11 months of age), finding ways to increase availability and access to dietary vitamin A sources, and ensuring local programme investments given the recent decentralization of the government.https://doi.org/10.1111/mcn.12954childhood infectionschild nutritionchild public healthInternational Child Health Nutritionprogramme evaluationvitamin A |
| spellingShingle | Andrew L. Thorne‐Lyman Kedar Parajuli Naveen Paudyal Stanley Chitekwe Ram Shrestha Dibya Laxmi Manandhar Keith P. West Jr To see, hear, and live: 25 years of the vitamin A programme in Nepal Maternal and Child Nutrition childhood infections child nutrition child public health International Child Health Nutrition programme evaluation vitamin A |
| title | To see, hear, and live: 25 years of the vitamin A programme in Nepal |
| title_full | To see, hear, and live: 25 years of the vitamin A programme in Nepal |
| title_fullStr | To see, hear, and live: 25 years of the vitamin A programme in Nepal |
| title_full_unstemmed | To see, hear, and live: 25 years of the vitamin A programme in Nepal |
| title_short | To see, hear, and live: 25 years of the vitamin A programme in Nepal |
| title_sort | to see hear and live 25 years of the vitamin a programme in nepal |
| topic | childhood infections child nutrition child public health International Child Health Nutrition programme evaluation vitamin A |
| url | https://doi.org/10.1111/mcn.12954 |
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