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Akoto Osei K, PhD Helen Keller International Asia Pacific Regional Office

Monitoring Outcomes of Programs for Vitamin A Deficiency. Akoto Osei K, PhD Helen Keller International Asia Pacific Regional Office. ~250 million children suffer from Vitamin A deficiency (VAD). Source: WHO. 2009 . VAD and Health. Over 250,000 children become blind each year due to VAD.

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Akoto Osei K, PhD Helen Keller International Asia Pacific Regional Office

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  1. Monitoring Outcomes of Programs for Vitamin A Deficiency Akoto Osei K, PhD Helen Keller International Asia Pacific Regional Office

  2. ~250 million children suffer from Vitamin A deficiency (VAD) Source: WHO. 2009 .

  3. VAD and Health Over 250,000 children become blind each year due to VAD VAD increases risk of morbidity and mortality

  4. Strategies to address VAD • Vitamin A supplementation • Twice yearly for children 6-59 months of age (currently in ~80 countries) • Dietary diversification • Promoting production and consumption of diversified foods • Optimal breastfeeding and complementary feeding practices

  5. Strategies to address VAD Home fortification (Micronutrient powders, etc.) Large scale food fortification (VA + oil, flour, sugar, etc.) Biofortification Crops with high beta carotene (Orange Flesh Sweet Potato)

  6. Monitoring outcomes of vitamin A programs Data to inform whether our activities where implemented successfully Data to inform if we have reached our objectives

  7. Challenges with monitoring outcomes of Vitamin A programs • Lack of field friendly indicators for assessing impact of these programs on vitamin A status • How to estimate the relative contribution of the multiple vitamin A interventions to vitamin A intake and status • Limited information on coverage of most VAD programs • Limited information on underserved populations • Inadequate use of the monitoring data to improve program implementation • Limited funding for monitoring VAD programs

  8. Decisions about VAD programs – the need for more data Palmer et al, Public Health Nutr., 2012 For how long should universal vitamin A supplementation programs continue, especially in countries with high coverage of this program? Coverage of vitamin A supplementation programs: ~ 72% globally; and >80% in resource poor countries

  9. Declining under 5 mortality rate; yet ~8 million child deaths per year

  10. Palmer et al, Public Health Nutr. 2012; 9:1-15 • Shift from vitamin A supplementation programs for children should be made only when there is sufficient and stable evidence that VAD has reduced, and risk of vitamin A deficiency is minimal. • Consecutive surveys shows low prevalence of VAD (< 5%, based on serum retinol) • Data shows dietary vitamin A intake has improved • High coverage is achieved for vitamin A programs • Twice yearly vitamin A supplementation of children 6-59 months should continue

  11. Implications for monitoring VAD programs • Continuous monitoring and evaluation of VAD programs is needed to guide decisions on how to improve and when to scale back programs. • More information is needed on: • Coverage of programs to address VAD • Vitamin A intake and status, including the relative contribution from different sources (fortified and non-fortified foods and supplements)

  12. Thank You

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