Supplementation
For children from six months to 5 years of age, vitamin A supplements are delivered semi-annually through a variety of health delivery approaches. Vitamin A supplements are also given to women up to eight weeks following childbirth and recommended for treating children who have measles, severe malnutrition or prolonged diarrhea. Supplementation maintains adequate vitamin A levels and ensures that immune functions are not damaged.
USAID Response
Research has led to the inclusion of vitamin A supplementation as a major component of USAID child survival programs. In the early-1990s, the United Nations Children's Fund (UNICEF), USAID, the Canadian Micronutrient Initiative (MI) and other donors began integrating vitamin A supplementation with national polio immunization days (NIDs). This led to widespread supplementation of children six months to approximately 6 years of age in over 40 countries.
Recognizing that NIDs are being phased out as large geographic areas become polio free, USAID, beginning in 1998 took the lead in helping countries establish and monitor programs to distribute vitamin A independently from NIDs. Developed by USAID as an alternative delivery approach to vitamin A supplementation through NIDS, the Child Health Week approach incorporates vitamin A distribution into a package of preventive services designed to improve child survival through periodic outreach and facility-based promotions.
To date, 15 (out of total of approximately 25) vitamin A deficient (VAD) countries are now carrying out semi-annual vitamin A supplementation, nine of them national in scope. Other countries have linked vitamin A supplementation to their immunization programs as well as to their child health service delivery approaches. The UN Special Session on Children in 2002 reported that vitamin A supplementation with a 70 percent minimum coverage of children under 5 has risen from 11 countries in 1996 to 43 countries in 1999.
USAID has had success in application of innovative approaches to increase the coverage and utilization of iron for women and children, through iron supplementation approaches. A national multi-sectoral Anemia Control program was launched in Ghana, combining resources and interventions in malaria, reproductive health, media and environmental health. Iron folate supplementation programs are being scaled up in India by actively engaging women health providers who are themselves anemic.
USAID is also collaborating with the World Health Organization (WHO) and UNICEF in developing an introductory approach for delivery of zinc supplements for treatment of acute diarrhea. Start-up programs in zinc supplementation have begun in three countries, adhering to clinical guidelines for health workers developed by USAID.
Other Interventions
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