TY - JOUR
T1 - To see, hear, and live
T2 - 25 years of the vitamin A programme in Nepal
AU - Thorne-Lyman, Andrew L.
AU - Parajuli, Kedar
AU - Paudyal, Naveen
AU - Chitekwe, Stanley
AU - Shrestha, Ram
AU - Manandhar, Dibya Laxmi
AU - West, Keith P.
N1 - Funding Information:
This paper is dedicated to the efforts of the Female Community Health Volunteers who continue to form the backbone of the National Vitamin A Programme in Nepal. We gratefully acknowledge the inputs of the following individuals who helped us identify resources and understand the programme or context (listed in alphabetical order): Dr. Ramesh Kanta Adhikari, Dr. Ramesh Prasad Adhikari, Dr. Bikash Lamichhane, Dr. Kenda Cunningham, Dale Davis, Rohita Gauchan, Amrit Gurung, Sanjeev Kumar Karn, Roman Karki, M.R. Maharjan, Pragya Mathema, Kedar Raj Parajuli, Pooja Pandey Rana, Giriraj Subedi, Deepak Thapa, Neff Walker, Purna Chandra Wasti, Sagar Sijapati, and FCHVs Geeta Thing and Rajani Manandhar. S. Chitekwe, N. Paudyal, and D. L. Manandhar are UNICEF staff members. The opinions and statements in this article are those of the authors and may not reflect official UNICEF policies.
Publisher Copyright:
© 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd
PY - 2022/1
Y1 - 2022/1
N2 - 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.
AB - 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.
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U2 - 10.1111/mcn.12954
DO - 10.1111/mcn.12954
M3 - Article
C2 - 32108438
AN - SCOPUS:85080137252
SN - 1740-8695
VL - 18
JO - Maternal and Child Nutrition
JF - Maternal and Child Nutrition
IS - S1
M1 - e12954
ER -