In this article we will be discussing a very common question: vitamin a prophylaxis programme. It’s quite a sensitive & complex subject, as such we will do our best at providing a clear and concise article to clear any doubts you may have.
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Abstract
The prevalence of severe undernutrition has come down significantly. Prophylactic mega dose administration of vitamin A is primarily advocated because of the claim of 23 per cent reduction in childhood mortality.
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Clinical as well as subclinical (detected by abnormal conjunctival impression cytology) assessment of vitamin A status was performed according to standard procedures, as per WHO recommendations.
Only milder manifestations of xerophthalmia were observed. Although nonsignificant, higher prevalence of subclinical vitamin A deficiency was observed in above three years of age group. In view of current age strategy for vitamin A supplementation (< or = 3 years) and observed higher prevalence of clinical and subclinical vitamin A deficiency above three years of age in this study (also endorsed by earlier studies) a call for review of current age strategy for vitamin A supplementation is warrante.
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Al Prophylaxis Programme against Nutritional Blindness due to vitamin A deficiency (NPPNB due to VAD) was started in 1970
– with the specific aim of preventing nutritional blindness due to keratomalacia
– As an urgent measure to combat the unacceptably high magnitude of xerophthalmic blindness in the country seen in the 1950s and 1960s
• The Programme was started as a 100 per cent centrally sponsored programme
• In 1994, under the National Child Survival and Safe Motherhood (CSSM) Programme, the age group of eligible children was restricted to 9 to 36 months of age
– Prophylactic mega dose administration of vitamin A was primarily advocated because of the claim of 23 per cent reduction in childhood mortality and
– Not mainly for blindness prevention. – The female multipurpose worker and other paramedics at the village level sub-health centres are responsible for administering vitamin A solution. – The services of ICDS functionaries are also utilized for Programme implementation.
• Universal supplementation of vitamin A to Indian children is being undertaken irrespective of their family background and nutritional status
• Recently it has been suggested that India is currently at a stage when universal vitamin A supplementation should transit to
– A targeted supplementation programme and
– The primary focus should now be on sustainable food based approaches to combat vitamin A deficiency
• To increase local production and consumption of green leafy vegetables and other plant foods those are rich sources of carotenoids. • Green leafy vegetables, many fruits and other plant foods are also good sources of folate, vitamin C, Fe, Ca and many other micronutrients
Reference:
• Umesh Kapil and H.P.S.