WHO recommends vitamin A supplementation (VAS) programmes for children 6–59 months where vitamin A deficiency is a public health problem. However, resources for VAS are falling short of current needs and programme coverage is suffering. The authors present the case for considering the options for shifting efforts and resources from a generalised approach, to prioritising resources to reach populations with continued high child mortality rates and high vitamin A deficiency prevalence to maximise child survival benefits . This includes evaluating where child mortality and/or vitamin A deficiency has dropped, as well as using under 5 mortality rates as a proxy for vitamin A deficiency, in the absence of recent data. The analysis supports that fewer countries may now need to prioritise VAS than in the year 2000, but that there are still a large number of countries that do. The authors also outline next steps for analysing options for improved targeting and cost-effectiveness of programmes. Focusing VAS resources to reach the most vulnerable is an efficient use of resources and will continue to promote young child survival.
- public health
- child health
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Handling editor Seye Abimbola
Contributors EM conceptualised the approach to revising the list of countries tracked for needing national programmes and worked on a first draft of this paper. RK provided input into the approach and drafts of the paper. HS conducted the analysis to use U5MR as a proxy indicator and provided input into the drafts of the paper. AG provided input into the approach and drafts of the paper.
Funding We are grateful to Global Affairs Canada and Proctor and Gamble for funding for vitamin A supplementation, which supported some staff and consultancy time to undertake this analysis and write this paper.
Competing interests The authors work for organisations that support vitamin A supplementation programmes.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon request.
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