Utilization of vitamin A supplementation services in high priority districts of Bihar

Abstract

Background: Vitamin A deficiency (VAD) is a major preventable public health problem. Prevalence of VAD in preschool children was 5.7% (India), and 4.5% (Bihar). India is implementing biannual Vitamin A Supplementation (VAS) since 2007 along with 80 other countries. VAS was originally proposed as a short term measure, followed by dietary improvement. Since vulnerability to VAD is more in high priority districts (HPDs), it was deemed worthwhile to study the extent to which VAS programme is utilized in the 10 HPDs of Bihar with respect to the processes involved and the ultimate outcome of empowering the community with knowledge and capacity to combat VAD on their own.Methods: Cross sectional observational study conducted in 6 randomly selected blocks and 5 session sites per block of the 10 HPDs. 300 sites sampled for processes and 893 caregivers interviewed for their knowledge.Results: Out of 300 sites, 269 sites found functional, 30.85% sites had due lists and 30.11% had MCP cards; 20.44% had adequate VA. IEC displayed at 52.78% and 71.3% sessions conducted in shade. In 79.55% sites efforts made to determine age of child before administration. Correct use of recommended spoon known to 80.66%, benefits of VA to 76.57% and diseases due to VAD to 81.7% of FLWs. Knowledge regarding VA good in 33.4% of caregivers, average in 35.5%, and poor in 30.9%.Conclusions: Crucial gaps found in necessary inputs and conduct of VAS. Community knowledge found lacking for sustainable programme withdrawal. Better programme management will improve utilization.