Vitamin A supplementation and estimated number of averted child deaths in Ethiopia: 15 years in practice (2005–2019)

Abstract

Vitamin A supplementation (VAS), started as a short-term strategy pending dietary improvements, has been implemented in Ethiopia for the last 15 years. We aimed to describe the trends in VAS coverage and estimated the associated reductions in child mortality. VAS coverage data obtained from the District Health Information System and the Demographic and Health Surveys were linked to child mortality data from the United Nations Interagency Group for Child Mortality Estimation (UN IGME).The number of child deaths averted was modelled assuming 12% and 24% reductions in all-cause mortality. From 2006 to 2011, VAS was delivered through campaigns, and coverage was above 85%. However, from 2011 onwards, VAS delivery was integrated to the routine health system, and the coverage declined to <60% with significant disparities by wealth quintile and rural-urban residence. VAS has saved between 167,563 to 376,030 child lives (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018)(2019), but additional lives (>42,000) could have been saved with a universal coverage (95%). Inconsistent supply of vitamin A capsules, but more importantly, low access to health care, and the limited contact opportunities for children after 24 months may have contributed to the declining VAS coverage. Any changes in target or scale-up should thus consider these spatial and socioeconomic variations. Increasing the coverage of VAS and closing the equity gap in access to nutrition services is critical. However, with alternative programmes like vitamin A fortification being set-up, the benefits and safety of VAS need to be closely monitored, particularly in areas where there will be overlap.

Geographic weighted regression analysis of hot spots of anemia and its associated factors among children aged 6–59 months in Ethiopia: A geographic weighted regression analysis and multilevel robust Poisson regression analysis

“…Besides, the spatial distribution of anemia among children aged 6-59 months in Ethiopia was non-random and the hotspot areas of anemia were identified in the central, west, and east Afar, Somali, Dire-Dawa, Harari, and northwest Gambella regions. Though numerous interventions have been implemented to reduce anemia among children such as nutritional interventions like food fortification and supplementation [43][44][45], iron-folate supplementation during pregnancy [46,47], appropriate breastfeeding practice [48], and improving personal hygiene [49], there was high spatial heterogeneity of anemia across areas.…”

Trends in inequality in the coverage of vitamin A supplementation among children 6–59 months of age over two decades in Ethiopia: Evidence from demographic and health surveys

“… 6 , 9 A recent study in Ethiopia shows that vitamin A supplementation (VAS) has saved between 167,563 to 376,030 child lives between 2005 and 2019. 14 …”

Effects of different drying methods and ascorbic acid pretreatment on carotenoids and polyphenols of papaya fruit in Ethiopia

“…Despite sustained nutrition education through the health system, consumption of fruits has remained very low (Baye & Hirvonen, 2020; Baye et al., 2019) and the reach of interventions like vitamin A supplementation has been inadequate (Laillou et al., 2020). The high price of fruits, their perishability, and seasonality are among the underlying factors influencing consumption of fruits (Baye & Hirvonen, 2020).…”