NEPAL NATIONAL VITAMIN A PROGRAM
Nepal Vitamin A ProgramObjectives
• reduce child mortality and prevent xerophthalmia through supplementation of children 6-60 months of age with high-dose vitamin A capsules
• reduce vitamin A deficiency to a level that no longer constitutes a public health problem.
Nepal Vitamin A ProgramImplementation Strategy
• twice yearly supplementation
• community-based
• female volunteers (FCHVs)
• vit A and health education
• monitoring and evaluation
Nepal Vitamin A ProgramImplementation Strategy
• training
• logistics support
• assistance with education and promotional activities
• field supervision
• monitoring and evaluation.
Nepali Technical Assistance Group (NTAG)
FCHV giving Vitamin A
CHALLENGES
Nepal Vitamin A Program
NVAP Initiated Districts
All 75 Districts are
covered now
35,329
29,12026,698
20,880
16,36514,727
12,581
8,486
9692
9686 86
90 9290
0
10000
20000
30000
40000
50000
1993/94 1994/95 1995/96 1996/97 1997/98 1998/99 1999/00 2000/01
Num
ber
of D
eath
s A
vert
ed
0
20
40
60
80
100
% C
overage
Estimated Child Deaths Averted
Coverage (6-59 months)
Child Deaths Averted by Vitamin A Supplementation
Trend in Under-Five Mortality
91
94
73
56
158
126
118
161
196
75
0
50
100
150
200
1983 1988 1993 1998 2003 2008
Based on 2001 DHS Based on 1996 DHS Projected from 1996 Projected from 2001
Trend based on the equation: Y = 211.66 exp -0.1379x
Dea
ths
per
100
0 li
ve b
irth
s
• community-based, female community health volunteers
• slow, consistent, gradual expansion• GON ownership, enabling policy environment• donor coordination • community empowerment and ownership• support systems strengthened• NTAG
Nepal Vitamin A Program Elements of Success
The Future …
