A Review of Vitamin A Supplementation in South Sudan: Successes, Challenges, and Opportunities for the Way Forward.

Autor:	Haselow NJ; UNICEF South Sudan, Neenah, WI, USA. njhaselow@gmail.com vjoshi@unicef.org., Joshi V; UNICEF South Sudan, Juba, The Republic of South Sudan. njhaselow@gmail.com vjoshi@unicef.org., Bayo PN; UNICEF Nigeria, Maiduguri, Nigeria., Murye JW; UNICEF South Sudan, Juba, The Republic of South Sudan., Shaban SN; UNICEF South Sudan, Juba, The Republic of South Sudan., Abebe KT; UNICEF South Sudan, Juba, The Republic of South Sudan., Kassim I; UNICEF, Yemen, Sana'a Yemen., Shiweredo T; UNICEF South Sudan, Juba, The Republic of South Sudan., Vinathan H; UNICEF Lao People's Democratic Republic, Vientiane, Lao People's Democratic Republic., Jaiswal CP; UNICEF South Sudan, Juba, The Republic of South Sudan., Miluwa KA; South Sudan Ministry of Health, Juba, The Republic of South Sudan., Ategbo EA; UNICEF South Sudan, Juba, The Republic of South Sudan., Ndiaye B; UNICEF Somalia, Mogadishu, Somalia., Ayoya MA; UNICEF Afghanistan, Kabul, Afghanistan.
Jazyk:	angličtina
Zdroj:	Global health, science and practice [Glob Health Sci Pract] 2022 Jun 29; Vol. 10 (3). Date of Electronic Publication: 2022 Jun 29 (Print Publication: 2022).
DOI:	10.9745/GHSP-D-21-00660
Abstrakt:	Aim: To identify vitamin A supplementation (VAS) trends in South Sudan and provide insights to refocus VAS programming vis a vis polio eradication campaigns recently phased out while access to health care, land, food, and markets remain challenging. Method: Review of data from survey and coverage reports; review of policy and program documents; key informant responses; general literature search. Results: Vitamin A deficiency (VAD) is likely a severe public health problem among preschool-aged children in South Sudan based on a high under-5 mortality rate (96.2 deaths/1,000 live births) and high levels of undernutrition, infections, and food insecurity. Vitamin A capsules, with deworming tablets (VASD), have been delivered to preschool-aged children during national immunization days (NIDs) for the past decade. Although areas of South Sudan and certain populations continue to have low VAS coverage, when comparing national VAS coverage (reported in the last 6 months) between 2010 and August 2019, a large improvement is noted from 4% to 76%. In 2021, VAS coverage was more than 90% at the national level during 2 stand-alone distribution campaigns. Deworming coverage trends generally mimicked VAS coverage. VAS is provided to postpartum mothers who deliver at health facilities (approximately 12%-25%), but coverage data are not available. Conclusion: Twice-yearly VAS should remain a key lifesaving intervention to address VAD, but alternative delivery strategies will be needed. Conducting events, such as child health days, supported by promotional activities or community-based VASD distribution activities for the youngest children and those missed during campaigns, should be considered. For the long term, a hybrid approach targeting underserved areas with mass distribution events while integrating VASD into community-based programs such as quarterly screening for wasting should be tested further and gradually scaled up everywhere as this has the potential to sustainably reach all vulnerable children twice yearly. (© Haselow et al.)
Databáze:	MEDLINE
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