ity and morbidity in developing countries and achieve the
MDGs where micronutrient deficiencies are common.
Vitamin A is necessary for good immune function
and for better recovery from diseases such as malaria
and measles.29 Vitamin A deficiency is a major contributor to the mortality of children under five; vitamin A supplementation enhances children’s resistance
to disease and can reduce mortality from all causes by
approximately 23 percent.30 Yet globally, more than a
third of preschool-age children are vitamin A deficient.31
Prevention and control of such deficiencies improve a
child’s chances of survival, reduce the severity of childhood illnesses, ease the strains on health systems and
hospitals, and contribute to the well-being of children
and their families and communities. Children at risk
should receive at least one high-dose vitamin A supplement between the ages of 6–59 months.32 Evidence suggests that vitamin A supplementation is a good strategy
for children living in malaria-endemic regions.33 Malaria
prevention and control efforts such as the U.S. President’s Malaria Initiative should integrate campaigns to
distribute vitamin A supplements and strengthen links
with agriculture programs to promote the production
and consumption of crops rich in vitamin A (such as
orange-flesh sweet potatoes).
The United Nations Children’s Fund (UNICEF) and
the World Health Organization (WHO) also recommend
high-dose vitamin A supplementation for women in the
immediate post-partum period, coupled with exclusive
breastfeeding, so that all infants receive the necessary
immune-boosting protection of vitamin A in the first
six months of life.34 These postnatal supplement also
help replenish the mother’s own stores of vitamin A,
which are depleted during pregnancy and lactation.
MCH services and platforms such as postpartum and
neonatal care, family planning, and preventing motherto-child transmission of HIV should be leveraged for
opportunities to counsel women on the importance
of vitamin A supplementation and distribute the
supplements.
Vitamin A efforts can be integrated into maternal and
child health services by providing supplements during
routine expanded programs on immunization every six
months for children ages 6—59 months and by targeting
for supplementation people in the following categories:
pregnant women and children with night blindness,
measles, or acute diarrhea lasting more than 14 days;
children older than 24 months with either severe or
moderate acute malnutrition. To complement these
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Khaled Sadiq/Photoshare
• Vitamin A Deficiency—Prevention and
Control in Women and Children
A young boy receives a Vitamin A application during National Immunisation
Days in Mazar-i-Sharif, Balkh province, Afghanistan.
targeted efforts, mass fortification of sugar and vegetable
oil with vitamin A is also very effective.
• Zinc Supplementation
Zinc supplementation is another highly cost-effective
nutrition intervention. It improves children’s ability to
recover from conditions such as diarrhea, pneumonia,
malaria, and respiratory infections and boosts their general immunity and growth.35 Promoting—and, further,
institutionalizing—preventative and therapeutic zinc supplementation can reduce both child mortality and stunting. Since zinc deficiencies put children at increased risk
of illness or death, it is natural to integrate zinc supplementation into the management of child illnesses. Zinc
supplementation for diarrhea in children should be
paired with distribution of oral rehydration salts within
maternal and child health services as well as services for
orphans and vulnerable children. Strong donor support
and advocacy is needed to encourage national governments to adopt national zinc supplementation policies
and persuade Ministries of Health to include zinc in
their diarrhea management policies. Once a government
categorizes zinc as an essential medicine, the country
may also need substantial support to procure sufficient
quantities of zinc locally.
• Iron Deficiency Anemia Prevention and
Control
Micronutrient deficiencies are a major contributor to
high rates of maternal anemia—and to maternal mortality. Anemia36 is a condition in which a person’s blood
contains too few red blood cells. One of the primary
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