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. 2020 Oct;16(4):e13041.
doi: 10.1111/mcn.13041. Epub 2020 Jul 27.

Routine vitamin A supplementation and other high impact interventions in Sierra Leone

Aminata S Koroma  1 , Sulaiman G Conteh  2 , Mariama Bah  3 , Habib I Kamara  3 , Mohamed Turay  3 , Abdulai Kandeh  3 , Anna Macauley  3 , Henry Allieu  3 , Anita A Kargbo  3 , Mustapha Sonnie  3 , Mary H Hodges  3
Affiliations

Routine vitamin A supplementation and other high impact interventions in Sierra Leone

Aminata S Koroma et al. Matern Child Nutr. 2020 Oct.

Abstract

In 2017, transition to routine vitamin A supplementation (VAS) commenced as an integrated reproductive and child health service including vaccinations, Albendazole for deworming, complementary feeding demonstrations, 'quality' family planning counselling and provision of modern contraceptives. After 10 months, a lot quality assurance sampling survey evaluated coverage of these interventions. Each of three districts was divided into five supervision areas (lots), and 19 villages were randomly selected in each lot proportional to population size. Households were randomly selected, and a questionnaire was administered to a caregiver of a child 6-11, 12-23 and 24-59 months in each village. Overall, caregivers of 855 children were interviewed, and 19 questionnaires were completed for each age group (6-11, 12-23 and 24-59 months) in each of the five lots in each district. All lots in one district passed the threshold of 80% for VAS and 75% coverage for Albendazole, and two lots failed for either VAS/Albendazole in the other two districts. Overall, weighted VAS coverage for children 6-59 months was 86.9%, and weighted Albendazole coverage for children 12-59 months was 80.9%. Most caregivers (77.2%) knew that complementary feeding should be introduced at 6 months, 44.9% were providing three or more (of six) food groups, 84.9% were aware of family planning and 37.5% were using a modern contraceptive. Integration of reproductive and child health services appears to be a suitable platform for routine VAS and Albendazole whilst improving complementary feeding practices and access to family planning.

Keywords: Sierra Leone; child survival interventions; complementary feeding; deworming; family planning; immunization; maternal health; teenage; vitamin A supplementation.

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Conflict of interest statement

The authors state that there is no competing interest and the contents are the responsibility of the authors and do not necessarily reflect the views of the Irish Aid, UNICEF, UNFPA or the Canadian Government. The 6MlyCP is co‐funded by Irish Aid and Global Affairs Canada. The United Nations Fund for Population Activities (UNFPA) provide FP commodities and the United Nations Children's Fund (UNICEF) provide vitamin A capsules, Albendazole, vaccines and child health cards to the MoHS. This study was made possible by the generous support of the Global Affairs Canada through UNICEF to Helen Keller International. The funders had no role in data collection and analysis, decision to publish or preparation of the manuscript.

Figures

FIGURE 1
FIGURE 1
Map of districts, chiefdoms and lots
FIGURE 2
FIGURE 2
Venue of vitamin A supplementation (VAS) receipt by district and by age group. Overall, significantly more caregivers of children 12–23 and 24–59 months reported their child had received VAS from outreach services than children 6–11 months (p < 0.001, p < 0.0001, respectively)
FIGURE 3
FIGURE 3
Sources of knowledge for vitamin A supplementation (VAS). CHW, community health worker; PHU, peripheral health unit
FIGURE 4
FIGURE 4
(a) Mean minimum dietary diversity reported by 285 caregivers of infants 6–11 months by district and caregivers' religion, education and occupation (95% confidence interval [CI]). (b) Mean minimum dietary diversity reported by caregivers of infants 6–11 months in the lot quality assurance sampling survey (LQAS) (2018) and by caregivers of children 6–23 months in the Sierra Leone National Nutrition Survey (SLNNS, MoHS, 2017) (95% CI)
See this image and copyright information in PMC

References

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