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. 2021 Jul;17(3):e13132.
doi: 10.1111/mcn.13132. Epub 2020 Dec 17.

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

Arnaud Laillou  1 , Kaleab Baye  2 , Meseret Zelalem  3 , Stanley Chitekwe  1
Affiliations

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

Arnaud Laillou et al. Matern Child Nutr. 2021 Jul.

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 (2005-2019), 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.

Keywords: equity; health system; mortality; vitamin A supplementation.

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Conflict of interest statement

The authors declare no conflict of interest. The opinions and statements in this article are those of the authors and may not reflect official policies or opinions of the organizations they belong to.

Figures

FIGURE 1
FIGURE 1
Trends of vitamin A and albendazole received at least two times each year in Ethiopia, 2005 to 2019
FIGURE 2
FIGURE 2
Prevalence of children receiving over the last 6 months a capsule of vitamin A in the four Ethiopian demographic health surveys according to their residence of living (left figure) and their social characteristics (right figure)
FIGURE 3
FIGURE 3
Estimated mortality rates in the presence and absence of preventive vitamin A supplementation among children aged 6–59 months (assuming a 12% or 24% mortality due to vitamin A), 2005 to 2019
FIGURE 4
FIGURE 4
Annual child deaths averted assuming 24% (left) and 12% (right) mortality reductions attributed to by vitamin A supplementation, Ethiopia, 2005–2019
See this image and copyright information in PMC

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