Including the excluded: over 13 million children reached with life-saving vitamin A supplements in the state of Bihar, India
NEW DELHI, India, 18 November 2009 – Vitamin A deficiency is widespread throughout India, but particularly so in rural areas, where up to 62 per cent of preschool-age children are deficient, according to the latest estimates. Moreover, the high prevalence of wasting (20 percent), stunting (48 percent), and anemia (70 percent) in children under 5 years old indicates widespread nutrition deprivation.
Global evidence shows that in areas where vitamin A deficiency is prevalent, preventive vitamin A supplementation can reduce child mortality by an average 23 percent.
This is why vitamin A supplements are often referred to as drops of life. India’s national policy recommends that all children 9-59 months old be given preventive vitamin A supplementation twice yearly to reduce the risk of child blindness, infection, undernutrition and death associated with vitamin A deficiency, particularly among the most vulnerable children.
Many states in India have put the fight against vitamin A deficiency on a war footing, and the State of Bihar – one of the poorest in India – is at the forefront of this battle.
Since 2007, the Government of Bihar, in partnership with UNICEF and others, supports a strategy to increase coverage of vitamin A supplementation beyond the levels achieved through routine contacts with the health system.
The goal is to reach out to all children, beginning with children in socially-excluded groups - scheduled castes and minority groups - as undernutrition and mortality rates are significantly higher among these children.
District planning has been a critical tool in including the children who were once excluded. More than 11,000 health centers and 80,000 anganwadis, or child development centers, that serve as the core distribution sites for vitamin A supplementation have now been mapped out.
Even small isolated communities located on the extreme periphery have been organized and grouped around more than 3,400 temporary sites to deliver vitamin A supplements with the help of trained volunteers from the community.
All village-based frontline health and nutrition workers and volunteers in the 38 districts of Bihar have been trained to administer preventive vitamin A syrup to children and to counsel mothers on how to improve the vitamin A content of their children’s diet.
The latest coverage data indicates that in the first semester of 2009, Bihar’s vitamin A supplementation programme reached 13.4 million children 9-59 months old, protecting 95 percent of children in this age group against the devastating consequences of chronic vitamin A deficiency.
The Government of Bihar is demonstrating that it is feasible to undertake inclusive programming for child nutrition and to reach children who are traditionally excluded from services when efforts are made to understand who these children are and where they live – and when political decisions are made to assign the human and programme resources needed to reach all children.