Vitamin A deficiency causes night blindness, raises the risk of dying from measles and diarrhoea, and in severe cases destroys the cornea. In the 1980s and 1990s a series of trials in Indonesia, Nepal, Ghana, India and elsewhere showed that giving preschool children a high-dose capsule every six months cut child mortality by around a quarter in deficient populations. That finding turned vitamin A supplementation into a global programme.
How the programme works
Children aged six months to five years receive a capsule of 100,000 or 200,000 international units twice a year, usually during immunisation days or child health weeks. UNICEF supplies most of the capsules. At its peak in the 2000s the programme reached about 80 percent of targeted children in the poorest countries. National surveys in Bangladesh, Madagascar, Zambia, Nepal and Ghana, many of them run with support from donor-funded micronutrient projects, documented both the coverage and the fall in clinical deficiency.
Food-based approaches
Capsules were always meant as a bridge. The lasting solutions are dietary: orange sweet potato, carrots, dark leafy greens, red palm oil, eggs and liver. Sugar fortification with vitamin A, pioneered in Guatemala and later adopted in Zambia and other countries, reaches households that rarely buy fortified flour. Vegetable oil fortification is now mandatory in dozens of countries. Community health workers and street-food vendors have been part of these campaigns, teaching families which foods matter.
The debate today
Coverage of the capsule programme has fallen since the mid-2010s as polio campaigns, which used to deliver it, wound down, and as measles vaccination and better diets reduced the underlying deficiency. WHO still recommends supplementation where deficiency is a public health problem, but researchers argue about whether the mortality benefit measured in the 1980s still applies. The trend is towards targeting: measure deficiency in a country first, then decide between capsules, fortification and dietary programmes.
This site is an independent reference on micronutrients and is not connected to the former MOST project.
