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To see, hear, and live: 25 years of the vitamin A programme in Nepal

Nepal has a rich history of vitamin A research and a national, biannual preschool vitamin A supplementation (VAS) programme that has sustained high coverage for 25 years despite many challenges, including conflict. Key elements of programme success have included (a) evidence of a 26–30% reduction in...

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Autores principales: Thorne‐Lyman, Andrew L., Parajuli, Kedar, Paudyal, Naveen, Chitekwe, Stanley, Shrestha, Ram, Manandhar, Dibya Laxmi, West, Keith P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770656/
https://www.ncbi.nlm.nih.gov/pubmed/32108438
http://dx.doi.org/10.1111/mcn.12954
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author Thorne‐Lyman, Andrew L.
Parajuli, Kedar
Paudyal, Naveen
Chitekwe, Stanley
Shrestha, Ram
Manandhar, Dibya Laxmi
West, Keith P.
author_facet Thorne‐Lyman, Andrew L.
Parajuli, Kedar
Paudyal, Naveen
Chitekwe, Stanley
Shrestha, Ram
Manandhar, Dibya Laxmi
West, Keith P.
author_sort Thorne‐Lyman, Andrew L.
collection PubMed
description Nepal has a rich history of vitamin A research and a national, biannual preschool vitamin A supplementation (VAS) programme that has sustained high coverage for 25 years despite many challenges, including conflict. Key elements of programme success have included (a) evidence of a 26–30% reduction in child mortality from two, in‐country randomized trials; (b) strong political and donor support; (c) positioning local female community health volunteers as key operatives; (d) nationwide community mobilization and demand creation for the programme; and (e) gradual expansion of the programme over a period of several years, conducting and integrating delivery research, and monitoring to allow new approaches to be tested and adapted to available resources. The VAS network has served as a platform for delivering other services, including anthelmintic treatment and screening for acute malnutrition. We estimate that VAS has saved over 45,000 young lives over the past 15 years of attained national coverage. Consumption of vitamin A‐ and carotenoid‐rich foods by children and women nationally remains low, indicating that supplementation is still needed. Current challenges and opportunities to improving vitamin A status include lower VAS coverage among younger children (infants 6–11 months of age), finding ways to increase availability and access to dietary vitamin A sources, and ensuring local programme investments given the recent decentralization of the government.
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spelling pubmed-87706562022-01-24 To see, hear, and live: 25 years of the vitamin A programme in Nepal Thorne‐Lyman, Andrew L. Parajuli, Kedar Paudyal, Naveen Chitekwe, Stanley Shrestha, Ram Manandhar, Dibya Laxmi West, Keith P. Matern Child Nutr Nutrition in Nepal: Three Decades of Progress for Children and Women Nepal has a rich history of vitamin A research and a national, biannual preschool vitamin A supplementation (VAS) programme that has sustained high coverage for 25 years despite many challenges, including conflict. Key elements of programme success have included (a) evidence of a 26–30% reduction in child mortality from two, in‐country randomized trials; (b) strong political and donor support; (c) positioning local female community health volunteers as key operatives; (d) nationwide community mobilization and demand creation for the programme; and (e) gradual expansion of the programme over a period of several years, conducting and integrating delivery research, and monitoring to allow new approaches to be tested and adapted to available resources. The VAS network has served as a platform for delivering other services, including anthelmintic treatment and screening for acute malnutrition. We estimate that VAS has saved over 45,000 young lives over the past 15 years of attained national coverage. Consumption of vitamin A‐ and carotenoid‐rich foods by children and women nationally remains low, indicating that supplementation is still needed. Current challenges and opportunities to improving vitamin A status include lower VAS coverage among younger children (infants 6–11 months of age), finding ways to increase availability and access to dietary vitamin A sources, and ensuring local programme investments given the recent decentralization of the government. John Wiley and Sons Inc. 2020-02-27 /pmc/articles/PMC8770656/ /pubmed/32108438 http://dx.doi.org/10.1111/mcn.12954 Text en © 2020 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Nutrition in Nepal: Three Decades of Progress for Children and Women
Thorne‐Lyman, Andrew L.
Parajuli, Kedar
Paudyal, Naveen
Chitekwe, Stanley
Shrestha, Ram
Manandhar, Dibya Laxmi
West, Keith P.
To see, hear, and live: 25 years of the vitamin A programme in Nepal
title To see, hear, and live: 25 years of the vitamin A programme in Nepal
title_full To see, hear, and live: 25 years of the vitamin A programme in Nepal
title_fullStr To see, hear, and live: 25 years of the vitamin A programme in Nepal
title_full_unstemmed To see, hear, and live: 25 years of the vitamin A programme in Nepal
title_short To see, hear, and live: 25 years of the vitamin A programme in Nepal
title_sort to see, hear, and live: 25 years of the vitamin a programme in nepal
topic Nutrition in Nepal: Three Decades of Progress for Children and Women
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8770656/
https://www.ncbi.nlm.nih.gov/pubmed/32108438
http://dx.doi.org/10.1111/mcn.12954
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