Vitamin A prophylaxis programme

Vitamin A prophylaxis programme

1. 4. VITAMIN-A
PROPHYLAXIS
PROGRAMME
1970

11. VitaminAdeficiencyisthemostcommoncauseof
preventableblindnessinchildren(1-3yrs).
20-40millionchildrenworldwide-estimatedtohave
atleastmildvitaminAdeficiency(VAD),halfresidein
India.
VADcausesanestimated60,000childreninIndiatogo
blindeachyear.

12. Prevalence rates vary greatly among the states and range
from less than 1% to6%.
Prevalence of Xeropthalmia 0.6% as per GBD(global
burden of disease) 2000 estimates
VAD in India remains a significant public health
problem.

13. 4. VITAMIN-A
PROPHYLAXIS
PROGRAMME
1970

20. Goal
To make vitamin –A deficiency no more apublic
healthproblem
To reduce Bitot’s spot to less than0.5%
To bring down the prevalence of night blindness to
less than1%

21. STRATEGY
•Until1992,thestrategyconsistedofadministrationof2lakhIUof
oralvitaminAconcentrationtochildrenbetween2&6years,at
intervalof6months.
•WithcommencementofCSSMprogramduring1992,thestrategy
waschangedtoadministrationof5megadosesofvitamin.
•Aconcentrateorallytoallchildrenbetween9monthsand3years
notonlytoeliminatenutritionalblindnessbutalsoother
consequencesofvitAdeficiency.
•However,itcanbeextendedupto5years.

23. Vitamin A prophylaxisschedule
DosenoAge Dose(orally)Remarks
1. At 9
th
month 1,00,00IU Along with measlesvaccine
2. At 18
th
month 2,00,00IU Alongwithboosterdoseof
DPT &OPV
3. At 24
th
month(2yr) 2,00,00IU NIL
4. At 30
th
month 2,00,00IU NIL
5. At 36
th
month 2,00,00IU NIL

24. •By the 5
th
year, each child is expected to have received
a total of nine oral mega doses of vitamin A under the
national programme availability of vitamin A, the
unstated policy has been to preferentially target the 6-
36 month child, and treat deficiencies in the older
preschool children.
•For infants, it is proposed to use the 9-12 month
contact for measles vaccine as the point for
administration of the vitamin A supplement of 100,000
IU.

25. APPROACH TO COMBAT
VITAMIN A DEFICIENCY

26. 1. Medium termmeasure
Fortification offood
Vanaspati fortification with vitamin A and D to the
extent of 2500 IU of Vit-A and 175 IU of Vit-D per
100grams
Fortified milk Currently, 62 dairies are fortifying
milk with 200 IU/100 ml with future plans for
expansion.
Other food considered for fortification include sugar,
salt, tea, margarine, dried skimmed milketc.

27. 2.Long termmeasures
Dietary improvement is, undoubtedly, the most
logical and sustainable strategy to preventVAD.
Nutritioneducation-Achangeindietaryhabits
and increased access to vitamin A-rich foods
through education.
Immunization against infectiousdiseases
Prompt treatmentofDiarrhealdiseases
Better feeding practices of infants andchildren

28. MAJOR THRUSTS OF THE PROGRAMME
1.Promotion of regular consumption of dark green leafy
vegetables or yellow fruits and vegetables.
2.Promotion of breast feeding and colostrumto protect
against Vitamin A deficiency.
3.Oral prophylactic doses of vitamin A as follows: One dose
of 100,000 IU to infants 6-11 months, 6 monthly doses of
200,000 IU of Vitamin A immediately at diagnosis, and a
follow up dose of 200,000 IU 1-4 weeks later.

29. 5.Prophylaxis against
nutritional
anaemia(1970)

30. The programme was launched in1970to prevent nutritional
anaemia in mothers and children.
Under this programme, expecting and nursing mothers as well as
acceptors of family planning were given the supplementation of
iron and folic acid.
This programme is being taken up by Maternal and Child Health
(MCH), division of Ministry of Health and Family welfare.
In1992it became part of CSSMprogramme.
In 1997 it became part of RCHprogramme.

31. Under this programme all expecting and nursing mothers as well as
acceptors of family planning are given 1 tablet of iron and folic acid
containing 100 mg elementary iron and 0.5 mg of folic acid daily for a
period of 100 days.
All anaemic mothers were given 2 tablets of iron and folic acid per
day for 100 days.
All anaemic children in the age group of 1-5 years are given 1 tablet
of iron containing 20 mg elementary iron (60 mg of ferrous sulphate and
0.1 mg of folic acid) daily for a period of 100days.
All acceptors of family planning (IUD) are given one tablet of
iron and folic acid for 100days.
All adolescent girls were given 1 tablet of iron and folic acid per
week.

32. Prevalence of nutritional anemia in India
(annualreportministry of health2009-
2010)
65%infantandtoddlers
60%1-6yearsofage,
88%adolescentgirls(3.3%hashemoglobin<7gm/dl;
severeanemia)
85%pregnantwomen(9.9%havingsevereanemia).
Theprevalenceofanemiawasmarginallyhigherinlactating
womenascomparedtopregnancy.
Thecommonestisirondeficiencyanemia.

33. LONG TERM MEASURES
•Fortificationoffooditemslikemilk,cereal,sugar,saltwithiron.
•Nutritioneducationtoimprovedietaryintakesinfamilyfor
receivingneededmacro/micronutrientsasprotein,ironand
vitaminslikefolicacid,forhaemoglobinsynthesisisimportant.
•NutritionalAnaemiaControlProgrammeshouldbe
comprehensiveandincorporatenutritioneducationthrough
schoolhealthandICDsinfrastructuretopromoteregularintake
ofiron/folicacidrichfoods,topromoteintakeoffoodwhich
helpsinabsorptionofironandfolicacidandadequateintake
offood.

34. Beneficiaries
1-5 yearsage 20mg elementaliron0.1mg(100mcg)of
folicacid
6-10years 30 mg elementaliron0.25mg(250mcg)
of folic acid
Pregnant woman
Lactatingmothers
100 mg elementaliron0.5mg(500mcg)
folicacid

35. 8.Balwadi nutritionprogramme
Started in 1970
6000 Balwadi centre -across thecountry
For children under the age group of 3-6years
Provide pre-primary education tochildren
Food supplement provides 300 kcal and 10 gramsof
protein per child perdayfor 270days