Vitamin A Deficiency - Central African Republic

Iodine

Central African Republic

Vitamin A

Iron

Chad




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Country Index		Epidemiological Data
Country Profile		Policy & Legislation
		Program Data
		Monitoring
		Program Resources

	EPIDEMIOLOGICAL DATA


Clinical Vitamin A Deficiency
Most Recent Clinical VAD Survey - No recent survey available.
	Date:
	Groups Surveyed:
	Sample Size:
	Sampling Method:
	Sampling Strategy:
	Estimated Prevalence of VAD:


Sub-clinical Vitamin A Deficiency
Most Recent Clinical VAD Survey - National
	Date:	1998-1999
	Groups Surveyed:	Children 6 - 36 months and pregnant women.
	Sample Size:	882 children, 303 pregnant women
	Sampling Method:	It was a cluster survey with two stages (geographic areas and households) and a proportional selection to size of 231 geographic areas and 2130 households were done. Finally 303 pregnant women and 882 children were surveyed.

Estimated Prevalence of VAD: Indicator is serum retinol < 20 µg/dl

Region/Group	Sample size	Pop. in region	Indicator(s) specify cutoff and/or median serum retinal	Prevalence in sample %
Health region N°1	Children: 216		Children MSR: 0.60 mmol/l	66.6%
	Preg. women		Pregnant women: MSR: 1.06 mmol/l
Health region N°2	Children: 216		Children MSR: 0.59 mmol/l	72.0%
	Preg. women		Pregnant women: MSR: 1.00 mmol/l
Health region N°3	Children: 216		Children MSR: 0.47 mmol/l	82.1%
	Preg. women		Pregnant women MSR: 0.88 mmol/l
Health region N°4	Children: 216		Children MSR: 0.62 mmol/l	63.2%
	Preg. women		Pregnant women MSR: 1.02 mmol/l
Health region N°5	Children: 216		Children MSR: 0.64 mmol/l	62.3%
	Preg. Women		Pregnant women MSR: 1.11 mmol/l
Bangui	Children: 216		Children MSR: 0.67 mmol/l	61.3 %
	Preg. Women		Pregnant women MSR: 1.10 mmol/l
National Total:	Children: 1296		Children: cutoff : <0.70 mmol/L MSR: 0.60 mmol/l	68.2 %
	Preg. women : 339		Pregnant women: MSR=1.04 mmol/l Cutoff: <0.7 mmol/L	16.8 %
			Cutoff: <1.05 mmol/L	53.7 %


	POLICY AND LEGISLATION

Legislation on VAD
	There is no VAD legislation in Central African Republic.
	Government documents stating national policy regarding VAD are to be released shortly.


Government Agency to Address VAD
	Direction of preventive medicine and disease control, and Direction of community health. These agencies functions are coordination and monitoring.
	Contact Info: BP 883 Ministere de la Sante Publique et de la Population, Republique Centrafricaine


	PROGRAM DATA


Supplementation
Program Description
	The national policy was just adopted by the MOH, however the vitamin A supplementation began in 1999. It has been coupled with the national immunization campaigns against polio. Capsules are given to children 6 to 59 months old once a year. In order to reach an adequate vitamin A supply to children, a second dose is given coupled with “ivermectin”, a drug used to prevent onchocercisis. This is distributed at the community level in 4 health regions out of five (about 80 % of the population). The second target for this community-based distribution of vitamin A are post-partum women(6 weeks).
	There is a policy to address vitamin A supplementation for mothers within 8 weeks of delivery. This is in 4 out of 5 health regions. It has been in effect since 2001 and will cover all of the country with the adoption of the national policy.

Targeting
	Children 6 - 59 mos:	approximately 600,000 children
Implementation
	Supplements are given through National Immunization Days and measles campaigns.

VA Supply (for target year):

Source	Supplementation: Capsules No. & Value of Capsules (000)
	200,000 IU		100,000 IU		50,000 IU		10,000 IU
	No.	$	No.	$	No.	$	No.	$
Imported into country	2762 PACKS/500 CAPS	MI Donation	427 PACKS/500 CAPS	MI Donation	200 PACKS/500 CAPS	MI Donation	NA	NA
Locally produced	NA	NA	NA	NA	NA	NA	NA	NA
Totals	1,381,000 CAPS		213,500 CAPS		100,000 CAPS


Fortification
	There is no fortification of vitamin A in CAR.


Other Programs
Dietary Change
	There are pilot, community-based nutrition activities in UNICEF concentration zones (2 districts), in rural villages targeting women and children.
	There are no large-scale or national programs to promote improved vitamin A status through dietary change.



	MONITORING

Clinical and Sub-clinical VAD
	The surveys described in the epidemiology section are not being repeated.
	The indicator used for monitoring sub-clinical VAD is serum retinol.
	There is no monitoring for clinical VAD.

Supplementation
	The number of capsules is monitored either by Unicef or the MOH.
	Coverage of the supplementation program is monitored through the NID's, ivermective monitoring, and an evaluation system.

Fortification
	There is no fortification.



	PROGRAM RESOURCES

Donor Agencies

Implementing Agency	Description of Activities	Expenditure and source of funds in current year
Implementing Agency	Description of Activities	Supplementation	Fortification
National (MOH)	NR
UNICEF		$13,784 - 2001 $10,240 - 2002

NR = Not Reported

VAD Program Funding History and Projections

Year	VAD Activity				Total $(000)
	Supplementation US$(000)	Fortification $(000)	Other (specify)
			Activity	$(000)
2001	23,810	Not Reported
2002	25,000
2003	25,000
2004	25,000
2005	25,000