Guinea Bissau Iodine

Kenya

vitamin a

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Program Data
Monitoring
Program Resources

EPIDEMIOLOGICAL DATA
     
Clinical Vitamin A Deficiency

No recent assessment of clinical VAD was reported. 

Sub-clinical Vitamin A Deficiency
Date: May- October 1999  
Groups Surveyed: Children 2-72 months, mothers, and adult males whose ages ranged from 28-36 years. 
Sample Size: 3229 children, 2163 mothers, and 1183 adult males. 
Sampling Method: Household cluster survey.  The purpose of this survey was to conduct a national survey of anemia, however the survey included data collection on other indicators of malnutrition, including vitamin A status. The sample size used was determined by the desire to estimate the prevalence of anemia within 5 pp of the true value.  The country was divided into ecological and altitude regions and 3-4 clusters were assigned to each of these regions.  In all 21 clusters were selected and surveyed Households were then randomly selected for participation within each cluster.  The average size range of the cluster was 150-240 households/cluster.  However, only 30 % of the households sampled were assessed for sub-clinical VAD through serum retinol levels.
Estimated Prevalence of VAD: Indicator is serum retinol < 20mg/ dL.

Group

 

Sample Size

Prevalence in Sample

Estimated Population Affected *

 

Children 2-72 mos 945 84.4%
Mothers 1674 50.7%

Adult males

618

 42.2%

  918,685

 * Based on US Census Bureau figures for Kenya, 1999, males age 25 - 34 yrs of age. (www.census.gov)
 
     
 

POLICY AND LEGISLATION
 

Legislation on VAD
     Currently there is no legislation covering VAD, but it is being developed to focus on supplementation and fortification.
 

Government Agency to Address VAD

     

The Ministry of Health is the agency designated to monitor and coordinate VAD activities. 

    

Contact Information:  Head, Nutrition Unit, P.O. Box 43319 Nairobi.  Tel 02-725105/6/7/8. 
     
     

PROGRAM DATA
   
Supplementation
Program Description
     The program targets children 6-59 months, lactating women within 4 weeks of delivery, and patients with diseases approved by the National Micronutrient Deficiency Control Committee.  Supplementation for pregnant women does not yet exist. 
     The program covers about 42% of children and 12% of lactating women according to the UNICEF/MICS 2000 survey.  However, in 1999 a coverage rate of up to 90% was recorded through NIDs.
     The program began in 1990, but did not organize well until 1995.
 
Targeting

    

The program targets approximately 6 million children and 1.2 million women. 
Capsule Information

    

The capsule sizes are 100,000 and 200,000 IUs.

    

About 17,193, 200 capsules were produced or imported.
Implementation

    

Coverage:  It is expected that the coverage rate will improve for mothers, in particular, as supplementation information will now be included on health cards.  Also, programmers are considering supplementing women at the community level since 70 % of women deliver at home. 

    

VA Supply:

Source

Supplementation: Capsules # and Value

 

200,000 IU

100,000 IU

50,000 IU

10,000 IU

Imported

15,493, 200

1,700,000

0

0

Locally Produced

0

0

0

0

Total

15,493,200

1,700,000

0 

0

*NR = Not Reported
    

Mode of Supplementation:  Currently, VA capsules are given routinely through immunization campaigns, national immunization days, and in conjunction with other program activities.
Fortification
Program Description
 

Fortified Foods

Status of Program

Approx. % commodity fortified

Level of Food Fortification

Monitoring

Yes

No

Maize

 

20%

250 RE/300mg

NR*

 

Margarine

Legislation enacted, but not well applied.

50% of what is  locally produced

The amount depends on the brand.  They range from 0 to 100% of RDA values. 

NR*

 

Cooking Fats

Legislation enacted, but not well applied or enforced.

 

Often does not contain the levels that the brands indicate. 

 

 

Complementary foods

Legislation enacted, but not well applied or enforced.

 

Range between 500-2997 IU/100gm.

 

 

Sugar, Oil, Milk, Wheat flour, and rice are not fortified
* NR - No Response
 
Other Programs
National/Large-Scale Programs

    

There are large-scale programs run by the Ministries of Health and Agriculture, NGOs, and CBOs.

    

The focus is the improvement of VA status through nutrition education.

Community-based Programs
     The Ministries of Health, Agriculture, and Social Services run these programs, along with women’s groups and NGOs.
     These projects target community members and focus on the production of fruits and vegetables locally.  In some areas, women’s groups have started to preserve foods for use and sale during the off season.
     
     
 
MONITORING
 

Clinical and Sub-clinical VAD
     Clinical and sub-clinical VAD are monitored mostly through surveys when resources permit.  The primary indicator used for sub-clinical deficiency is the level of blood serum retinol.
 
Supplementation
     Monitoring activities exist at the national and regional levels, however these activities are still very weak in the latter.  As supplementation is extended to the community level in the current year, procedures for monitoring distribution in this sphere will have to be developed as well as continued strengthening of regional monitoring.
Fortification
     Monitoring of fortification programs is not yet strongly in place.  It is hoped that after new policies harmonize with older legislation, that these activities will better develop and improve.
     
     
PROGRAM RESOURCES
   
Donor Agencies

Implementing Agency

Description of Activities

Expenditure Current Year

 

 

Suppl.

Fort.

Other

National/ State governments

Human resources to coordinate activities such as training, distribution, and monitoring.

NR*

NR*

NR*

UNICEF

Technical and financial support.

CIDA

Provision of capsules, financial and technical support, and monitoring. 

USAID

Advocacy for sugar fortification, support to community component of IMCI, which carries out VA supplementation. 

                    *NR - Not Reported
 
VAD Program Funding History and Projections

    

Information not reported