Vitamin A Deficiency

Mexico

Nicaragua

Vitamin A

Iron




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Country Profile		Policy & Legislation
		Program Data
		Monitoring
		Program Resources

	EPIDEMIOLOGICAL DATA


Clinical Vitamin A Deficiency
Most Recent Clinical VAD Survey - Not Reported

Sub-clinical Vitamin A Deficiency
Most Recent Sub-clinical VAD Survey National level
	Date:	2000
	Groups Surveyed:	Children 6-59 months, Children 6-9 years old, and women 15 years and older.
	Sample Size:	2,537
	Sampling Method:	Individual interviews within a target group

Estimated Prevalence of VAD: Indicator is serum retinol <30µg/dl for women 15 years and older women

Area	Sample Size	Indicator/Prevalence (%)
Pacific- Urban	428	9
Pacific- Rural	343	11.5
Managua	278	21.6
Central- Urban	306	4.5
Central- Rural	491	3.5
Atlantic- Urban	164	12.5
Atlantic- Rural	200	8.3
More Groups	1,176
National Total	2,210	10.9

Estimated Prevalence of VAD: Indicator is serum retinol <20µg/dl for children 6-59 months.

Area	Sample Size	Indicator/Prevalence (%)
Pacific- Urban	428	7.0
Pacific- Rural	343	8.0
Managua	278	11.4
Central- Urban	306	7.3
Central- Rural	491	10.0
Atlantic- Urban	164	6.9
Atlantic- Rural	200	6.6
National Total	2,381	8.8

	POLICY AND LEGISLATION

Legislation on VAD

There is VAD legislation in the country that focuses on fortification of sugar with Vitamin A.

	Coordinated through National Commission for Quality and Technical Control, along with the Ministry of Foreign Exchange, Commerce, and Industry. Exchange,

Government Agency to Address VAD
	Ministry of Health - The agency's function are to coordinate and monitor VAD activities as well as coordinate the National National Commision of Micronutrients.
	Contact Information: Dr. Aurora Velásques, General Director of Health Services.


	PROGRAM DATA

Supplementation
Program Description
	In 1994 started a supplementation for Vitamin A program along with a National Health Campaign that included vaccinations, de-worming, and administration of Vitamin A.

2000

Targeting

Children 6-59 months and expectant women.

Implementation

2000

Group	Systematic Vaccinations (# of doses)	Vaccination Campaign	Systematic Coverage	Campaign Coverage	Total Coverage (%)
6-11 months	2600	69,022	3.2	85.8	89
12-48 months	5,639	573,571	0.8	88	88.8
6-48 months	8,239	642,593	1.1	87.7	88.8
6-59 months	9.958	775,643	1	88	89
Expectant Women	4,969	2,787	2.7	1.5	4.2

2001

Group	Systematic Vaccinations (# of doses)	Vaccination Campaign	Systematic Coverage	Campaign Coverage	Total Coverage (%)
6-11 months	836	73,195	1.0	91	92
12-48 months	2002	583,647	0.3	89.5	89.8
6-48 months	2,838	656,842	0.3	89.7	90
6-59 months	4,405	79,864	0	89	89
Expectant Women	2,796	4,288	1.5	2.3	3.8

Other Programs

Supplementation of Vitamin A for mothers within 8 weeks of delivery

National Immunization Day/Week used to implement supplementation.

Fortification

Use 4 million quintiles with 40 metric tons of locally produced premix of fortified Vitamin A for the population.

Sugar, milk, and wheat flour are the products currently fortified.

Sugar and wheat flour fortification programs have been implemented and legislated.

Milk fortification is being conducted through industry in Nicaragua.

Ministry of Health is implementing a monitoring program titled 'Integrated Nutritional Monitoring, Evaluation and Surveillance System' to oversee the fortification processes.

Other Program
	There are no programs either large-scale or national to promote improved Vitamin A status.


	MONITORING

Clinical and Sub-clinical VAD
	In 2001 with a partnership of various world agencies, the Ministry of Health designed a monitoring system dealing with interventions of nutrition.
	This system dealt with process monitoring which monitored production centers and export levels.
	This system also dealt with biological monitoring which focused on a household population survey.

Indicators
	Coverage of supplementation with Vitamin A in women who have given birth in the last 12 months of the study.
	Vitamin A Deficiency in women
	Vitamin A Deficiency in children 6-59 months.
	Coverage of adequate sugar fortification

.
Supplementation
	The monitoring of imported or produced Vitamin A capsules is conducted by the Ministry of Health through the Department of Nutrition and the Direction of consumable and non-consumable medicines.
	Coverage of Program monitored through the Information System of the Ministry of Health.
.
Fortification
	Content and Distribution of vitamin A fortified commodities monitored through information collected individual vaccination records along with survey results.
	Extended Immunization Program also details information on each area of health through the Local System of Integral Health Attention (SILAIS)
	All information collected in computerized database by the Department of Statistics under the National Ministry of Health.



	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/State Governments
External Agencies	MI, MOST/USAID, UNICEF, ROTARY CLUB, WORLD BANK, INCAP, OPS	ND	ND


VAD Program Funding History and Projections
	Not Reported.

EPIDEMIOLOGICAL DATA

POLICY AND LEGISLATION

PROGRAM DATA

MONITORING

PROGRAM RESOURCES