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uganda

Vitamin A

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Program Data
Monitoring
Program Resources

EPIDEMIOLOGICAL DATA
 
Clinical Vitamin A Deficiency*   
* 4 out of the 45 total districts were excluded due to insecurity
Most Recent Clinical VAD Survey:  National Household Survey
Date: 2000-2001
Groups Surveyed: Women who had given birth in the last 5 years
Sample Size: 7,246
Sampling Method: A national household survey was conducted to determine whether women who had given birth in the 5 years preceding the survey experienced night blindness during the pregnancy.  Survey was conducted using UDHS sampling methodology.
  Estimated Prevalence of VAD:   

Region/Group

Sample size

Prevalence in sample %

Women age 15-49 who gave birth during the 5 years preceding the survey.

 4,489

1 (women

National Total
Sub-clinical Vitamin A Deficiency
Sub-clinical Vitamin A Deficiency
Most Recent Sub-Clinical VAD Survey: National Survey
Date: 2000-2001
Groups Surveyed: Men and Women throughout the country
Sample Size: 2003 (978 men and 1,025 women)
Sampling Method: A national survey using UDHS was conducted throughout Uganda.  A sampling of men and women were taken and tested to determine serum retinol levels.  Sampling was conducted by analyzing blood spots collected on filter paper from pricking the finger or the heel.  Retinol levels in dried blood samples were adjusted for possible decay during the first 7-10 days after collection.  Survey was conducted in 2000-2001 during which venous and filter paper samples were collected and analyzed.  
  Estimated Prevalence of VAD:   

Region/Group

Sample size

Indicator(s) specify cutoff and/or median serum retinol

Prevalence in sample %

Children 6-59 months

 859 <0.7 mmol/L

27.9

Women 15-49 years

944

 Any VAD- <1.05 mmol/L

Marginal- 0.70-1.05 mmol/L

Moderate- 0.35-0.69 mmol/L

Severe- <0.35 mmol/L

51.9 lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll

29.3 lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll

20.6 lllllllllllllllllllllllllllllllllllllllllllllllllllllllllllll

2.1

National Total

1803

79.8
 
     
     
 

POLICY AND LEGISLATION
 

Legislation on VAD
     There is no VAD legislation in Uganda, nor is it being developed or about to be enacted into law.
     There is national vitamin A policy which developed programs for bi-annual supplementation for all children ages 6-59 months.  
     The Ministry of Health also launched guidelines on Planning and Implementation of vitamin A capsule supplementation.  These guidelines were enacted to replace the previous guidelines regarding the supplementation which were developed as part of the measles vaccination program.

Government Agency to Address VAD

      Ministry of Health- The Nutrition Unit.  Their function is both coordination and monitoring.

    

Contact Information: Mrs. Ursula Wangwe, Principal Nutritionist.
     
     

PROGRAM DATA
Supplementation-  Children 6-59 months
Supplementation-  Children 6-59 months
Program Description
     Vitamin A supplementation campaigns target children 6-59 months and supplementation begins at 9 months of age.
     Vitamin A supplementation first began in combination with measles vaccination, but it is now given through various National Immunization Days including those for polio and measles.
     The Ministry of Health recently began new campaigns to target more children by expanding the program so that supplementation occurs more often and reaches more people.
Targeting

    

Approximately 900,000 children 6-11 months and 3.5 million children 12-59 months
Capsule Information

    

1.6 million capsules of 100,000 IU

    

5.6 million capsules of 100,000 IU
Implementation

    

Supplementation was given through National Immunization Days such as those for polio and mass measles campaigns.

    

The Ministry of Health has launched separate campaigns targeting children 6-59 months for VAC supplementation through EPI, Child Health Days, or local campaigns. 

    

Those areas not reached during the National Immunization Days are targeted for two months out of the year through a combination of strengthened and expanded routine and local campaigns.

    

This program began in 1994 and has increased supplementation each year to reach more people.
Vitamin A Supply

Vitamin A 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  

5.6 million

1.6 million

Locally produced

Totals

5.6 million 1.6 million
Fortification   
Other Programs

    

There is policy to address vitamin A supplementation for mothers within 8 weeks of delivery.

    

This policy began in 1994 and provided one dose (200,000 IU) of vitamin A capsules to postpartum women within 2 months of delivery.  

    

Program has increase since 1994, initially started with one dose of vitamin A capsules within 6 weeks of delivery and now reaches 11.3% of the targeted population.
Other Programs
Fortification   
Food Fortification

    

Currently some oil and some margarine are fortified, whereas fortification full fortification for oil, sugar, and maize flour is in discussion.

    

Imported oil is fortified with vitamin A and UNILEVER conducts a program that fortifies margarine with vitamins A and E.
Implementation
Dietary Promotion
Large scale or National Programs

    

There are large-scale/national promotions conducted by the Ministry of Health and the Ministry of Agriculture.  These ministries create and implement policies that provide diet diversification.
Community-based Programs
Community-based Programs

    

There is a community-base program in Uganda that is conducted by USAID.

    

Goal of pilot program is promotion of small-scale farming and consumption of sweet yellow/orange potatoes in specific districts of Uganda.  

    

This program targets rural households and is conducted through existing community centers/groups.
     
     
 
MONITORING
 

Clinical and Sub-clinical VAD
     There is no regular clinical or sub-clinical monitoring.  
     The Uganda Demographic Health Survey is conducted periodically and looks at retinol levels in children and women as well as report on night blindness among pregnant women.
     Serum Retinol is used as the indicator for monitoring sub-clinical VAD in children.
     These surveys are repeated every 5 years.
 
Supplementation

    

There is no local production of vitamin A capsule supplementation.  Import of capsules is conducted through UNICEF by the courtesy of Canada.

    

Coverage of the supplementation program is accomplished through HMS (VACS along with measles vaccination only) and compilation of tally sheets during specific vitamin A capsule supplementation (VACS) exercises.
Fortification
     There is no fortification to monitor.
     
     
PROGRAM RESOURCES
Donor Agencies

 

Implementing Agency

 

Description of Activities

Expenditure and source of funds in

current year

Suppl.

Fortif.

Other (specify)

National/State governments

Ministry of Health- Nutrition Unit

 

External agencies

UNICEF

 

USAID

Micronutrient Project- MOST

 
Total VAD Program Funding History and Forecast for Country-   Not Reported