Thailand Iodine

Vietnam

Vitamin A

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Monitoring
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EPIDEMIOLOGICAL DATA
     
Clinical Vitamin A Deficiency
Most Recent Clinical VAD Survey
Date: National Survey in August - October, 1994.
Groups Surveyed: Pre-school age children and their mothers.
Sample Size: 37,500
Sampling Method: A representative sample of preschool -age children and their mothers was chosen. A three -stage sample protocol was followed in order to gain 25 distinct province estimated which could be post-stratified to calculate ecological zone and national levels estimates; Finally, the number of subjects was chosen following:  25 provinces x 30 clusters/province x 50 children/cluster = 37,500 children <5y
Estimated Prevalence of VAD:

Area

Sample Size

Indicator/Prevalence (%) *

Est. Pop. Affected

National

37,920

(XN) Night blindness (<5yrs): 0.05

 

 

 

(X1B) Bitot's spots: 0.045

 

 

 

 X2 / X3A / X3B:  0.005

 

 

 

 Corneal scars:  0.048

 

 

 

  

 
  27620 XN (mothers):  0.58  

* 95% C.I.
 
Sub-clinical Vitamin A Deficiency
Most Recent Sub-Clinical VAD Survey
Date: November 2000 -  February 2001, Sub-clinical Vitamin A deficiency in Vietnam.
Groups Surveyed: Children under 5 yrs. and lactating women in 4 ecological zones; North mountainous (R1): November 2000; Red River Delta (R2): December 2000; South Central Coast (R5): January- February 2001; Mekong River Delta (R7): January- February 2001.
Sample Size: Children: 1975
Lactating women:  1144
Sampling Method: 10 communes/region) were randomly selected for sub-clinical vitamin A assessment. In each commune, 30 lactating women and 50 children <5 yrs. old were randomly selected.
Estimated Prevalence of VAD:  Serum retinol < 0.7 mmol/Liter
Area/Location Sample Size Prevalence (%) Est. Pop. Affected
National 1975 12.4  
North mountainous 489 21.9  
Red River Delta 499 4.2  
South Central Coast 484 10.5  
Mekong River Delta 503 12.9  

 
 
     
 

POLICY AND LEGISLATION
 

Legislation on VAD
     There is VAD legislation in Vietnam.  At first, it was for vitamin A capsule supplementation to children from 6 to 60 months old.  Since 1997, it has focused on children 6-36 months old.  It calls for supplementation two times per year in June and in December in integration with NIDs.  It also calls for promotion of dietary diversification to ensure the availability of micronutrients and other nutrients.  Likewise, it includes nutrition education and communication activities for communities.
     In 1988, the program was an implemented in 7 pilot districts; then in 27 provinces in 1989, and 31 provinces in 1990. Since 1993, the program has expanded to a national scale. During the first period, the program focused on supplementation of vitamin A capsule and nutrition education, since 2000, the program has also improved the fortification strategy.
     Vitamin A fortification is being promoted for sugar and some condiments.
     Documents stating the national policy regarding VAD have been published.  The booklet is entitled "Control of Vitamin A Deficiency and Xeropthalmia" published in 1991.  Then there was the National Plan of Action on Nutrition in 995-2000, and then the National Nutrition Strategy for 2001-2010.
 

Government Agency to Address VAD

      The Steering Committee with participation of members from the Ministry of Health.  Their function is to support the health system, two micronutrient campaigns per year and for monitoring VAD.

    

Contact Information:  Not reported.
     

PROGRAM DATA
Supplementation
Program Description
     Universal vitamin A capsule distribution twice a year for children 6-36 months old (100,000 IU for children<12 mo, 200,000 IU for children >12mo),
     One 200,000 IU capsule for mothers after delivery.
     One dose for children experiencing a period of infectious disease (i.e. diarrhea, respiratory infection).
     Since 1993 the program has expanded to a national scale.
     Coverage of vitamin A capsule was 99.4% and 73% in 2000 respectively for children <36 months and mothers after delivery.
Targeting

    

Children 6-36 months: 4,300,000

    

Post partum women: 1,176,000
Capsule Information

    

100% of vitamin A capsules imported and supported by UNICEF. Two sizes of capsules are imported, 100 000 IU (for children<12mo) and 200,000 IU.
Implementation

    

Vitamin A capsule distributions occur twice per year, in June and in December, through two campaigns, “Micronutrient day” in June and integrated with NID's in December.

    

There is no policy for supplementation for mothers within 8 weeks of delivery, but there is for one dose just after delivery.
Fortification

Program Description
     There are no current programs to fortify food, but it is being considered.
Other Programs
     There is promotion of dietary change to improve vitamin A status via the VAC system (gardens, ponds, cattle sheds) to provide more foods rich in vitamin A and carotene and animal protein sources.
     There are mass media campaigns to promote the awareness of the people concerning the control of VAD, especially one week before capsule distributions.
     Community-based programs include the promotion of nutrition education, breast-feeding practices, and proper use of supplementary "colored rice-porridge".
     
     
 
MONITORING
 

Clinical and Sub-clinical VAD
     For clinical monitoring, data is collected based on reporting by the health preventative system from communes - districts- and provinces each year.  The staff of the National Institute of Nutrition (NIN) participate by checking the data in several areas.  Sub-clinical monitoring  depends on the availability of funds and is completed by the staff of the NIN.
     Surveys in Section II will be repeated.
     Night blindness (XN) is used as the indicator for monitoring clinical VAD.
     Serum Retinol is used as the indicator for monitoring sub-clinical VAD in children and breast-milk retinol for women in the first year of lactation.
 
Supplementation
     Capsules are monitored through the Secretariat of the national committee and from UNICEF Hanoi.

    

Coverage of the supplementation program is accomplished via reporting from the administration within the preventative health system.
Fortification
     There is no fortification to monitor.
     
     
PROGRAM RESOURCES
Donor Agencies
     External agencies are MI and UNICEF.  UNICEF has provided US$700,000 for 2001 -2005 in support of the vitamin A program.