Impact of nutrition education and mega-dose vitamin A supplementation on the health of children in Nepal.
Bull World Health Organ
; 74(5): 533-45, 1996.
Article
em En
| MEDLINE
| ID: mdl-9002334
ABSTRACT
PIP: The effectiveness of two approaches to vitamin A deficiency prevention--nutrition education and mega-dose capsule distribution--was compared in a 3-year study involving almost 40,000 children 6 months to 10 years of age from seven ecologically diverse districts in Nepal. The nutrition education program promoted increased intake of vitamin A-rich foods during the dry season, serving wild greens, and primary health care service utilization. At baseline, 44.9% of the study villages did not have any cases of Bitot's spots; by the third year, 65.5% were free of this sign of vitamin A deficiency. 85% of community risk variation was explained by agricultural patterns, market food availability, household income, maternal literacy, sanitation, and the village's average nutritional status. At 12 months, capsule distribution had reduced the risk of new Bitot's spots by 55% (relative risk (RR), 0.45; 95% confidence interval (CI), 0.33-0.60); however, its impact had declined by 24 months and was non-significant at 36 months. At 24 months, the reduction of risk for xerophthalmia was greatest among children whose mothers were able to identify vitamin A-rich foods (RR, 0.25; 95% CI, 0.10-0.62) and were literate (RR, 0.06; 95% CI, 0.01-0.42). By 24 months, child mortality risk had declined in both the nutrition education (RR, 0.64; 95% CI, 0.48-0.86) and capsule distribution (RR, 0.57; 95% CI, 0.42-0.77) groups. Although the effects of both programs were similar, the capsule program achieved higher coverage rates at a lower cost while the educational intervention provided economies of scale and potential for long-term sustainability. Most feasible would be a comprehensive national program that included both these components as well as maternal literacy training.
Palavras-chave
Age Factors; Asia; Biology; Child; Child Mortality; Child Survival; Comparative Studies; Delivery Of Health Care; Demographic Factors; Developing Countries; Diseases; Education; Family And Household; Family Characteristics; Family Relationships; Health; Health Education; Health Services; Infant; Length Of Life; Mortality; Mothers; Nepal; Nutrition; Nutrition Disorders; Nutrition Programs; Nutrition Surveys; Ophthalmological Effects; Parents; Physiology; Population; Population Characteristics; Population Dynamics; Primary Health Care; Research Methodology; Research Report; Southern Asia; Studies; Survivorship; Vitamin A; Vitamins; Youth
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Terapia Ortomolecular
/
Vitamina A
/
Ciências da Nutrição
Idioma:
En
Ano de publicação:
1996
Tipo de documento:
Article