• The National Prophylaxis Programme against Nutritional Blindness due to vitamin A deficiency (NPPNB due to VAD) was started in 1970
– with the specific aim of preventing nutritional blindness due to keratomalacia
– As an urgent measure to combat the unacceptably high magnitude of xerophthalmic blindness in the country seen in the 1950s and 1960s
• The Programme was started as a 100 per cent centrally sponsored programme
• In 1994, under the National Child Survival and Safe Motherhood (CSSM) Programme, the age group of eligible children was restricted to 9 to 36 months of age
– Prophylactic mega dose administration of vitamin A was primarily advocated because of the claim of 23 per cent reduction in childhood mortality and
– Not mainly for blindness prevention.
• In 2006, the age group of eligible children was revised as 9 months to 5 yr. of age (oral prophylactic dose):
– One dose, 1,00, 000 IU along with measles immunization (operational feasibility)
– 8 doses at six – monthly intervals of 2.00, 000 IU
National Vitamin A Prophylaxis Programme – Current Scenario (2016)
• Clinical VAD has declined drastically during the last 40 years
– There has been virtual disappearance of keratomalacia, and
– a sharp decline in the prevalence of Bitot spots
• Vitamin A supplementation (VAS) is implemented through the PHCs and sub-centres.
– The female multipurpose worker and other paramedics at the village level sub-health centres are responsible for administering vitamin A solution.
– The services of ICDS functionaries are also utilized for Programme implementation.
• Universal supplementation of vitamin A to Indian children is being undertaken irrespective of their family background and nutritional status
• Recently it has been suggested that India is currently at a stage when universal vitamin A supplementation should transit to
– A targeted supplementation programme and
– The primary focus should now be on sustainable food based approaches to combat vitamin A deficiency
• To increase local production and consumption of green leafy vegetables and other plant foods those are rich sources of carotenoids.
• Green leafy vegetables, many fruits and other plant foods are also good sources of folate, vitamin C, Fe, Ca and many other micronutrients
Reference:
• Umesh Kapil and H.P.S. Sachdev. Massive dose vitamin A programme in India - Need for a targeted approach; Indian J Med Res. 2013 Sep; 138(3): 411–417 available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3818610/
National Vitamin A Prophylaxis Programme: http://www.ihatepsm.com/blog/national-vitamin-prophylaxis-programme
National Iron+ Initiative: http://www.ihatepsm.com/blog/national-iron-initiative