Most of us know that vitamin A— naturally occurring in certain fruits, vegetables, and animal foods—is needed for good vision. But it’s also essential for immunity and healthy growth in children. In fact, vitamin A deficiency, which affects an estimated 250 million preschool children worldwide, is both the leading cause of preventable child blindness and a principal factor in early childhood deaths in both sub-Saharan Africa and South Asia.
Fortunately, there is a highly effective protocol for addressing this problem, one that is based on a wide body of evidence showing significant reductions in the devastating outcomes that normally result from eating an insufficient diet. Providing twice-yearly oral vitamin A supplementation (VAS) ensures optimal doses of the nutrient to vulnerable children aged six months to five years.
An infant receives a dose of Vitamin A supplementation during “Malezi Bora” (“Good Nurturing” in Kiswahili) Week in Kenya.
With a price tag of less than one dollar per dose, this simple solution is also one of the world’s most cost-effective public health interventions. And HKI is recognized as having been at the forefront of this vital work since the 1970s.
Yet a few years ago, VAS programs faced a formidable hurdle. To maximize financial and logistical efficiency, vitamin A supplements had often been administered to children as a part of polio immunization campaigns. But with polio eradication efforts now on the verge of success, many of the campaigns are ending, leaving VAS without a comparable cost-saving vehicle for delivery. While winning the fight against polio is undoubtedly an enormous victory, it has come with an unintended consequence: a gap in the coverage for VAS in many of the countries where disadvantaged communities need it most.
HKI has extensive experience with adapting to change as a means of optimizing programs. In the case of VAS, we have now pivoted to a sustainable, two-pronged delivery system that is both cost-effective and independent of polio immunization campaigns.
First, we are training healthcare workers in government-sponsored clinics to deliver the first dose of vitamin A to six-month-old infants during routine post-natal visits. Second, we are working with governments to help them transition the VAS program from polio- elimination campaigns to community health weeks, which are bi-annual events combining vitamin A supplementation with the delivery of other high-impact child survival interventions, such as vaccinations and anti-parasitic medications.
On a recent sunny afternoon in August, 28-year-old Saran Conde Dalamara brought her five-year-old son Demba to the first Child Health Week in Dalamana, a poor village in west central Guinea. Nearly half of all preschool-age children in Guinea lack sufficient amounts of vitamin A in their diets. So in addition to receiving the scheduled vaccinations, Demba was given his first of two annual doses of the vitamin.
“I heard on the radio that we needed to come today to have our children vaccinated,” says Saran. “The vitamin A, I know it has benefits, too. It will protect my son from sickness and prevent him from having defective sight.”
Saran, who also has a seven-year-old daughter, is grateful for these services. “We like that these health workers come to help. The medications cost us nothing.”
Local health workers, in turn, deeply value the chance to bring this vital aid to their communities. Gnalen Oularé manages vaccinations and VAS at the health center in nearby Kankan, and she is quick to note, “Not only do I like the work, but I chose to do it so that I can help parents here. We’re building a health infrastructure.”
HKI routinely works with a host of partners and donors who make our work possible. To launch the new two-pronged VAS delivery model, we engaged for a full year with GiveWell, the leading charity assessment organization, as it vetted our programming before validating us as a “top charity” based on our strong evidence base, leadership, cost effectiveness, transparency and solid track record.
This partnership led to very generous support from Good Ventures Foundation. It also opened the door to funding from GiveWell itself and organizations and individuals who use GiveWell’s recommendations to inform their charitable giving. These new sources of revenue have thus far provided funding for VAS programs in several of the highest-need countries: Guinea, Burkina Faso, Mali, and Côte d’Ivoire.
With VAS positioned on this new, sustainable delivery track, vulnerable children all across West Africa are gaining access to better health— and much brighter futures.
Above left: Saran Conde Dalamara with her son Demba. Above: Gnalen Oularé administering doses of vitamin A to children near Kankan. “Vitamin A will protect my son from sickness.”
