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Supplement: Proceedings of the XX International Vitamin A Consultative Group Meeting

Recommendations for Monitoring and Evaluating Vitamin A Programs: Outcome Indicators¹

The Institute of Nutrition, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom 73170, Thailand

²To whom correspondence should be addressed. E-mail: numdk{at}mahidol.ac.th.

Monitoring and evaluation are essential components of vitamin A intervention programs. They enable program managers to track progress in achieving their goals. Recommendations for outcome indicators are based on suggestions from the International Vitamin A Consultative Group Meeting (IVACG) workshop in late October 2000 in Annecy, France, followed by a pre-XX IVACG meeting in Hanoi, Vietnam. In areas with detectable xerophthalmia or eye signs, a fall in the prevalence of Bitot’s spots to <0.5% and a decrease in night blindness during pregnancy to <5% indicates that vitamin A deficiency (VAD) is no longer a public health problem, although it still may be responsible for excess morbidity and mortality. Pupillary dark adaptation has been proposed as an objective indicator of vitamin A status. A program is considered to have made progress when the mean pupillary threshold improves to better than -1.24 log cd/m². For biochemical indices, the shift of mean or median values or the frequency distribution of preschool children with serum retinol concentration below 0.70 µmol (20 µg/dL), lactating mothers with breast milk retinol values below 0.70 µmol (6 µg per g of milk fat) or below 1.05 µmol (8 µg per g of milk fat) are useful to monitor program progress.

KEY WORDS: • xerophthalmia • maternal night blindness • pupillary dark adaptation • serum retinol • breast milk retinol

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