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J. Nutr. First published November 25, 2009; doi:10.3945/jn.109.110700
 Journal of Nutrition, doi:10.3945/jn.109.110700
Vol. 140, No. 1, 208S-212S, January 2010
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© 2010 American Society for Nutrition

Supplement: The Impact of Climate Change, The Economic Crisis, and the Increase in Food Prices on Malnutrition

The Role of Expanded Coverage of the National Vitamin A Program in Preventing Morbidity and Mortality among Preschool Children in India1–3,

Richard D. Semba4,*, Saskia de Pee5, Kai Sun4, Martin W. Bloem5 and V. K. Raju6

4 Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD 21287; 5 Nutrition Service, Policy, Strategy and Programme Support Division, World Food Programme, Rome 00148, Italy; 6 Eye Foundation of America, Morgantown, WV 26505

Higher food prices increase the risk of vitamin A deficiency among preschool children in poor families, because a larger part of the household food budget is spent on grain foods and less on vitamin A-rich foods. Vitamin A supplementation is an important source of vitamin A for children. Our objective was to characterize coverage of the India national vitamin A program for preschool children and identify risk factors for not receiving vitamin A. Anthropometric and demographic data were examined in 23,008 children aged 12–59 mo in the India National Family Health Survey, 2005–2006. Within the last 6 mo, 20.2% of children received vitamin A supplementation. The prevalence of stunting, severe stunting, underweight, and severe underweight was higher among children who did not receive vitamin A compared with those who received vitamin A (P < 0.0001). In families with a child who did and did not receive vitamin A, respectively, the proportion with a history of under-5 child mortality was 8.4 vs. 11.4% (P < 0.0001). By state, vitamin A program coverage was inversely proportional to the under-5 child mortality rate (r = –0.51; P = 0.004). Maternal education of ≥10 y [odds ratio (OR) 2.22; 95% CI 1.69–2.91], 7–9 y (OR 1.99; 95% CI 1.57–2.53), or 1–6 y (OR 1.65; 95% CI 1.28–2.13) compared with no education was an important factor related to receipt of vitamin A. Poor coverage of the vitamin A supplementation program in India has serious implications in the face of rising food prices. Expanded coverage of the vitamin A program in India will help protect children from morbidity, mortality, and blindness.

* To whom correspondence should be addressed. E-mail: rdsemba{at}jhmi.edu.

Published online 25 November 2009.