Abstract
BackgroundAbout 30% of children < 5 years old are estimated to experience vitamin A deficiency worldwide. Globally, vitamin A deficiency can be reduced by five major interventions: supplementation, dietary modification, fortification, promotion of both public health, and breastfeeding. This prospective policy analysis (Prospective policy analysis focuses on the future outcomes of a proposed policy. Adapted from Patton, CV, and Sawicki DS. Basic Methods of Policy Analysis and Planning, Prentice-Hall, Inc. New Jersey,1993). (Patton A, Carl V, and David S. Basic methods of policy analysis and planning, prentice-hall, 3th ed. 2012) aimed to identify evidence-based policy options to minimize prevalence (VAD) among 15–23 months-children in Iran.MethodsThirty-eight semi-structured face-to-face interviews were held with experts at high, middle, and low managerial levels in Iran’s health system, as well as at Schools of Nutrition Sciences and dietetics, using purposive and snowball sampling. All interviews were recorded by a digital voice recorder and then transcribed, codified, and eventually analyzed using a mixed approach (inductive-deductive) by MAXQDA software version 10.ResultsMost policies related to VAD reduction in this age group are supplementation, expansion of education, and awareness. Three main factors affecting VAD reduction policies emerged from the analysis: basic factors (governance, infrastructure, and organization), underlying factors (social factors, economy), and immediate factors (services). Due to its cross-sectoral nature, evaluating the results of the implementation of this policy requires strong and coherent inter-sectoral cooperation. The existing primary healthcare network (PHC) is a crucial means for successful implementation of policies to address VAD in Iran.ConclusionsIn addition to supplementation and assistance in this age group, other policies should be also planned to reduce VAD in various regions. In addition to the Ministry of Health & Medical Education (MoHME), other actors need to be involved, we advocate, throughout the entire policymaking process of policy-making to reduce VAD in Iran.
Highlights
Interviewees were policymaker, healthcare manager, expert and academician in nutritional sciences and dietetics, nutrition expert working in comprehensive community health centers, nutrition-related Nongovernmental Organizations (NGO) (e.g., Imam Khomeini Relief Foundation (IKRF); and high-level officials of international agencies, such as United Nations International Children’s Emergency Fund (UNICEF))
Most policies related to vitamin A deficiency (VAD) reduction in Iran emphasize supplementation, expansion of education, and awareness (Table 3)
We have reported to the Ministry of Health & Medical Education (MoHME), but no response was given so ‘far’ (SNSD4)
Summary
About 30% of children < 5 years old are estimated to experience vitamin A deficiency worldwide. Vitamin A deficiency can be reduced by five major interventions: supplementation, dietary modification, fortification, promotion of both public health, and breastfeeding. Basic Methods of Policy Analysis and Planning, Prentice-Hall, Inc. New Jersey,1993). Basic methods of policy analysis and planning, prentice-hall, 3th ed. An increased prevalence of VAD was observed among children aged 15–23 months (18.3% in 2012 compared to 2.1% In 2001) in two national surveys [4, 5]. 35% of boys and 21% of girls in the capital city of Tehran had low serum retinol concentrations [6]
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