Children aged 12–59 months missed through the National Vitamin A Capsule Distribution Program in Bangladesh: findings of the Nutritional Surveillance Project

Abstract

From January 1990 to December 2006, Helen Keller International implemented the Nutritional Surveillance Project (NSP) in Bangladesh, which has been used to conduct regular surveillance and special surveys to provide information on health and nutritional status of children and mothers, and report on the coverage and impact of nutrition and health programs in Bangladesh. The Government of Bangladesh (GOB) distributes vitamin A Capsule (VAC) among children aged 12–59 months biannually. The NSP data was analyzed to assess VAC coverage and to explore which children were less likely to receive a VAC in order to help GOB identify necessary modifications aimed at higher coverage of VAC among all eligible children. Results showed that coverage among girls and boys was not different (P=0.970). However, coverage was consistently lower among children aged 12-23 months compared to older children (24–59 months) (P≤0.001) in each of the distribution rounds. Coverage among children from poorer households was lower than among children from wealthiest households (P<0.001), with the extent of this difference varying by round. Coverage was significantly higher if households had had contact with a government health assistant in the last month (P<0.001); and among households who owned a radio or a TV compared to those who did not. The VAC distribution campaign needs to be strengthened to cover the children who are currently not reached; especially younger children, children living in underserved regions, children from poorer households and from households with less contact with health service providers or mass media.