Importance of Micronutrient Supplementation Programme in Childhood to Reduce Child Mortality: The Haryana Experience.

Abstract

The World Health Organization (WHO) estimates that more than 2 billion population of the world is deficient of micronutrients primarily micronutrients are iron, Vitamin A, iodine and zinc and of these, one-third are children below 5 years. Majority of these malnourished children lives in developing countries like India.[1] In India, in terms of the loss of productivity, illness, increased healthcare costs, and death is 1% of Gross Domestic Product (GDP) (loss of Rs. 280 million approximately) per annum due to micronutrient deficiency (MND).[2] The MNDs diseases cause unacceptable high morbidity and mortality in children, especially below the age of 5 years. In India, more than 6000 children below 5 years die per day, and more than half of these deaths are because of micronutrients deficiencies diseases majorly due to deficiency of Vitamin A, iron, iodine, and folic acid. Some of the studies quoted that about 57% of preschool children suffered from subclinical Vitamin A deficiency (VAD).[3] Micronutrients such as Vitamin A, iron, and iodine deficiency in children are considered as the second major risk factor in the global burden of disease.[4] In India, VAD precipitate approximately 0.33 million child deaths every year and due to folic acid deficiency, around 0.2 million children are born every year with neural tube birth defects.[2] The nutrients that are required in small quantities (microgram) for maintenance of healthy life are called micronutrients. The micronutrients such as iron, Vitamin A, zinc and iodine which are of significant public health importance.[5] MNDs usually occurs when children do not have access food such as fruit, vegetables which are rich in micronutrients, especially green leafy vegetables, animal products, and fortified foods. In India, the micronutrients-rich food does not access because they are too expensive to buy or are locally unavailable or inadequate complementary feeding practices. MND has global health impact because its manifestations become less visible and usually begins to show when the condition is severe and has already led to serious health burdens, that is why the name is hidden hunger.[6] Globally, India contributes to over one-fifth child death, and more than half of child deaths are because of diarrhea and acute respiratory infection (ARI), here comes the role of micronutrients, which play a highly significant contribution in prevention and control of this morbidity.