Perspective from 2021 The Need for More Nuanced Policy Guidance

Abstract

Since publishing the findings of our feasibility study on neonatal vitamin A supplementation (NVAS) in Bangladesh in 2014, new evidence confirms NVAS reduces infant mortality in South Asia in contexts where prevalence of maternal vitamin A (VA) deficiency and rates of early infant mortality are high, but not in contexts characterized by low prevalence of vitamin A deficiency and lower rates of infant mortality.1 Unfortunately, this new evidence has not led to policy recommendations from the World Health Organization (WHO), nor to the implementation of NVAS in appropriate country contexts. Even in Bangladesh, where both NVAS efficacy and feasibility evidence is strong, NVAS has not been scaled up. Why?