Promoting vitamin A status in low-income countries

Abstract

Adequate vitamin A status decreases mortality among children under age 5 years by an average of 23%. The benefits of such status for maternal mortality are also now being recognized. Health benefits likely accrue through the effects of retinol upon the maintenance of epithelial integrity and the promotion of immune functions, and in the case of maternal mortality in Nepal, possibly also through the antioxidant activity of provitamin A carotenoids, the form of vitamin A in plants. The clear importance of vitamin A for health has led to the implementation in many countries of programs to improve the vitamin A status of women and children. The main strategies for improving micronutrient status among populations are supplementation, food fortification, and dietary diversification. All of these approaches have been investigated for vitamin A and, at least in some populations, have been shown to be effective in improving vitamin A status and child health or survival. The choice of strategy must be context specific and take into account climate, the agricultural potential of the region, local infrastructure, food beliefs and practices, and the population's socioeconomic status.