An Evaluation of Post-Event Coverage Surveys: Challenges Facing Vitamin A Distribution in Four African Countries from 2010-2013 Público

Abstract

Introduction: Vitamin A deficiency is prevalent in sub-Saharan Africa, contributing to childhood blindness and mortality. Vitamin A supplementation (VAS) is a well-established intervention utilized to combat this problem. Countries have recently begun to transition from door-to-door VAS distribution to facility-based with outreach strategies. Multiple challenges during this transition have prevented VAS distribution programs from reaching desired levels of effectiveness. Little evidence-based research exists on the challenges associated with new VAS distribution strategies as well as the steps necessary to address them.

Objective: This study aimed to assess the challenges VAS campaigns faced from 2010-2013 in four sub-Saharan African countries that had already made the transition from door-to-door distribution to facility-based with outreach.

Methods: Twenty-four post-event coverage (PEC) surveys from four countries of interest (Kenya, Mozambique, Nigeria and Tanzania) that were administered by HKI from 2010-2013 following VAS distribution campaigns were analyzed. The analysis focused on distribution challenges and suggestions for improving future VAS campaigns.

Results: In all four countries,VAS coverage in children aged 6-59 months did not meet the 80% target set by the World Health Organization. While some of the challenges discovered were country-specific, the most prevalent challenge was the same in each country. The PECS data overwhelmingly indicated a gap in social mobilization, which prevented caretakers from hearing about the campaigns and taking their children to receive VAS.

Discussion: Low VAS coverage in these four countries utilizing facility-based distribution with outreach is linked to inadequate social mobilization strategies, among other challenges, such as living in remote areas. Mobile outreach efforts to distribute VAS to hard-to-reach children help increase coverage, but they are not able to reach all children, leaving many out of the campaigns. Challenges with newer VAS distribution strategies as well as recommendations for improvement will be shared with HKI in order that programming can be improved to reach more children with life-saving VAS.

Table of Contents

Chapter 1: Introduction. 1

Chapter 2: Literature Review. 5

Chapter 3: Methods. 22

Chapter 4: Results. 28

Chapter 5: Discussion, Recommendations & Conclusion. 40

References. 50

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Nutrition Health Sciences, Public Health
Palabra Clave	Door-to-door Vitamin A Supplementation (VAS) Sub-Saharan Africa VAS Distribution Fixed-post
Committee Chair / Thesis Advisor	Martorell, Reynaldo, Emory University
Partnering Agencies	International Non-governmental organization (e.g., CARE, Inc.)

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