SEATTLE — In developing countries across the globe, many people suffer from micronutrient deficiencies, stemming from improper nourishment and leading to a number of health problems. Vitamin A and iodine deficiencies have serious consequences for mothers and children, making it imperative that they have access to supplements for these nutrients if they are not getting them naturally through their diet.
Vitamin A Supplementation Critical in Addressing Micronutrient Deficiencies
Vitamin A deficiency weakens the immune system, causing children to have an increased risk of contracting infections (including measles) or diarrheal illnesses, which often prove fatal. Approximately one-third of impoverished children are vitamin A deficient; however, children in sub-Saharan Africa and South Asia are more likely to be affected.
To combat vitamin A deficiency, vitamin A supplementation (VAS) programs have been developed and carried out around the world. For vitamin A supplementation to be effective, children under the age of 5 must receive two high-dose supplements per year.
Many VAS programs have been integrated into already established health and nutrition delivery platforms in order to have a greater impact on the reduction of micronutrient deficiencies. These programs include deworming, immunization, severe malnutrition screenings and growth monitoring.
In 2016, the percentage of children under 5 in priority countries receiving two doses of vitamin A supplements each year was 64 percent, the lowest it had been in six years. UNICEF’s goal is to reach 80 percent coverage globally, a number that is currently unattainable. Only 21 priority countries reached 80 percent coverage in 2016, while many countries with high under-5 mortality rates had a decline in coverage.
This can be seen most clearly in sub-Saharan Africa, which has the highest under-5 mortality rate in the world. VAS coverage had improved greatly from 2000 to 2009, increasing from five countries with at least 80 percent coverage to 27. Between 2009 and 2016, however, the number of countries in the region with high coverage decreased to 10, with six countries having less than 20 percent coverage.
Moving forward, UNICEF has a number of recommendations for how VAS programs can help nations achieve high supplementation coverage and reduce micronutrient deficiencies. Electronic-based data collection and regular staff training will help countries track which children have received two-dose coverage, improving coverage estimates and efforts. Additionally, integrating VAS into broader immunization programs will help bring these services to vulnerable populations. UNICEF also recommends looking beyond VAS and working to improve diets to decrease vitamin A deficiency in the long term.
Successful Reduction of Iodine Deficiency Seen Worldwide
A lack of iodine can lead to iodine deficiency disorders (IDDs), which are the most damaging during pregnancy and early childhood. IDDs can lead to cretinism, stillbirth and miscarriage. Iodine deficiency greatly impacts a child’s learning ability and is a major cause of preventable mental retardation.
Iodine is generally obtained through food, and iodine deficiency generally occurs in areas where flooding or glaciation have depleted the iodine in the soil, impacting all plants grown in the region. Salt iodization is the primary method for reducing iodine deficiency. Individuals should not increase salt consumption, but rather exclusively use iodized salt.
Based on UNICEF estimates, less than 20 percent of households in developing countries were using iodized salt in 1990. By 2000, however, this had increased to approximately 70 percent, and UNICEF reports that 86 percent of the world’s population currently has access to iodized salt, a major success in the reduction of micronutrient deficiencies.
In Egypt, 92.5 percent of the population now uses iodized salt, a result of the Egyptian Ministry of Health and Population taking responsibility for procuring potassium iodate and distributing iodized salt. Prior to 2002, Egypt relied on UNICEF to help procure potassium iodate, but after the country began paying the total cost of procurement, the percentage of households with iodized salt increased substantially, from 28 percent in 2000 to 78 percent in 2005.
Ghana has also been successful in increasing the use of iodized salt in the nation. In 1995, less than 1 percent of households were consuming iodized salt, but through partnerships and a nationwide marketing campaign, 56.8 percent of the population currently uses iodized salt. In 2001, Ghana began a partnership with Unilever to produce and sell iodized salt at an affordable price. The government then began airing advertisements on television and radio stations on the benefits of iodized salt consumption. It has also relied on road shows to carry the message throughout the country.
To continue this global progress, UNICEF recommends continuing to increase access to iodized salt, focusing on creating sustainable salt iodization, and developing partnerships that foster scientific research and data collection and increased collaboration between nations.
Hopefully, with UNICEF planning and support, micronutrient deficiencies around the world will continue to decrease, improving the lives of millions.
– Sara Olk