Strategies for promoting vitamin A production, consumption, and supplementation : four case studies

Half a million children become blind each year and another 231 million are more vulnerable to infectious disease because of inadequate vitamin A in their diets, resulting in millions of preventable child deaths. The four case studies of USAID projects presented here illustrate how communication programs can be designed to improve vitamin A status in different contexts by applying the principles of behavioral science and social marketing. These projects all used a systematic methodology based upon audience/situation research and rigorous planning. The different interventions are aimed at promoting carefully selected behaviors that would increase the vitamin A intake of at-risk populations. Type of program, cultural framework, and foods available in the target areas varied widely, as did the resources available for these interventions. The Niger study looks at a pilot project to test ways of diversifying food production and family diet under difficult climatic and horticultural conditions. The Philippines study examines how planners aimed to promote both production and consumption of green leafy vegetables in urban areas as part of a new national emphasis on dietary solutions to vitamin A deficiency. Two case studies focus on Indonesia. The ROVITA study looks at communication approaches to improve capsule distribution. The follow-on SOMAVITA project was a bold three-pronged national effort to test models to change vitamin A consumption patterns, improve capsule distribution nationwide with an emphasis on high-risk provinces (in order to address the immediate problem), and develop NGO distribution and promotion systems in urban areas. The scale of the projects varied from a small experimental effort in Niger reaching 250,000 people, to a multi-level program in Indonesia covering a national population of 179 million in the capsule distribution component and 2.2 million in the dietary change pilots. The lessons learned from these projects, while quite different, are applicable to new contexts. References are included. (Author abstract)