From rxpgnews.com
Vitamin A Supplementation Programme to Stay
By Anjali Ojha,
Jul 27, 2010 - 12:06:11 PM
A programme to administer Vitamin A to Indian children is unlikely to be scrapped despite new research advising against it. The health ministry and several doctors say it is needed to combat malnutrition, which affects over 20 percent of the country's population.
'A blanket scrapping of the Vitamin A administration cannot be suggested as a majority of Indian children are still malnutritioned,' Arvind Sindwani, consultant paediatrician in Faridabad's Metro Hospital, told IANS.
The health ministry said there are no plans for scrapping the programme as of now. 'Nutrition is a problem, specially for the economically weaker sections. There are no plans to scrap Vitamin A administration,' a ministry official said.
The Vitamin A supplementation programme has been in operation in India since 1970. Under the government sponsored programme, children between nine months and three years are given six-monthly doses of Vitamin A.
The administration of the first two doses is linked with routine immunisation.
An article published in the international journal World Nutrition has suggested scrapping the Vitamin A programme, stating it has gained ground due to 'powerful commercial interests'.
The article has C. Gopalan, a leading nutritionist and former chief of the Indian Council of Medical Research, Umesh Kapil of the All India Institute of Medical Sciences and H.P.S. Sachdev of the Sitaram Bhartia Institute of Science and Research advising against it.
The Vitamin A programme was launched to combat keratomalacia, an eye disorder, often referred to as night blindness that was prevalent in the 1950s and 1960s. Gopalan says keratomalacia is no more a massive health problem in the country.
Other doctors, however, say the programme is important due to the prevalence of malnutrition.
The Food and Agriculture Organisation states that 22 percent of India's population is undernourished. The deficiency of Vitamin A, which is critical for the eyes and teeth, may lead to acute problems leading to blindness. According to a Unicef report, only 53 percent of Indian children were covered under the Vitamin A programme in 2006.
'The problem is specially severe for the rural population. The nutritional needs of women are not met during pregnancy, which may lead to several deficiency diseases in children. Vitamin A administration is, therefore, important,' said Punit Kumar Pruthi, a consultant physician at the Asian Institute of Medical Science.
'The shortage of Vitamin A leads to blindness. And seeing the versatile demography of the country, continuing the programme is important,' he said.
The World Nutrition article also mentioned major side effects in children due to overdosing of Vitamin A.
But experts at the health ministry said the oral doses administered at the time of vaccination are water soluble and, hence, have minimal side effects.
'The Vitamin A which is administered in syrup form, along with other vaccines, is water soluble and has very low risks. The major side effect is rashes,' the official said.
The oil soluble variety of the vitamin, which was for long the only one available, posed a threat of accumulating in the liver, causing health problems.
'More than 50 percent children still have Vitamin A deficiency. Most deficiencies are sub-clinical which do not cause any major disease,' Sindwani said.
'Since the beginning of the project, the cases of clinical deficiency - which causes severe diseases - have reduced but they still persist, specially among the poorer sections,' he added.
Stating that the variation occurs across classes as well as regions, Sindwani suggested screening before the administration of the dose.
'A region-wise approach can be taken in states like Uttar Pradesh, Madhya Pradesh, Bihar, the northeastern states and some other backward states. Deficiency is high and common,' he said.
'Therefore, complete scrapping of the project cannot be done. However, a region-based approach is suggested,' he added.
Speaking on the same lines, Pruthi said: 'It should be properly implemented in the areas where people do not have proper information about nutrition.'
He added that for sub-clinical deficiencies, a proper diet is enough.
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