Vitamin A supplementation keep children healthy and strong
Vitamin A supplementation at health facilities and outreach sites help protect children from life-threatening illnesses during the first stages of life
5 April 2023, Siem Reap – 25-year-old mother Chhoeung Thoeung knows exactly what she needs to do to help her baby grow healthy and strong, from breastfeeding right after birth to preparing the right meals when she is ready to eat solid food.
“Based on the counselling I received from the health workers, I am trying to give nutritious food to my daughter as much as possible,” said Chhoeung, a housewife from Thnot Chrum village in Don Keo commune, around 30 kilometres from Siem Reap city. She is a mother to her two-year-old daughter, Nam Hva. “I prepare food like rice and soup with fish and vegetables, and I have also learned that vitamins can be found in ripe yellow fruits such as mango, papaya, banana, and breastmilk.”
As some of these seasonal, vitamin-rich foods aren’t readily available year-round, she also depends on the outreach events organised by her local health centre to keep her baby’s diet well-balanced and full of nutrients, which she knows is essential to protect against life-threatening illnesses, especially during the first stages of life.
“I learned from the health workers that giving Vitamin A supplementation and deworming tablets to children under five helps protect them from diseases and maintain healthy growth,” she said. “That’s why I bring my child to receive Vitamin A during outreach services in my community.”
Baby Hav is just one of 300,000 children who has been benefiting from UNICEF’s support for the Royal Government of Cambodia’s (RGC) Vitamin A supplementation programme, which aims to address Vitamin A deficiency across eight provinces by reaching as many children under five as possible with high-dose supplements twice a year.
Vitamin A deficiency is a leading cause of preventable childhood blindness and increases the risk of death from common childhood illnesses such as measles and diarrhoea. Across the country, 29 per cent of children have marginal level Vitamin A deficiency, which is considered a significant public health concern, while overall Vitamin A deficiency is at 9 per cent, just below the threshold for a major public health problem. In countries like Cambodia, where many families cannot afford to feed their children nutritious foods, including those rich in Vitamin A, supplements are a low-cost intervention that can strengthen the immune system and improve chances of survival.
UNICEF’s support for the programme, which has been running since 2022, focuses on strengthening Primary Health Care and training health workers to conduct integrated health and nutrition outreach in their communities – ensuring that every child aged six months to five years, no matter where they live, can benefit from Vitamin A supplementation twice a year.
Don Keo Health Centre, which serves almost 16,000 people across 13 villages, including 1,600 children under five, offers Vitamin A supplementation as part of their integrated maternal and child health services and also conducts regular outreach programmes in the community. The centre works closely with the Operational District (OD), local authorities and particularly the community volunteers that form part of Village Health Support Groups (VHSGs) to identify and mobilise target children to receive doses of the Vitamin A capsules (VAC) both at outreach events and at the health centre. Beyond Vitamin A supplementation, the centre also provides nutrition counselling for infants and young children, deworming, treatment for severe acute malnutrition, growth monitoring, and routine immunisation, among other services.
Uon Malis, the nurse who attended to baby Hav at the centre’s latest outreach event, says she knew she was due her next dose as her medical card had indicated that she had taken the last VAC about six months earlier at a community hall half a kilometre from her house.
As part of the programme, Malis and other health staff at the health centre received refresher training last September on integrated nutrition service delivery, which covers deworming, early identification and treatment of severe acute malnutrition, as well as Vitamin A supplementation.
“We want to make sure that children are getting their two doses of Vitamin A supplements twice a year,” she said. “We deliver the services both as part of routine health programmes at health centres as well as through outreach in villages to bring services closer to the community. We also provide health education on the benefits of Vitamin A supplements and counselling on child feeding.”
As eyes on the ground, VHSGs also play an important role in tracing children who have missed their VAS doses, which health workers say can be because the family has moved to a different area or region or because they lack transportation to the nearest health centre, and encouraging them to go to a health facility or the next outreach event.
Poeun Sopheap, 42, has served with her local VHSG for over 20 years and helps to mobilise target groups during outreach campaigns as well as inform community members about the benefits of Vitamin A supplementation for their children.
“I want to see no child in my village left behind,” she said. “If children do not receive Vitamin A, I am afraid they might become ill or catch other diseases and night blindness. It is my commitment to ensure they are protected from disease.”
She says the success of the outreach programmes depends on the joint effort from everyone, from health workers to the community volunteers and to the families themselves, to protect children from life-threatening illnesses and help them reach their full potential as they grow older.
“I appreciate all health centre staff who are committed to come down to our village to deliver nutrition services, which make my community healthy,” she said. “I am also grateful to people in my village who listen to me and always utilise the services and I urge them to maintain their participation in the next outreach event.”
The Vitamin A initiative is part of UNICEF's broader support for integrated maternal and child health and nutrition programmes for the most vulnerable children in Cambodia, including those who experience multiple deprivations and those in hard-to-reach areas. Efforts are aimed at strengthening health systems and improving the demand and utilisation of services, including immunisation, growth monitoring and promotion (GMP); counselling for maternal, infant, and young child nutrition (MIYCN); treatment of severe malnutrition; antenatal, delivery, and postnatal health and nutrition services; as well as integrated management of childhood illness (IMCI), among others.
“One dose of Vitamin A every four to six months can dramatically reduce child deaths in settings where vitamin A deficiency is prevalent,” said Anirban Chatterjee, UNICEF Cambodia Deputy Representative. “Vitamin A supplementation offers simple and affordable protection, for as little as two cents a dose, and can boost immunity and save lives of the most vulnerable children. Thanks to the financial support from L’Occitane Fondation and the French National Committee for UNICEF, many more children under the age of five, especially in hard-to-reach areas, are being reached with this life-saving intervention.”
By listening to health workers like Malis and VHSG volunteers like Sopheap, Chhoeung Thoeung says she can take care of her daughter without worry.
“I enjoy taking good care of my daughter, and I believe that Vitamin A and other health services are helping my child’s health,” she said. “My daughter Hva never catches serious illness, which could be because of the six-monthly Vitamin A supplements, the vaccinations she has received and the breastmilk.”