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Swaziland: Vitamin A programme to fight child mortality

A 50 percent rise in mortality of children under five since 2000 has led to a new campaign by the health ministry, in conjunction with the UN Children's Fund (UNICEF), to supply all young children with vitamin A capsules

MBABANE (IRIN / August 8, 2002) -- Young mothers queuing at health clinics in Swaziland this week knew that the immunisation cards they clutched would guarantee their children a new regimen of vitamin supplements as fortification against disease.

"Insufficient vitamin A can lead to blindness, but also makes a child 25 percent more prone to fatal childhood diseases like malaria, diarrhoea and the measles," UNICEF national director Alan Brody told IRIN.

Vitamin A supplements have cut mortality from these and other diseases by 23 percent in the under-five age group, and have specifically lowered deaths from diarrhoea by 33 percent, and from measles by half, according to a World Health Organisation (WHO) study.

"Swaziland is grateful to the UN agency for supplying vitamin A capsules for every child under five, and these will be available in hospitals and clinics nationwide," the government's new health minister, Sipho Shongwe, told IRIN.

UNICEF and the health ministry sought to inform rural and urban residents of all ages in an awareness campaign that kicked off last week.

"Just as we are doing with our efforts to enlighten people about mother-to-child transmission of the HI virus, we are not restricting information to just mothers - everyone needs to understand health issues," said Satu Pehu-Voima, the UNICEF programme officer in charge of the vitamin A distribution effort.

"A vitamin A deficiency exposes a child to all kinds of illnesses, and it affects a child's overall development. There is an established link between vitamin A deficiency and child mortality," she explained.

A 1995 study of Swazi childhood illnesses showed that 8 percent of children were severely deficient in vitamin A, while 40 percent of children suffered a mild deficiency, a problem exacerbated by the ongoing food crisis in Swaziland.

"Children are getting less nutrition, and this has compromised their immunity systems," said Brody.

About one-quarter of the Swazi population will need food assistance by early next year, according to the World Food Programme, the main supplier of the kingdom's food aid. UNICEF and WHO have instituted a school feeding scheme to bring nutrition to children. The project has boosted overall health and brought many students back to classrooms they had abandoned because a lack of energy made it difficult to concentrate.

"Our objective is to make vitamin A part of routine services in Swaziland, like inoculations. Every six months, a vitamin A capsule will be taken by all children aged six to 59 months," Pehu-Voima said.

UNICEF and the health ministry have achieved 90 percent immunisation coverage in Swaziland, which is considered good. The vitamin A capsules, seen as a type of immunisation, will be incorporated into the 20-year-old programme.

"Today, Swazi parents understand the role of immunisation and preventive medicine. Before, they only came to clinics when their children were sick," said Pehu-Voima.

At the Lobamba clinic in central Swaziland, the queue of mothers with immunisation cards, carrying their babies on their backs, clearly understood the preventive medicine message.

The government-issued cards show a happy cartoon baby lifting a Swazi warrior's protective shield. Illustrations are used to chart a child's growth, with clearly identified stages when immunisation is required.

"From six months to eleven months, my child should take orally 100,000 IU of vitamin A, and from 12 months to 59 months she should take 200,000 IU," noted Top’sile Mabuza, the mother of a six-month-old girl. Although she was uncertain what an IU is, she had confidence that the clinic nurses would distribute the required dosage in capsule form.

While welcoming the vitamin A initiative, Health Minister Shongwe feels the ultimate answer to the nutritional needs of Swazi children will come with food security.

"Vitamin A has always been available in the traditional foods Swazi eat, like umbhidvo (a type of spinach) and ligusha (an edible weed). Processed foods have compromised the diets of many young people - it is not just the rural poor and drought victims who suffer from nutritional deficiencies," he said.

Shongwe plans to emphasise the customary Swazi foods that for generations provided health and natural nutrition as part of his healthcare policies.

"Artificial vitamins are not free. The purchase and donations of these take away from other needs. All the necessary vitamins are found in the products of a Swazi garden," he said.

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