Testing Feasibility of Delivering Vitamin A to Newborns in Bangladesh’s Health Care System
S. Kaushik *
Micronutrient Initiative, Asia, India.
Rolf Klemm
Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.
Lesley Oot
FHI360, Washington DC, USA.
Zeba Mahmud
Micronutrient Initiative, Dhaka, Bangladesh.
*Author to whom correspondence should be addressed.
Abstract
Objectives: Supplementing newborns with vitamin A within 48 hours of birth has been shown to reduce infant mortality in Bangladesh, India and Indonesia. This study evaluated the feasibility of delivering vitamin A to newborns through existing maternal and child health services in Bangladesh.
Methods: Two sub-districts in each of 3 districts were randomized to one of two newborn vitamin A supplement (NVAS)distribution strategies: (1) providing theNVASandadministration instructions to pregnant women during clinic-based ANC visits (ANC model), and (2) having a health worker directly dose newborns during a post-natal visit (PNC model).All intervention components (i.e. health worker training, vitamin A capsule supplies, delivery of education messages and birth notification) were implemented through the existing health infrastructure. Primary outcomes, assessed by a pre-post survey, included coverage (% of newborns dosed) and timing of dose (% dosed within 48 hrs of birth) in December 2010 and June 2011.
Results: 54% and 40% of newborns were supplemented in ANC and PNC models, respectively. 75%of dosed infants were reached within 48 hours of birth. Integrating NVAS into the health program did not increase ANC coverage, but significantly increased post-natal visits in both models(from 38% to 67% and 30% to 62% in the ANC and PNC models, respectively). Newborn VAS dosing was positively perceived by health workers and mothers. There were no serious side-effects.
Conclusions: Introducing newborn VAS through existing public maternal and child health services is feasible in Bangladesh.