Feasibility and Effectiveness of Introducing a Six-month Contact Point for Vitamin A Supplementation into the Tanzanian EPI Vaccination Calendar
Christina Nyhus *
HKI, Dar es Salaam, Tanzania.
Margaret Benjamin
HKI, Dar es Salaam, Tanzania.
Jeffrey Oruru
HKI, Nairobi, Kenya.
Meba Haruni
HKI, Dar es Salaam, Tanzania.
Temina Mkumbwa
HKI, Dar es Salaam, Tanzania.
Dafrosa Lyimo
MOH - EPI, Dar es Salaam, Tanzania.
Francis Modaha
TFNC, Dar es Salaam, Tanzania.
Heather Katcher
HKI, Nairobi, Kenya.
Jessica Blankenship
HKI, Nairobi, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Objectives: The study was seeking to;
1. Obtain the age at first vitamin A dose in comparison to current practices.
2. Assess acceptability of a new 6 month contact point by caretakers and health care workers.
Methods: A randomized, facility-based intervention trial was implemented in four intervention and two control health facilities. Children (435 intervention, 137 control) were enrolled at 12-14 weeks of age during their DPT3 visit and followed until they were nine months. At intervention facilities, VAS, growth monitoring and IYCF counseling were provided at six months while standard care of growth monitoring was offered at control facilities.
Results: The median (IQR) age at first receipt of VAS was 6.3 (6.0, 6.8) months in the intervention group and 9.3 (9.1, 9.6) months in the control group (p<0.001). At six-months of age, clinic attendance was 88% in the intervention group compared with 0% in the control group. Health workers reported no negative effect on their routine work and 93% recommended the six-month contact point to be implemented in other facilities.
Conclusions: Introduction of a six-month contact point into the EPI vaccination calendar significantly reduced the age of first receipt of VAS for children and was well-accepted by health workers.