Planning a National Food-Based Strategy for Sustainable Control of Vitamin a Deficiency in Ghana: Steps toward Transition from Supplementation

Abstract

In an effort to control the high prevalence of vitamin A deficiency in Ghana, which studies have shown to be of public health significance, a number of interventions are being pursued. Periodic, massive-dose supplementation strategy, developed as a short-term life-saving intervention, is currently under way, either as part of the polio eradication program or combined with the existing health delivery system, schools, or community-based infrastructures. This has been successfully accomplished, and therefore the stage is set for the design and implementation of a long-term, sustainable solution. This is important in order to make the transition from a subsidized periodic capsule-distribution effort to a more sustainable food-based intervention, which could supply other vital nutrients as well as vitamin A in the diet. This report describes a proposal for a food-based strategy against a backdrop of low consumption in spite of the relatively high availability of some vitamin A–rich foods in most parts of Ghana. The aim is to improve vitamin A status of vulnerable groups through increased production, availability, and consumption of vitamin A–rich foods. The proposal is therefore to undertake a range of food-based interventions that will include horticultural interventions that aim to increase production and availability of vitamin A–rich foods, such as dark-green leafy vegetables and orange-colored fruits and vegetables and tubers in the diet of Ghanaian households. There will also be a comprehensive behavior change and communication strategy, to raise awareness of the causes and consequences of vitamin A deficiency and the need for consumption of adequate vitamin A–rich foods at the household level. Further emphasis will be placed on efforts to promote consumption of red palm oil, since this oil is generally available and not subjected to acute seasonal shortages. A phased community-based program will be implemented in four districts during the next three years, with the aim of applying lessons learned to the rest of the country. The monitoring framework will cover the planning process, provision of services, utilization of services, and coverage of target groups. These dietary approaches offer long-term sustainable options for improving the quality of family diets and overcoming vitamin A deficiency.