Ambrose Alli University, Nigeria
Ignatius Onimawo obtained his Ph.D. in Human Nutrition from University of Ibadan. He is Head of Department of Human Nutrition and Dietetics of Michael Okpara University of Agriculture, Umudike. Formerly he was the Editor-in-Chief of the Nigerian Journal of Nutritional Sciences and currently the Director of Academic Planning, Ambrose Alli University Ekpoma, Nigeria. He has more than 90 papers published in reputed national and international journals. He is currently the Secretary General of the Federation of African Nutrition Societies. He has authored two books and was a co author for four other books.
Background and Objectives: Vitamin A supplementation has been carried out in Nigeria for over the past twelve years. It is therefore necessary to assess the progress made in vitamin A supplementation and the challenges experienced. Methods: Reports from various monitors and supervisors were analysed from all over the country. The NDHS (1999, 2003, and 2008) were used as secondary sources of information. Results: Under-five mortality rate in Nigeria was 200/1000 live birth in 1999 (NDHS 1999) and this informed the need to include vitamin A supplementation as a plus in the national immunization days (NIDs). The NID programme was later change to national immunization plus days (NIPDs) thus regarding vitamin A as a plus in the program. NIPDs were essentially implemented as a WHO led program and this led to resistance by the WHO-supported health workers to accommodate input from UNICEF that brought in the VACs as a component of the NIPDs. There was mutual suspicion between WHO assisted health workers and nutrition professionals who saw themselves as the owner of VACs and were remunerated by UNICEF. There were also disparity in the remuneration between health workers supported by WHO and those supported by UNICEF. Some health workers could not administer VACs correctly due to poor training. In some cases political considerations informed the recruitment of adhoc staff who had no knowledge of the program and could not administer both the vaccines and VACS. Data management was poorly carried out and some WHO staff refused to record the data on vitamin A. Poor micro-plans and supply of enough quantities of VACs, scissors, wipes and tally sheets were also observed. Conclusion: Despite these challenges, vitamin A coverage for under-five children had risen from initial 27% in 1999 to 75% in 2011. This has also positively affected the under-five mortality by reducing it to 157/1000 live birth (NDHS, 2008).