‎National Prophylaxis Programme for Prevention of Nutritional Blindness

Can you recall some of the symptoms which appear due to deficiency  of vitamin A? Vitamin A deficiency leads to complaints of night blindness and other eye signs like conjunctival dryness (xerosis) and bitot spots. These signs are not dangerous because they can be cured by giving vitamin A. Rut the severe forms of vitamin A deficiency  specially among children of preschool age (1 to 5 years) result in keratomalacia, a condition where. the cornea (black portion of the eye) gets completely destroyed. This condition is irreversible (incurable) and when occurs, - makes the child blind. The socio-economic implications of blindness or blind children are tragic for the family as well as for the society. Therefore, a preventive programme of distribution of massive doses of vitamin A is being undertaken in the country. The basis of this programme is the fact that the human liver can store vitamin A consumed in excess of daily requirement. The stored vitamin A is released as and when  the body-needs it. !n  other words the liver acts asa 'saving bank', in which the body saves (stores) its surplus vitamin A and withdraws it when the intake falls short of 

the requirement. Making use of this knowledge, the National Institute of Nutrit~on gave 2000 preschool children large doses of vitamin A, two times a year. The do\e called as the massive or mega  (big) dose, was calculated to give the child adequate vitamin A every day for sin months. An examination of these children at the end of a year showed most 'encouraging results. These'were : 

•  None of the children were night blind 
•  None developed conjuctival xerosis or bitot spots 
•  None developed nutritional blindness. 

Thus the National  Prophylaxis Programme for prevention of Nutritional Blindness was born. 

Let us now study about the details of the programme. We shall discuss this programmes as well as other nutrition programmes in the block under three main headings - objectives, target groups and distribution strategy. You should get familiar with these terms. 

Objectives : Refer to the specific aims to be achieved through the programme. 

Target group : Nutrition  programmes cater to only vulnerable sections of the community. Each programme targets at some particular vulnerable sections of the community i.e. target group. 

Distribution Strategy : Refer to the method of distribution of benefits of the programme. 

Let us learn about the objectives, target group and the method of distribution benefits of National prophylaxis programme for prevention of nutritional  blindness. 

Objectives : The programme aims at preventing blindness due to vitamin A deficiency in children (between 6 months to 5 years) by supplying mega (high) dose ef vitamin A. 

Target group : All children of 6 months to 5 years are eligible (particularly those living in rural, tribal and urban slum areas). 

Dose and distribution strategy : A liquid preparation of vitamin A in oil providing 200,000 IU (in 2 ml) is given to every child between the ages of 1 and 5 years. Vitamin A solution is kept away from direct sunlight and a bottle once opened is utilized within 6-8 weeks. A child must receive a total of 9 oral doses of vitamin A by fifth birthday. An infant between the age of 6-11 months is given a dose of 100,000 IU.  The contact with an infant during. administration of measles vaccine between the age of 9-12 months is considered practical time for administering the vitamin A supplement of 100,000 IU to infants. 

The mother child immunization card is used to record and monitor the administration of vitamin A children under two years. Similarly growth monitoring cards or register, used for monitoring growth of children under the ICDS Programme are used for recording and monitoring administration of vitamin A solution till the age of five years. 

Distribution of vitamin A is carried out by the Auxiliary Nurse Midwife (ANM) - a functionary belonging to Health Department in Ministry of Health and Family Welfare. There is an ANM for a population of 3000-5000 people in a state. Her main task is family welfare. She also educates people about healthy living and helps in distributing the benefits of nutrition programmes. Actual feeding (administration) of the dose is conducted at the 'door-step'  of the beneficiary, once in six months. It i: recommended that the health worker, as soon as she receives the stock of vitamin A, shpuld cover all the eligible children of her area within as short a period as possible (on cash basis) by home (domicilliary) visits (administration  at the clinics or at one place is not recommended). Wherever Integrated Child development Services (ICDS) is functioning, anganwadi workers should be involved in the distribution and administration of vitamin. You will learn more about anganwadi workers and .  Integrated Child Development.