NATIONAL VITAMIN A PROPHYLAXIS PROGRAM

NATIONAL VITAMIN A PROPHYLAXIS PROGRAM

• Vitamin A is an essential micronutrient responsible for maintaining vision, epithelial integrity, immune function, and growth.

• Its deficiency is a major public health problem in developing countries, including India.

• India launched the National Vitamin A Prophylaxis Programme (NVAPP) to combat this deficiency and prevent nutritional blindness, especially in children.

RELEVANCE OF VITAMIN A IN AYURVEDA

• In Ayurveda, the importance of maintaining eye health is emphasized through the concept of Netra Swasthya.

• Though Vitamin A as a nutrient is not explicitly mentioned, signs of deficiency like night blindness (Nyctalopia) correlate with Naktandhya described in classical texts.

🔸 “नक्तन्द्या भवत्यन्ध्या दिवा च प्रकाशदर्शिनी ।
नक्तन्द्या तु या रात्रौ न पश्यत्यन्धवत् स्वयम् ॥”
— Ashtanga Hridaya, Uttara Tantra, 13/31

• Importance of Rasayana therapy is emphasized for immunity, tissue nutrition, and longevity — closely linked to preventing deficiencies.
  🔸 “बल्यं वर्ण्यं च चक्षुष्यम्... रसायनं परं स्मृतम्”
  — Charaka Samhita, Chikitsa Sthana 1/7

OBJECTIVES OF THE NATIONAL VITAMIN A PROPHYLAXIS PROGRAM

• To prevent Vitamin A deficiency and its manifestations like xerophthalmia and night blindness.

• To reduce under-5 mortality through immunological support.

• To supplement adequate Vitamin A in children aged 6 months to 5 years in high-risk zones.

TARGET POPULATION

• Children from 6 months to 5 years of age.

• Especially those from economically backward or malnourished populations.

• Areas with endemic Vitamin A deficiency.

VITAMIN A SUPPLEMENTATION SCHEDULE

• As per MoHFW (Ministry of Health and Family Welfare, India):

  • 1st Dose: 100,000 IU at 9 months along with measles vaccination.

  • 2nd to 9th Doses: 200,000 IU at 6-month intervals from 16–18 months till the age of 5 years.

  • Administered orally using a calibrated dropper.

MODERN COMMUNITY MEDICINE PERSPECTIVE

• Vitamin A is a fat-soluble vitamin crucial for phototransduction in the retina.

• Deficiency leads to:

  • Night blindness (Nyctalopia)

  • Conjunctival xerosis

  • Bitot's spots

  • Corneal xerosis and keratomalacia

• WHO categorizes Vitamin A deficiency as a public health problem when prevalence of night blindness >1% in children aged 24-59 months.

• The program contributes to achieving Sustainable Development Goals (SDGs), particularly child survival and nutrition.

OTHER STRATEGIES FOR VITAMIN A DEFICIENCY CONTROL

• Dietary diversification:

  • Promotion of locally available Vitamin A rich foods such as green leafy vegetables, yellow/orange fruits, liver, dairy.

• Health education:

  • Awareness among parents and caregivers regarding signs of deficiency and diet.

• Breastfeeding promotion:

  • Colostrum and exclusive breastfeeding for the first 6 months.

FOOD SOURCES OF VITAMIN A

• Animal sources: Liver, eggs, butter, ghee, fish liver oil.

• Plant sources (Beta-carotene): Mango, papaya, carrot, pumpkin, spinach, drumstick leaves.

AYURVEDIC NUTRITIONAL PRINCIPLES RELATED TO VITAMIN A

• Ayurveda emphasizes the role of Chakshushya Aahara (eye-promoting food).

• Netrya dravyas are mentioned in Ayurvedic texts:
  🔸 “घृतं चक्षुष्यम्” — Sushruta Samhita, Sutrasthana 45/103

  • Ghee is indicated for nourishing and strengthening vision.

• Use of Rasayana like Amalaki, Haritaki, and Ghee for preventive care.

INTEGRATION OF AYURVEDA WITH NATIONAL PROGRAM

• Use of Ayurvedic Rasayana as complementary therapy in child health programs.

• Integration of Netra Raksha camps and school health programs with Rasayana support.

• Educating through Swasthavritta about eye-protective lifestyle and balanced diet.

ACHIEVEMENTS AND IMPACT OF THE PROGRAM

• Significant decline in prevalence of keratomalacia and blindness due to deficiency.

• Drop in incidence of xerophthalmia in many states.

• Contributes to overall reduction in child mortality.

CHALLENGES

• Poor compliance and follow-up in remote areas.

• Inadequate training of field workers.

• Misconceptions among caregivers.

WAY FORWARD

• Strengthen IEC (Information, Education and Communication) campaigns.

• Convergence with POSHAN Abhiyan and Integrated Child Development Services (ICDS).

• Enhanced monitoring, evaluation, and digital tracking.