Evaluation of the implementation of the vitamin A supplementation programme in the Boland/Overberg region of the Western Cape Province

Abstract

Objective: To assess the implementation of the vitamin A supplementation programme in primary health care (PHC) clinics in a rural area of the Western Cape Province. Material and methods: A study was conducted at 14 randomly selected PHC clinics. All children aged 6 - 60 months attending on the day of surveying with their mothers/caregivers were selected by purposive sampling, after they had been seen by a PHC nurse in the clinic. A structured exit interview was conducted with the mother/caregiver of each child. The information from 56 such interviews could be utilised for data analysis. The manager of each clinic was also interviewed. Results: Seventy-seven per cent of the study population (N=40) was eligible for high-dose vitamin A supplementation on the day of the study, based on the criteria of the vitamin A supplementation protocol. However, 25% of these children (N=10) did not receive vitamin A, even though there was an indication to administer it. Only 39% of mothers (N=22) reported that they were aware of the supplementation programme. All the health facility managers of the clinics had received training in the programme. Staffing problems and stock shortages appeared to play a role in inadequate implementation of the programme at some clinics. In addition, health facility managers reported that many children failed to receive their vitamin A dose because parents did not bring them regularly to clinics. Conclusions: The vitamin A supplementation programme appears to be reasonably successfully implemented in the Boland/Overberg region. Informing mothers about the importance of vitamin A supplementation and regular clinic attendance, as well as improving the availability of human and material resources and logistic support at PHC facilities, may further enhance the implementation and success of the programme.