Assessment of the Vitamin A supplementation protocol in primary health care settings: A case study of Mookgophong sub-district in South Africa

The Integrated Nutrition Programme in South Africa provides Vitamin A supplementation to targeted children. It began in 1994 when marginal vitamin A deficiency was 33 %. Since that time, malnutrition remains a serious problem in South Africa as one of the greatest contributors to childhood illness and death. It is estimated that about 27% of South African children are stunted from a lack of adequate nutrition in the early years of their lives. A poor intake of vitamin A is one of the cofactors in sight and contribute to blindness amongst children. In addition, it is required for cellular integrity. Furthermore, children with poor intake of vitamin A are underweight, fail to grow properly and are more likely to get infections and to die from them. The main purpose of this study was to assess the implementation process of the vitamin A supplementation protocol in primary health care institutions in the Mookgophong sub-district of Limpopo Province. The study design was descriptive and qualitative. All seven facilities, the clinics and the district hospital in the sub-district were purposefully selected. Data were collected from the seven health care facilities and 16 health care workers provided information on the implementation process of the Vitamin A programme, using a self-administered structured questionnaire. An observation questionnaire was also used by the researcher to validate some of the information and to check compliance with the protocol. The findings revealed poor availability of blue (100 000 IU), white (500 000 IU) and yellow (200 000 IU) capsules in stock (56.3%). Approximately half of the health care workers reported to know the preventative schedule, while most of them did not know the treatment schedule. There was generally good adherence to the implementation of preventative protocol. The health care workers complied with the Vitamin A protocol despite the lack of stock or resources in this low resource setting. Key words: Vitamin A supplementation protocol, health care workers, South Africa