Overview of actions to control vitamin A deficiency of in Brazil

Objective This manuscript aims to describe the implementation of actions to control vitamin A deficiency in Brazil. Methods The study was based on secondary data obtained from official reports and technical documents from the former Instituto Nacional de Alimentac (a) over tildeo e Nutric (a) over tildeo (inactivated in 1997), from the Coordenac (a) over tildeo Geral da Political Nacional de Alimentac (a) over tildeo e Nutric (a) over tildeo, Ministry of Health and information obtained from key informants employing the multidimensional approach based on the triad: structure-process-result. Results Brazil was pioneer in taking the initiative of linking vitamin A distribution to the National Immunization Days, a strategy that later on was recommended by the World Health Organization and the United Nations Children's Fund. Since 1983, vitamin A megadoses are employed as a strategy to fight this micronutrient deficiency by the Ministerio da Saude. Coverage of the target population (children 6-59 months old) is steadily increasing, reaching 72% and 68% in the years 2002 and 2003 respectively. These coverage rates are similar to those reported in the 40 countries that have also adopted this strategy. Since 2001 the program was extended to lactating women, in the immediate post-partum period. Conclusion The program achievements until 1992 were very modest, fact that could be explained by the irregularity of vitamin A capsule distribution. From 1994 on the distribution was more constant, but the need to promote more integrated actions in the health services, as well as far reaching social actions, beyond the routine distribution of vitamin A capsules, still remains.