Research - National Surveys: South African Vitamin A Consultative Group (SAVACG)
Children aged 6-71 months in South Africa 1994: Their anthropometric, Vitamin A, Iron and Immunization Coverage Status
Initially, the purpose of this descriptive national survey was to evaluate the anthropometric, vitamin A and iron status of children 6-71 months of age. Following discussions with the Department of Health, the survey was expanded to include a detailed assessment of immunisation coverage, not only for the purpose of avoiding duplication but also because preventable infectious diseases do impact adversely on the general nutritional as well as micronutrient status of children. Further, on mutual agreement with UNICEF, the assessment of the prevalence of visible goitre was also incorporated in the survey.
In the executive summary, the findings of the survey are presented in the order of the main and subsidiary objectives of the study. In the report itself, the general findings and the findings on the anthropometric status are presented first, in order to impart sufficient background for the main findings. A separate chapter is devoted to each of the objectives of the study and includes the relevant proposed recommendations for the specific objective. In order to address some other important aspects of the study and for ease of presentation, a chapter of general discussion and of general recommendations has been included. The tables, figures and recommendations in each chapter are numbered according to the particular chapter number.
The South African Vitamin A Consultative Group (SAVACG) attached great urgency in compiling this report with a view to making the main results of the study available as soon as possible. For this reason, the statistical analysis of the data has been limited to the most important descriptors of vitamin A, iron, (iodine), anthropometric and immunisation coverage status. Further detailed analysis, including refined analysis of socioeconomic status, regression analysis, and the calculation of confidence intervals around cluster estimates has not yet been completed. However, the results of this further analysis are unlikely to have a major influence on the proposed recommendations and will be provided in due course. The results of the study will also be published. Some selected details of the study are presented in the form of appendices at the end of the report.
In general, the process followed for arriving at the proposed recommendations included the definition of "action points" (prevalence beyond which intervention is deemed necessary) according to international criteria, as well as according to the feasibility and efficacy of implementing internationally recommended plans of action within the country's framework of health care services and the available expertise within SAVACG and the country. Although the report makes recommendations of a general nature regarding nutrition, immunisation and community development, because of their impact on the reduction of vitamin A and iron deficiency, these recommendations may not be complete in terms of reducing undernutrition, lack of immunisation or poverty and deprivation. A detailed discussion, for example, of the mechanisms for rural economic development, an essential ingredient of sustainable elimination of undernutrition, falls well outside the scope of this study. Nevertheless, in general terms, such recommendations are made, using both the findings from the present study and some plausible solutions suggested in other policy documents.
The Department of Health is the major sponsor for this survey. UNICEF also made a substantial financial contribution. The catalytic contribution of Task Force Sight and Life, Basel, Switzerland, is also acknowledged. This study would not have been possible without the excellent community support it received, neither without the commitment, dedication and hard work of the community members that were employed for the study and the personnel of the Department of Health (at national, provincial and local level), the Medical Research Council and the Universities (in alphabetical order) of Cape Town, Durban-Westville, Orange Free State, Medical University of Southern Africa, Natal, Pretoria and Stellenbosch as well as other role players, who are all duly acknowledged in the appropriate chapter.
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Table of contents