7.4  Causes of vitamin A, iron and iodine deficiencies

Vitamin A deficiency (VAD) results when body stores are used up either because too little vitamin A is present in the foods, or there is insufficient absorption of vitamin A from foods. For example, if a diet is lacking in oils or fats, vitamin A is not well absorbed and utilised. VAD can also result from rapid utilisation of vitamin A during illnesses (particularly measles, diarrhoea and fevers), pregnancy and lactation, and during phases of rapid growth in young children. If the vitamin A status in the body is very low:

  • The immune systems become weak and illness is more common and more severe, increasing under-five death rates
  • The eye could be damaged with appearance of lesions, and when severe, blindness can occur
  • There is an increased risk of a woman dying during pregnancy or during the first three months after delivery.

Iodine is found naturally in topsoil, but in most areas of the country and especially the highlands, top soil has been lost due to deforestation, erosion and flooding, and thus food crops lack iodine resulting in dietary iodine deficiency.

Anaemia has multiple causes. Its direct causes can be broadly categorised as poor, insufficient or abnormal red blood cell production, excessive red blood cell destruction, and excessive red blood cell loss. Contributing causes include poor nutrition related to dietary intake and dietary quality (iron deficiency in particular), infectious and parasitic diseases; inadequate sanitation and health behaviours; lack of access to health services; and poverty. The two major direct causes of anaemia, with excessive red cell destruction, are malaria and worm infections.

The NNP and the Health Sector Development Plan IV have a number of programme objectives and targets and these are set out in Tables 7.1 and 7.2.

Table 7.1  Population at risk of vitamin A, iodine and iron deficiencies.
Vitamin A deficiencyIodine deficiency diseaseIron deficiency anaemia
Infants and children under five and pregnant and lactating women

People of all ages and sexes are vulnerable

More at risk are the fetus, young children, pregnant women, and lactating mothers

Low birth weight infants

Children aged six-24 months

Adolescent girls

Pregnant and lactating women

Children between six and 11 years of age

People living with HIV and AIDS

Table 7.2  Goals for controlling vitamin A, iodine and iron deficiencies.
Vitamin A deficiencyIodine deficiency diseaseIron deficiency anaemia

Goal: to virtually eliminate vitamin A deficiency by the year 2015

Objectives: At least 90% of children 6-59 months given vitamin A every six months (all the country except Addis Ababa)

Supplement 70% of postpartum women with high doses of vitamin A within 45 days of delivery

Goal: Virtual elimination of iodine deficiency disorders by the year 2015 by means of universal salt iodisation (USI)

Objectives: Decrease current goitre rate by 50%. Increase access to iodised salt among households up to 80%

Goal: Virtual elimination of ion deficiency amaemia

Objectives: Reduce the prevalence of ion deficiency anaemia in women of reproductive age and children under five, by one third by 2015

7.3.3  Rationale for action against iron deficiency anaemia

7.5  Strategies to control vitamin A, iodine and iron deficiencies