Children's Nutrition Summary and Giving Recommendation

This is a Founders Pledge summary and interpretation of original research published by GiveWell. For GiveWell's full research, see their report on Vitamin A Supplementation.

The giving recommendation based on this research is Helen Keller International's Vitamin A Supplementation programme.

Please note this page was last updated in 2018. While our overall views remain unchanged, some details may be out of date.

The problem

The WHO estimates that 250 million children under five years of age are affected by vitamin A deficiency. Vitamin A deficiency can occur when a diet does not include any fortified foods, animal sources, or other rich sources of vitamin A - as is the case in many low-income countries. Vitamin A is crucial for the proper functioning of the immune system and deficiency can cause severe problems, especially for children: it is the leading cause of preventable blindness in children, and it increases the risk of disease and death from severe infections, like measles and those causing diarrhoea. An estimated 250,000 to 500,000 vitamin A-deficient children become blind every year, half of them dying within 12 months of losing their sight.

The solution

Vitamin A deficiency can be addressed cheaply and effectively through supplementation. It can cost less than $1.50 per person per year to deliver the supplements if delivery is carried out by existing infrastructure. This makes vitamin A supplementation an extremely cost-effective intervention.

The evidence

Evidence suggests supplementation of vitamin A is very effective in reducing child mortality, especially in settings where there are high rates of vitamin A deficiency.

The organisation: HKI’s Vitamin A Supplementation Programme

Helen Keller International (HKI) works on malnutrition and blindness, and carries out a programme on vitamin A deficiency. They engage in an array of activities to address the problem from several angles. They do advocacy (encouraging governments to allocate funding to vitamin A supplementation), provide technical assistance (for different phases of the delivery, such as budgeting and planning, training, monitoring and evaluation), and help fund government-run vitamin A supplementation programmes. HKI usually works in regions with high rates of vitamin A deficiency and child mortality, where their programmes are most likely to have a high impact.

HKI can deliver a supplementation round for roughly $1.35 per child, and it is currently estimated to avert a child’s death for about $3,200 on average. As a frame of reference, the UK National Health Service would consider it cost-effective to spend around $600,000 to save a life. HKI plan to use additional funding for the vitamin A supplementation programme to support programmes in Guinea, Mali, Burkina Faso, Nigeria, Côte d'Ivoire, Niger, Cameroon, Democratic Republic of the Congo, Kenya, and Mozambique. As of the end of 2017, it has the capacity to productively employ $21 million in additional funding for their vitamin A supplementation programme.

Sources

Channel 4 News. “Why the NHS thinks a healthy year of life is worth £20,000” (23 April 2014) Source (accessed 27th of March 2018)

Imdad A et al. “Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age (Review)” Cochrane Database of Systematic Reviews (Issue 12, 2010); World Health Organization. “Nutrition – Global and regional food consumption patterns and trends” Source (accessed 27th of March 2018)

Imdad A et al. “Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age (Review)” Cochrane Database of Systematic Reviews (Issue 12, 2010)

World Health Organization. “e-Library of Evidence for Nutrition Actions (eLENA) - Vitamin A supplementation in infants and children 6-59 months of age - Guidance summary” Source (accessed 27th of March 2018)

World Health Organization. “Global prevalence of vitamin A deficiency in populations at risk 1995-2005. WHO Global Database on Vitamin A Deficiency” (2009)

World Health Organization. “Micronutrient deficiencies – Vitamin A deficiency” Source (accessed 14th December 2018)

Research