Monitoring and Quality Assurance of Routine Vitamin A Supplementation (VAS) and Deworming Programmes in Sierra Leone in the districts of Bo, Kenema and Koinadugu.

Background/Purpose of Assignment

Vitamin A deficiency is a major public health problem affecting 17%[1] of children in Sierra Leone. Infants and children have increased vitamin A requirements to promote rapid growth and to help combat infections. Inadequate intakes of vitamin A among children under-five could lead to vitamin A deficiency, which, when severe, may cause visual impairment (ranging from night blindness and permanent blindness) or increase the risk of illness and mortality from childhood infections such as measles and diarrhea. Preformed vitamin A can be found in both animal and plant food sources. However, consumption of Vitamin A rich foods (yellow or orange coloured fruits & vegetables) by children 6 -23 months is poor (13.9 per cent) [2]. Vitamin A supplementation is therefore required to meet daily recommended needs.

Vitamin A supplementation (VAS) and deworming have been predominantly administered to children 6-59 months in Sierra Leone through mass bi annual campaigns since 2006. The campaigns are highly donor dependent, resource intensive and require robust planning. To support the Government’s health system strengthening strategy, UNICEF is supporting partners to integrate VAS with routine services at healthcare facilities. A pilot of the transition from campaigns to routine VAS commenced implementation in 2017 in Bo, Kenema and Koinadugu districts. The integration of VAS with reproductive and child health services included: Immunization, deworming (12-59 months), infant and young child nutrition and family planning. The pilot phase of the transition comprised of community advocacy meetings, ensuring no stock out of supplies at the facilities and capacity building efforts of the District Health Management Team (DHMT) for effective program delivery. The DHMT is required to take ownership and manage the implementation of the program for sustainability.

To support Ministry of Health and Sanitation (MoHS) in monitoring community and health facility VAS services, an independent contractor will be recruited to ensure quality standards in the implementation of VAS services in target districts (Bo, Kenema and Koinadugu).