National Vitamin A Prophylaxis Programme: Should be continued, stopped or targeted

Vitamin A is an essential nutrient needed for normal functioning of visual, immune and reproductive system; growth and development & maintenance of cellular epithelial integrity. Clinically, its deficiencies can be seen as xeropthalmia (severe form) night blindness, bitot spot, keratomalacia and other ocular manifestations), keratinization in skin, retarded growth of bones & impaired reproductive system. In public health deficiency is mainly seen clinically in the form of xerophthalmia (severe) or subclinical form especially among young children with others infections, due to increased nutrient requirements for growth. To prevent this deficiency Government of India had started to provide Vitamin A supplementation under the Vitamin A Prophylaxis Programme with a certain dose and schedule. As the time passes, a remarkable change has been observed in the prevalence, incidence, form (clinical to subclinical) of the deficiency disease, which bring many controversies over vitamin A Prophylaxis Programme with regard to its doses, schedule, beneficiaries and marker. This puts a question on the Programme whether it should be revised, continued or stopped.