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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 micro-nutrient
status of children. Further, on mutual agreement with
UNICEFF, 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 mist 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
under-nutrition, 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 under-nutrition, 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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