During the week following Bangladesh’s National Vitamin A Campaign, health assistant Habibullah has a special assignment. He’s tasked with distributing vitamin A to children under five within Islampur, Jalampur, who were unable to reach distribution points during the formal campaign period. “Every morning, I collect vitamin A capsules from the health complex and then travel for hours by boat and on foot to reach my field. I go door-to-door, administering doses and educating parents about the importance of vitamin A and nutritious diets,” shares Habibullah.

Vitamin A is an essential micronutrient critical for the immune system, vision, and overall growth in children, yet is often lacking in the diets of children in countries like Bangladesh. Deficiency in vitamin A can lead to severe health issues, including night blindness, increased risk of infectious diseases, and death from those diseases.

Vitamin A supplementation (VAS) is a crucial public health intervention that has transformed the lives of children under five. In remote areas of Bangladesh, a major effort is underway to improve the health and future of millions of children, ensuring no child is left behind.

To address this major public health concern, Bangladesh’s National Nutrition Services (NNS) within the Ministry of Health and Family Welfare carries out a biannual distribution of vitamin A supplements to children aged 6-59 months through its National Vitamin A Campaign (NVAC). Since 1997, Nutrition International has played a vital role in supporting the NVACs. The campaign reaches over 22 million children during each round, highlighting its critical importance.

But despite the widespread success of the NVACs, reaching children in hard-to-reach areas remains a significant challenge. These regions, often isolated by rivers, forests, and inadequate infrastructure, pose logistical difficulties for people living in those areas to access health and nutrition services. In response to inequities in access to nutrition services, Nutrition International supports the government to implement the post-campaign Child-to-Child Searching Strategy.

Introduced and piloted by Nutrition International in 2006, the Child-to-Child Searching Strategy involves community members and health workers, like Habibullah, conducting door-to-door searches to ensure every child receives their vitamin A dose. Due to its success, this approach was officially adopted by the government in 2013 and has since been a cornerstone post-campaign activity, to ensure no child is left behind, especially in remote areas.

“When my baby was about six months old, a health assistant came to my house to give the vitamin A capsule. The community clinic is very far from my house, so this service was a blessing,” shares Mosammat Shima Akter, a mother from a remote village. “Since my child received the vitamin A capsules, she has become healthier and her eyesight has improved.”

Sharifa, another mother from a different village, had a similar experience. “I couldn’t take my son to the clinic because of work and the long journey,” she says. “When they came to our home to give my son the vitamin A capsule, it was a great help. Now, my son is healthier, and I am grateful for this service.”

“Nutrition International supports the vitamin A supplementation program from the national level to the field level,” explains Dr. Edwin Theophilus Goswami, Program Officer at Nutrition International. “We provide technical and financial support, train health workers, and ensure effective monitoring and reporting. Our aim is to make sure every child, even in the remotest areas, receives this essential nutrient.”

Those efforts are paying off. Due to the Child-to-Child Searching Strategy an additional 65,820 children aged 6-59 months received VAS in June 2023 and 68,868 received VAS in December 2023. Without this mop-up, these children would have otherwise been missed.

Nutrition International continues to advocate for and support the government’s efforts to enhance the program. One of these ways is through the introduction of the VAS e-learning app. Nutrition International developed the online training tool with the government to train health workers on effective VAS service delivery. Habibullah, his peers, and their supervisors, were able to access this training through their smartphones, which included a chapter on child-to-child search. Staying up to date on best practices and ensuring proper training for those delivering VAS results in high coverage for service delivery, and truly going the extra mile to reach every child.

Continued collaboration is needed to ensure children under five continue to receive their vitamin A dose when needed. Health workers like Habibullah make this possible. “It’s challenging but rewarding to see the positive impact on these children’s lives,” he shares.

Learn more about our work in Bangladesh.

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