An estimated 250 000 to 500 000 vitamin A-deficient children become blind every year, half age to go to preschool them dying within 12 months of losing their sight. In pregnant women VAD causes night blindness and may increase the risk of maternal mortality. Vitamin A deficiency is a public health problem in more than half of all countries, especially in Africa and South-East Asia, hitting hardest young children and pregnant women in low-income countries.
Crucial for maternal and child survival, supplying adequate vitamin A in high-risk areas can significantly reduce mortality. Conversely, its absence causes a needlessly high risk of disease and death. For children, lack of vitamin A causes severe visual impairment and blindness, and significantly increases the risk of severe illness, and even death, from such common childhood infections as diarrhoeal disease and measles. For pregnant women in high-risk areas, vitamin A deficiency occurs especially during the last trimester when demand by both the unborn child and the mother is highest. The mother’s deficiency is demonstrated by the high prevalence of night blindness during this period.
The impact of VAD on mother-to-child HIV transmission needs further investigation. To successfully combat VAD, short-term interventions and proper infant feeding must be backed up by long-term sustainable solutions. Vitamin A is a crucial component. Since breast milk is a natural source of vitamin A, promoting breastfeeding is the best way to protect babies from VAD.
6 months and 6 years of age can reduce overall child mortality by a quarter in areas with significant VAD. However, because breastfeeding is time-limited and the effect of vitamin A supplementation capsules lasts only 4-6 months, they are only initial steps towards ensuring better overall nutrition and not long-term solutions. Cultivating the garden, both literally and figuratively, is the next phase necessary to achieve long-term results. Food fortification takes over where supplementation leaves off.
Food fortification, for example sugar in Guatemala, maintains vitamin A status, especially for high-risk groups and needy families. For vulnerable rural families, for instance in Africa and South-East Asia, growing fruits and vegetables in home gardens complements dietary diversification and fortification and contributes to better lifelong health. In addition, over the past few years, WHO, UNICEF and others have provided support to countries in delivering vitamin A supplements. This article is about schools for younger children between the ages of three and five. For the stage of childhood which ranges from 5-8 years old, see early childhood. In some European countries the term “kindergarten” refers to formal education of children classified as ISCED level 0 – with one or several years of such education being compulsory – before children start primary school at ISCED level 1. May also be used to define services for children younger than kindergarten age, especially in countries where kindergarten is compulsory.