Vitamin A supplements have been distributed during National Immunization Days since 1983, and Brazil has been a pioneer in this kind of strategy. The current study evaluated the National Program from 1995 to 2002, from a structure-process-results perspective. The methodology involved document research, interviews with health services managers, and a case study in 44 municipalities in Bahia State, resulting in 1,344 household interviews. In relation to structure, from 1998 on the program operated without a normative instrument due to the extinction of the National Institute of Nutrition. Improvements in the processes of vitamin supply procurement and distribution had a positive impact on coverage, reaching 3.5 million capsules in 2002 (72% coverage). For the 2,546 children studied in Bahia, vitamin A distribution was irregular, with annual coverage varying from 8% to 26%. Program managers reported time constraints and insufficient human resources, consistent with the hypothesis that this type of strategy does not help inform the population about the importance of vitamin A. These findings point to the need for systematic linkage between different levels of government in order to fully implement and monitor the program.
Food Security; Nutrition Programmes; Vitamin A
