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• W3143670069 abstract "Agbessi Amouzou and colleagues1Amouzou A Habi O Bensaid K for the Niger Countdown Case Study Working GroupReduction in child mortality in Niger: a Countdown to 2015 country case study.Lancet. 2012; 380: 1169-1178Summary Full Text Full Text PDF PubMed Scopus (107) Google Scholar provide a vital contribution in analysing the remarkable progress in reduction of child mortality in Niger. However, best available data have not been used in reporting the history of campaign approaches and coverage of vitamin A supplementation (VAS). The contribution of high, twice-yearly VAS coverage—one of Niger's signature child survival achievements—to this dramatic reduction in child deaths is therefore likely to be a major underestimate. Niger started campaigns in 1996, combining VAS with vaccination, and continued once-per-year mass VAS distribution until 1999. It was one of the first countries in sub-Saharan Africa to ensure twice-yearly VAS coverage (starting in June, 1999).2Aguayo VM Baker SK Crespin X Hamani H MamadoulTaïbou A Maintaining high vitamin A supplementation coverage in children: lessons from Niger.Food Nutr Bull. 2005; 26: 26-32PubMed Google Scholar, 3Aguayo VM Garnier D Baker SK Drops of life: vitamin a supplementation for child survival. Progress and lessons learned in West and Central Africa.http://www.unicef.org/wcaro/documents_publications_2382.htmlGoogle Scholar Amouzou and colleagues focus only on campaign approaches starting in 2004, stating that there were two mass campaigns per year for VAS since 2000. VAS coverage, presented in Amouzou and colleagues' appendix, is significantly lower than that from other validated sources. Figure 7 shows coverage ranging from about 60% to 80% during 2005–09 (with no data between 1998 and 2005). In fact coverage has been maintained at more than 80% since June, 1999.2Aguayo VM Baker SK Crespin X Hamani H MamadoulTaïbou A Maintaining high vitamin A supplementation coverage in children: lessons from Niger.Food Nutr Bull. 2005; 26: 26-32PubMed Google Scholar, 3Aguayo VM Garnier D Baker SK Drops of life: vitamin a supplementation for child survival. Progress and lessons learned in West and Central Africa.http://www.unicef.org/wcaro/documents_publications_2382.htmlGoogle Scholar Finally, in their use of the Lives Saved Tool (LiST), Amouzou and colleagues have only factored in VAS's effect on reduction of diarrhoea-specific mortality and use of VAS in treatment of measles, whereas several meta-analyses have shown VAS as producing a 22–25% reduction in all-cause mortality for children aged 6–59 months in settings such as Niger. It is recommend that this effect be incorporated into LiST analyses.4Mayo-Wilson E Imdad A Herzer K Yakoob MY Bhutta ZA Vitamin A supplements for preventing mortality, illness, and blindness in children aged under 5: systematic review and meta-analysis.BMJ. 2011; 343: d5094Crossref PubMed Scopus (229) Google Scholar, 5Imdad A Yakoob MY Sudfeld C Haider BA Black RE Bhutta ZA Impact of vitamin A supplementation on infant and childhood mortality.BMC Public Health. 2011; 11: S20Crossref PubMed Scopus (84) Google Scholar SKB is the Vice-President and Regional Director for Africa of Helen Keller International, which has been supporting VAS delivery in Niger since 1987. LN is Chief Technical Advisor and Director of Technical Services for the Micronutrient Initiative, which has been supporting VAS delivery in Niger since 1998. GD is an independent consultant and has no conflicts of interest. Reduction in child mortality in Niger: a Countdown to 2015 country case studyGovernment policies supporting universal access, provision of free health care for pregnant women and children, and decentralised nutrition programmes permitted Niger to decrease child mortality at a pace that exceeds that needed to meet the MDG 4. Full-Text PDF Reduction in child mortality in Niger – Authors' replyWe thank the three sets of authors for their comments on our case study,1 as well as the many other Lancet readers who have contacted us to express interest in doing similar work. Full-Text PDF" @default.
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• W3143670069 title "Reduction in child mortality in Niger" @default.
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• W3143670069 doi "https://doi.org/10.1016/s0140-6736(13)60011-2" @default.
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