The status of Uganda’s food-based vitamin a deficiency mitigation strategies

Abstract

Vitamin A deficiency (VAD) threatens public health especially among children in developing countries. Various interventions and their efficacy have been much discussed at a global level to alleviate VAD. Yet, studies indicate individual countries afflicted with VAD may be running relevant programs without adequately updated data or evidence from situational analyses. This study takes Uganda as a case to examine the status of its existing VAD mitigation programs, focusing on food-based interventions. To review the VAD mitigation programs, nationally representative data from the Ugandan public institutions, policy documents from the government and VAD-relevant data from the United Nations agencies were mainly examined. Also analyzed in detail were published studies and working papers directly or indirectly related to Uganda’s VAD and/or VA issues. The results from the review pointed to some evidence on the existing issues with the country’s VAD mitigation strategies. First, gauging a temporal trend of VAD prevalence in the target population was not possible due to changes and inconsistencies in the survey formats and methodologies. This implies the present VAD interventions might rely on unsynchronized VAD assessments in the first place. Second, of the ongoing food-based VAD interventions, effectiveness of food fortification with VA seemed constrained by questionable food vehicle choices, reluctant food industries, low stakeholder engagement, and weak public supervision. Third, for biofortification, wide adoption/utilization of the VA-biofortified orange sweet potato appeared to be complicated by farmer and consumer preferences, social factors, and immature value chains of the crop. But adoption/utilization of the genetically modified VA-biofortified banana seems to have been even more complicated by additional issues around the relevant biotechnology law of the country and public concerns about the genetic modification. Collectively, these VAD interventions in Uganda appeared to be continued without sufficiently updated documents and monitoring frameworks. This suggests that Uganda should review its current VAD interventions for more effective and efficient VAD mitigation.