Vitamin A capsule supplementation in Malawi villages: missed opportunities and possible interventions.

A population-based survey was used to assess childhood and maternal vitamin A capsule coverage in Malawi and to investigate missed opportunities for capsule distribution. Overall, 9.3% of children had received vitamin A supplementation in the previous 6 months. Missed opportunities for receiving vitamin A were high in younger children. Fifty-five percent of mothers were covered in 8 villages served by volunteers and 23% in the 58 villages without volunteers. Existing strategies need to be redesigned and new strategies defined. For instance, mothers could receive supplementation during infant BCG vaccination, and children could receive initial supplementation during measles vaccination. Village health volunteers could be used to target children over 2 years of age.