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Deficiencies of micronutrients are major health problems in Ethiopia. According to a national survey conducted by the former Ethiopian Nutrition Institute in 1985, the prevalence of Bitot's spots exceeded 1%, and low serum vitamin A levels were found in 16% of preschool children. In a 1997 baseline study by World Vision Ethiopia, the prevalence of Bitot's spots was 6.4% and 7.5% in preschoolchildren and schoolchildren, respectively. In October 1998, World Vision Ethiopia launched a comprehensive Micronutrient Program with the goal of improving the micronutrient and health status of mothers and children. Promoting the production of vitamin A–rich foods was adopted as one of the strategies to reduce vitamin A deficiency in the target population. Intensive nutritional education was given in the project areas, focusing on community leaders, women's groups, teachers, and students. Vegetable seeds and hand tools were made available for demonstration purposes, and production of vitamin A–rich foods (dark-green leafy vegetables, carrot, beet root, cabbage, and kale) was started in community demonstration plots and schools. Community members began replicating vegetable gardens at the household level. In areas where the climate is suitable, production of vitamin A–rich fruits, such as mango, papaya, and avocado, was also demonstrated to the communities. Seedlings grown in community plots were distributed to households. At the end of the second year (1999), 11,708 backyard gardens, 275 school gardens, and 77 community gardens had developed with the full participation of the community. In addition to improved micronutrient status, vegetable production contributed to household food security and income generation of the community. Our experience shows that production of vitamin A–rich vegetables is well accepted by the community. It is sustainable and cost-effective. The challenge ahead is the need to develop local vegetable seed production, since the availability and cost of imported seeds are a hindrance, particularly for very poor community members. A food-based approach, and particularly production of vitamin A–rich vegetables and fruits, should be the mainstay in designing a sustainable micronutrient program in poor developing countries.

Experience of World Vision Ethiopia Micronutrient Program in Promoting the Production of Vitamin A–Rich Foods