Abstract
In several Eastern and Southern African countries, between one-third and one-half of the children are vitamin A deficient. Not just one strategy, but a combination of supplementation, fortification, and dietary diversification will provide the solution to the elimination of vitamin A deficiency. Food diversification in general is limited by increasing poverty and household food insecurity. Supplementation coverage rates increased from an average of 22% to 68% during the last four years. This was mainly due to integration of supplementation into national immunization days. Now the challenge is to integrate supplementation into sustainable delivery systems. Several countries have started or are planning maize and/or sugar fortification initiatives, but most of the experience so far has been on a pilot scale, and little is known about the impact of the interventions. There is a need to develop strategies for vitamin A supplementation and fortification of different foods to reach all areas and individuals in a country.