Nutrition

2. Scope of document

Define the content, the questions and the likely recommendations

Five recommendations are expected to be produced from the result of this proposed guideline work. These five recommendations will be published in the format of a WHO Position Statement.

The Position Statements will include the following format: 1) purpose 2) background/introduction 3) supportive evidence 4) description of the Technical Consultation convened to agree on the recommendation, 5) recommendations; 6) summary of statement development; 7) conflicts of interest section; 8) plans for update; 9) references and 10) suggested citation.

The five priority questions that have currently been identified include:

  • Effects and safety of neonatal vitamin A supplementation
    • Should vitamin A supplements be given to all apparently healthy newborns to:
      • Reduce infant all-cause mortality (0-6 months; 0-12 months)?
      • Prevent vitamin A deficiency during the first 12 months of life?
      • Reduce infant cause-specific morbidity?
    • If so, at what dose and timing after birth?
  • Effects and safety of vitamin A supplementation in children 6-59 months of age
    • Should vitamin A supplements be given to all apparently healthy infants 6-59 months of age to:
      • Reduce child all-cause mortality (children 6-59 months of age)?
      • Prevent vitamin A deficiency in children 6-59 months of age (as defined by biochemical indicators)?
      • Reduce cause-specific morbidity in children 6-59 months of age?
    • If so, at what dose, frequency and duration for the intervention?
  • Effects and safety of vitamin A supplementation given to postpartum women
    • Should vitamin A supplements be given to all apparently healthy postpartum women to:
      • Improve maternal vitamin A status (as measured by biochemical indicators)?
      • Improve the vitamin A composition of breast milk? (i.e. protect her breastfed child against vitamin A deficiency?)
      • Reduce maternal mortality in the postpartum period?
      • Reduce infant all-cause mortality (0-6 months)?
      • Reduce maternal morbidity?
      • Reduce infant all-cause morbidity (0-6 months)?
    • If so, at what dose, and time after delivery?
  • Effects and safety of vitamin A supplementation for women during pregnancy
    • Should vitamin A supplements be given to all apparently healthy women during pregnancy for optimal pregnancy outcomes?
      • Reduce maternal mortality?
      • Improve vitamin A status at term (as measured by biochemical indicators)?
      • Prevent clinical signs of vitamin A deficiency (night blindness) during pregnancy?
      • Reduce adverse effects during pregnancy (i.e. anaemia)?
      • Improve the vitamin A status of the infant at 3 or 6 months of age (as measured by biochemical indicators)
    • If so, at what dose, frequency and duration for the intervention?
  • Effectiveness and safety of vitamin A supplementation for HIV-infected women during pregnancy
    • Should vitamin A supplements be given to all HIV-infected women during pregnancy to reduce mother-to-child transmission of HIV?
    • If so, at what dose, frequency and duration for the intervention?

The likely recommendations will be either to supplement or not supplement these population groups with vitamin A as a public health intervention in developing countries settings.


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