Context
According to the 2022 SMART national nutritional survey, 26% of children in Guinea under 5 years of age are stunted. Guinea conducts two Vitamin A Supplementation (VAS) campaigns annually for children aged 6 to 59 months, with more than 90% administrative coverage. These campaigns are combined with deworming using Mebendazole for children aged 12 to 59 months and retroactive birth registration for children under 6 months.
Despite high administrative coverage, the 2022 SMART survey showed that effective national VAS coverage is 66.4%. A Post Event Coverage Survey (PECS) conducted in 2024 showed that 84.6% of children received VAS, compared to 106% administrative coverage. Pilot projects for the routinization of VAS were postponed to 2025 due to coordination challenges.
In 2024, the project maintained a focus on the interoperability strategy, integrating VAS, deworming, catch-up vaccination for under-vaccinated children, and birth registration. Two major changes were introduced: the finalization of the transition plan to routine VAS and the development of the Routine VAS Implementation Guide, and the digitalization of VAS data through the DHIS2 platform.
Increased coverage of VAS in girls & boys under age 5
In 2024, Guinea conducted two VAS campaigns. In the first semester, 2,803,411 out of 2,649,061 expected children aged 6 to 59 months (106% coverage) received VAS, including 1,514,161 girls (54%) and 1,289,250 boys (46%). VAS coverage disaggregated by gender was 110% among girls and 102% among boys. Age-specific coverage was 104% among children aged 6 to 11 months and 106% among children aged 12 to 59 months.
In the second semester, 2,886,505 out of 2,649,061 children aged 6 to 59 months (109% coverage) received VAS, including 1,409,517 girls (54%) and 1,210,288 boys (46%). Deworming coverage reached 2,404,255 children aged 12 to 59 months (102% of target), a significant increase from 75% in 2023.
The equity analysis showed that in the first semester, 100% (38) of health districts conducted the VAS campaign, with 37 out of 38 districts achieving coverage rates above 80%. In the second semester, 100% of health districts conducted VAS campaigns, up from 82% in 2023, with all achieving coverage rates above 80%.
Advocacy efforts encouraged the government to mobilize additional funds through the African Childhood Partnership and the World Bank project. Preparation for pilot integration of VAS into routine services in two regions was initiated to ensure continuity and health system ownership.
The VINA project supported the involvement of political and administrative authorities in official launch events across all prefectures, ensuring broad mobilization and maintaining coverage above 85% during both rounds.
In 2024, 5,809 out of 6,270 targeted community volunteers (93%) were trained on gender and equity aspects of VAS, including 2,469 women (42%) and 3,361 men (58%). This represents an increase of nearly 150% in women's participation compared to 2023.
Additionally, 2,166 health workers (30% female) and 1,468 supervisors were involved in VAS activities. Gender-sensitive training contributed to increased female participation and improved gender-balanced service delivery.
Increased empowerment in VAS programming for women with children under age 5
UNICEF trained 935 women’s groups in 67 municipalities to enhance their ability to support VAS outreach and mobilization. Parental sensitization efforts reached 706,989 individuals (42% men and 58% women) per campaign round, though this represents a decline from 80% in 2023 to 36% in 2024.
Community volunteers supported outreach activities, helping to improve VAS coverage and sustain positive health behaviors. Efforts were made to align VAS with maternal and child health services, birth registration, and social protection initiatives.
Community campaigns targeted fathers’ participation in child health and nutrition. In 2024, 296,935 out of 706,989 parents sensitized were fathers. Efforts focused on encouraging male involvement in health decision-making.
Community volunteers played a key role in outreach and mobilization for VAS uptake. 935 women’s groups were engaged, and a U-Report survey of 1,837 youth (71% men, 29% women) showed that 87% were aware of VAS but only 82% ensured their children received services.
Lessons learned
- Multisectoral coordination improved VAS outcomes by combining supplementation with immunization and birth registration.
- Increased women’s participation in VAS programming enhanced outreach and equity.
- Community-level mobilization through local influencers and health workers increased acceptance and demand for VAS.
- Digital platforms like U-Report helped improve real-time monitoring and engagement.
Key Challenges and mitigation measures
Challenges included reliance on external funding, stockouts due to uneven distribution, and weak integration into routine health services. Mitigation measures included increased advocacy, improved supply chain planning, and strategic alignment with maternal and child health services.