Cameroon VITAMIN A IN A NEW AGE, 2024

Increased coverage of VAS in girls & boys under age 5

Despite high coverage during campaigns, some children were missed due to time gaps between campaigns. To address this, the Big Catch-up strategy under the Expanded Programme on Immunization (EPI) was implemented in ten regions, targeting low-performing health districts. A total of 103,655 children (50% girls and 50% boys) were supplemented.

Women's associations in Adamawa Region were engaged to deliver a package of preventative and promotional interventions, reaching 1,256 children aged 6 to 59 months. These efforts led to a 2% increase in VAS coverage among children aged 6 to 59 months. To reduce inequity between urban and rural areas, two strategies were adopted: mapping geographical areas for each distribution and increasing the number of supervisors, reducing the ratio from 1 supervisor for 8-10 teams to 1 for 4-5 teams.

The integration of VAS into routine immunization activities at health facilities has strengthened long-term sustainability. Joint advocacy by the health and nutrition sectors led to the introduction of additional VAS contact points at 18 and 24 months, establishing a total of four contact points between 6 and 24 months. This enables children to receive four out of the nine required doses within the first 1000 days of life.

As a result of this integration, the number of children aged 12 to 23 months reached through routine services increased from an average of 13,720 in 2023 to 374,400 in 2024. A rapid bottleneck analysis in Bertoua and Garoua Boulaye health districts identified key barriers, including irregular service provision, stock-outs of vitamin A capsules, and missed opportunities where VAS was not administered during health facility visits.

Campaigns provided key opportunities to build the capacity of social mobilizers and distributors on VAS delivery. In the first semester of 2024, 31,652 social mobilizers and 37,338 distributors were trained. During the second campaign, 32,972 social mobilizers and 38,204 distributors were trained, contributing to a 12-percentage point increase in VAS coverage.

Additionally, 100 members of the women's association were trained on VAS as part of the healthcare package they deliver. This training improved the reach and quality of VAS services by addressing gender-based barriers.

Increased empowerment in VAS programming for women with children under age 5

Women’s associations played a significant role in improving access to VAS. In Adamawa Region, they reached 109,260 caregivers, including 69,030 women, with key messages on infant and young child feeding (IYCF), diet diversity, and the importance of VAS. Within the Big Catch-up strategy, 1,013,557 people were sensitized on immunization and VAS, with 56% being women.

The integration of VAS with IYCF, immunization, and social protection services ensured continuity of care. Mothers were supported to track their children's immunization and supplementation status using health cards. Routine healthcare visits reinforced the importance of VAS and provided opportunities to deliver other essential services.

Gender barrier analysis explored the role of fathers in improving access and utilization of VAS and immunization services. Recommendations from this analysis will inform activities targeting fathers in 2025 to increase their involvement in shared care responsibilities.

Women and youth networks were engaged to deliver VAS and advocate for better coverage. Future plans include expanding this approach to other regions and leveraging the Adolescent Global Girl Leaders Advisory Group to increase youth participation.