Researchers in the Democratic Republic of the Congo asked government health leaders and program managers whether giving children vitamin A supplements is still the best way to fight vitamin A deficiency. While everyone agreed the supplements help prevent serious health problems, they disagreed about whether this approach is still necessary or if other methods—like adding vitamin A to everyday foods or helping families eat more vitamin A-rich foods—might work better. The study shows that even though vitamin A supplements are helpful, leaders want more recent information about how many children actually lack vitamin A before deciding on the best strategy.

The Quick Take

  • What they studied: Whether vitamin A supplement programs are still necessary and effective in the Democratic Republic of the Congo, based on what government health leaders and program managers think
  • Who participated: 25 health officials and program planners working at different government levels in the Democratic Republic of the Congo—from national leaders down to local health zone managers
  • Key finding: Everyone agreed vitamin A supplements help children stay healthy and prevent blindness and serious infections, but they disagreed about whether supplements are still the best approach or if other methods like food fortification might be better and more affordable
  • What it means for you: If you live in or work with communities in the DRC, this suggests that vitamin A programs may need to change. Rather than just giving pills, programs might focus more on helping families eat foods naturally rich in vitamin A. However, more recent research is needed before making major changes to current programs.

The Research Details

Researchers conducted one-on-one interviews with 25 health leaders and program managers in the Democratic Republic of the Congo. They asked open-ended questions about their views on vitamin A supplement programs—what’s working, what’s not, and whether other approaches might be better. The researchers then looked for common themes and patterns in what people said.

This qualitative approach is like having a conversation rather than giving a survey with yes/no answers. It allows researchers to understand the ‘why’ behind people’s opinions and uncover real-world challenges that numbers alone might miss. The researchers talked to people at three different levels: national government, provincial government, and local health zones, to get a complete picture of how the program actually works.

The interviews were analyzed by looking for repeated ideas and themes that emerged from what participants said. This helps researchers understand not just what people think, but why they think it and what concerns them most.

This type of research is important because it captures the real-world perspective of people actually running health programs. They see daily challenges like supply shortages and staff motivation that don’t show up in statistics. Understanding their viewpoints helps policymakers make better decisions about whether to continue, change, or replace current programs. Since the last real data on vitamin A deficiency in the DRC is from 1998—over 25 years old—getting input from experienced leaders is crucial for deciding what to do next.

This study has both strengths and limitations. The strength is that it directly asks the people responsible for these programs what they think and experience. The limitation is that it’s based on opinions rather than hard data about how many children actually have vitamin A deficiency today. The sample size of 25 people is reasonable for this type of qualitative research, but the findings reflect what these specific leaders think, not necessarily what’s true about vitamin A deficiency rates. The study doesn’t measure actual vitamin A levels in children or track health outcomes—it’s purely about what program leaders believe and perceive.

What the Results Show

All 25 participants agreed that vitamin A supplements are important for reducing childhood illness and death, and for preventing blindness. This shows strong consensus that the supplements themselves are beneficial and worth continuing.

However, when asked whether the supplement program should continue as-is, opinions split. Some leaders believed the program should definitely continue because vitamin A deficiency is still a serious problem. Others suggested that instead of giving supplements, it might be better to focus on making sure families eat more foods naturally containing vitamin A, or to add vitamin A to foods people already eat regularly (called fortification).

A major theme that emerged was the practical challenges of running the program. Leaders mentioned problems like not having enough supplements in stock, difficulty getting healthcare workers motivated to distribute them, and challenges in communicating to families why the supplements matter. These real-world obstacles were seen as just as important as the question of whether supplements are still needed.

Participants emphasized that any decision about vitamin A programs should be based on current, accurate information about how many children in the DRC actually have vitamin A deficiency today. Since the most recent national survey was from 1998, leaders felt they were making decisions without good current data. They also noted that alternative approaches like food fortification and promoting vitamin A-rich foods might be more cost-effective and sustainable long-term, especially if vitamin A deficiency rates have decreased since 1998.

Previous research has consistently shown that vitamin A supplements save lives and prevent blindness in children, especially in countries where vitamin A deficiency is common. This study doesn’t contradict that—participants agreed supplements work. However, this research adds an important question: if vitamin A deficiency rates have dropped since 1998, are supplements still the best use of limited health resources? Some countries have shifted toward food fortification and dietary improvement as vitamin A deficiency rates decline, and some DRC leaders are suggesting the same approach.

The biggest limitation is that this study is based on what leaders think and believe, not on actual measurements of vitamin A deficiency in children today. We don’t know if their perceptions match reality. The study also only includes 25 people from one country, so the findings may not apply elsewhere. Additionally, the study doesn’t measure whether the supplement program actually improved health outcomes or whether alternative approaches would work better. Finally, since this is based on interviews, people might have given answers they thought researchers wanted to hear rather than their true opinions.

The Bottom Line

Based on this research, the recommendation is NOT to immediately stop vitamin A supplements (moderate confidence). Instead, the DRC should: (1) Conduct a new survey to measure actual vitamin A deficiency rates in children today, (2) Continue supplements while gathering this data, (3) Explore and pilot alternative approaches like food fortification and promoting vitamin A-rich foods, and (4) Address practical problems like supply shortages and staff motivation. These steps should happen together, not one at a time.

This research matters most to: government health officials and policymakers in the DRC deciding how to allocate health resources; international health organizations working in the DRC; and health workers implementing vitamin A programs. It’s less directly relevant to individual families, though it could eventually affect what health services are available. People in other countries with similar vitamin A deficiency challenges might also find this useful.

If the DRC decides to shift toward food fortification and dietary improvement instead of supplements, changes would likely take 2-3 years to plan and implement. Benefits from improved diet would take several months to show up in children’s health. Any new survey to measure current vitamin A deficiency rates would take 6-12 months to complete. This is not a quick fix—it requires careful planning and data collection first.

Want to Apply This Research?

  • For health workers: Track vitamin A supplement distribution rates weekly (number of children who received supplements divided by number eligible), and note any supply shortages or staffing challenges. For families: If using a nutrition app, track consumption of vitamin A-rich foods like orange vegetables, leafy greens, and eggs to monitor dietary intake.
  • Health programs could use an app to: (1) Send reminders to healthcare workers about supplement distribution days, (2) Track which communities have received supplements and which haven’t, (3) Provide education materials about vitamin A-rich foods families can afford and access locally, and (4) Monitor feedback from health workers about real-world challenges like supply issues.
  • Long-term, programs should track: monthly supplement distribution numbers, quarterly surveys of health worker motivation and challenges, annual assessments of vitamin A-rich food availability and affordability in communities, and periodic measurements of actual vitamin A levels in children (every 3-5 years). This creates a complete picture of whether the current approach is working or whether alternatives should be tried.

This study reflects the opinions of health leaders in the Democratic Republic of the Congo and does not provide current data on actual vitamin A deficiency rates. Decisions about vitamin A supplementation should be made by qualified health professionals and government health authorities based on current scientific evidence and local health data. This research is informational only and should not replace professional medical advice or official health policy guidance. Parents and caregivers should follow recommendations from their local health authorities regarding vitamin A supplementation for children.