Effective prevention of vitamin A deficiency (VAD) requires repeated administration of vitamin A every three to four months. This report summarizes some of the challenges that we have encountered in achieving this goal in rural Haiti, and suggests a new approach for vitamin A distribution involving Geographic Information Systems technology and a rotation of home visits. Consistency is one of the most valued but least achieved goals for community health. Preventative healthcare, growth surveillance, vaccinations, elimination of intestinal parasites, and vitamin A distribution are all examples of community health practices in which repeated patient contact is essential for success. In the case of preventing VAD, dosing intervals have been established to maintain adequate body stores of vitamin A while still preventing vitamin A toxicity. Current vitamin A dose recommendations are calculated such that a single dose will alleviate VAD for 3–4 months. Maximal benefit is most likely to be achieved, however, by sustaining maintenance of body stores over a much longer period of time. To meet this goal, repeated interval dosing is obviously necessary.
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