It’s with some irony that this India special of Sight and Life Magazine coincides with the publication of the Deworming and Enhanced Vitamin A (DEVTA1) study. While the DEVTA study represents an earnest attempt to evaluate a large Government of India program delivering vitamin A to children, it contradicts the results of a number of randomized controlled trials (RCTs) carried out in different regions, which have conclusively demonstrated that vitamin A supplementation to children under the age of five every four to six months results in a 24% reduction in under-five mortality. DEVTA, however, showed only a non-significant 4% reduction in child mortality. The reasons for this lack of effect are likely to be found in how the program was run and evaluated – the problems it experienced are common in large intervention strategies and point to the urgent need for us to consider how scaled-up implementation research should best be undertaken.
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