Shazia’s story: Vitamin A Supplementation during COVID-19 in Pakistan

Shazia Amjad

Since the COVID-19 pandemic began, frontline health workers in Pakistan like Shazia Amjad have been working tirelessly to combat fear and stigma, dispel myths, and keep people informed. As a Lady Health Worker (LHW), Shazia provides essential health and nutrition services to the Ravi Town area of Lahore, Pakistan.

Growing up, Shazia always felt a calling to serve her community. She has been promoting nutrition, specially for infants and young children, in Ravi Town for nearly 20 years. In that time, she has counselled countless families—particularly women—on safe pregnancy, healthy delivery and postnatal care, and optimal infant and young child feeding practices. When the pandemic disrupted vital health and nutrition services, Shazia endeavoured to reach as many children as possible with critical vitamin A supplementation (VAS).

In Pakistan, 51.5 percent of children suffer from vitamin A deficiency (VAD)[1]. According to the World Health Organization, VAD can cause blindness and increase the risk of illness and death from common childhood conditions like diarrhoea and measles.

In 1998, with Nutrition International’s  support, the Government of Pakistan took the decision to carry out the Polio Plus Campaign, which co-delivers VAS to children 6-59 months of age during the National Immunization Days (NIDs). Since that time, as part of the NI’s global capsule donation program, Nutrition International has provided over 1 billion vitamin A capsules to the Government of Pakistan, including almost 80 million capsules in 2020. Distributed twice a year, these essential doses deliver lifesaving vitamin A to more than 32.5 million children in the country each year.

But when the global COVID-19 pandemic struck in March, Pakistan’s NIDs ground to a halt. At the same time, the government implemented restrictions to contain the virus, which required people to limit social interactions and rely on technology and online platforms more than ever before. Many vulnerable households in Pakistan do not have access to the internet, leaving them unable to access vital information on nutrition and health.

To address these issues, Nutrition International advocated with the government to adapt the VAS program according to the new COVID-19 protocols and regulations. We worked with district focal persons to raise awareness about the new VAS guidelines and shared information with frontline health workers.

Delivering healthcare on the front lines of the pandemic

These new guidelines proved useful for LHWs like Shazia. When the pandemic delayed the NIDs, she began going door-to-door to record COVID-19 cases and deliver VAS and polio vaccines to children under five. At every visit, she educates caregivers on the importance of VAS, emphasizing that vitamin A helps boost immunity, which is especially important during the pandemic.

Shazia meticulously recorded every child who missed their vaccination, and who she was able to reach. The families that Shazia serves can’t afford nutritional supplements or a trip to the doctor if their children get sick. To them, Shazia is more than a health mentor—she’s a blessing.

“The present time is precarious, and COVID-19 requires us all to be cautious,” says Shazia. “My community is even more vulnerable now due to decreased access to health services. Without frontline health workers, they would have nobody to counsel them on health and nutrition, which is of utmost importance during this pandemic.”

VAS champion an inspiration to her colleagues

Shazia efforts have motivated her colleagues at the Integrated Reproductive, Maternal, Newborn, Child Health and Nutrition program in Punjab. Her supervisors hope every LHW will follow her lead and deliver vitamin A to all children in the province.

Nutrition can’t wait—especially in a global pandemic. VAS programs are lifesaving interventions and must be carried out as planned. With government support and the efforts of dedicated champions like Shazia, Pakistan will be able to reduce the burden of malnutrition and reach every single child in the country.

[1] National Nutrition Survey 2018