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Combined data on micronutrient deficiencies (and underweight prevalences) were previously assembled for the Micronutrient Report in 2001 published by the Micronutrient Initiative and the International Development Research Centre. To update these data and understand recent trends we carried out a global survey of national micronutrient programs and survey results from 2001 to 2003 mainly through e-mail contact with governmental United Nations and nongovernmental offices in some 100 developing countries (referred to below as the "country survey"). The published literature and unpublished material were searched by various means including through on-line databases and web searching. The results described here were first used for the publication on "Vitamin and Mineral Deficiency" issued by Micronutrient Initiative and UNICEF in 2004 for which an early draft of the present results was provided. This document now presents the results on prevalences at the national regional and global (all developing countries) levels with further detail. Here the methods are recorded and the estimates are provided in tables figures and annexes. The information from countries responding to the questionnaire in the country survey (49 replied with new data) are available on file and certain of these have been transferred to the Web. (excerpt)

The following are summaries of country case studies that were presented at a workshop on "Successful Micronutrient Programs" held at the International Union of Nutritional Sciences Vienna August 2001. In the past decade Bangladesh has made substantial improvement in food production. However people still suffer from imbalance in nutrient intake characterized by protein and micronutrient deficiencies. From 1991 to 1999 among children under five years of age the prevalence of stunting decreased from 71% to 55% and the prevalence of underweight decreased from 72% to 61%. Women had in 1991-1999 an average pregnancy weight gain of less than 6 kg. Over half of the adult population was undernourished during this time with 10% suffering from severe malnutrition. (excerpt)

Micronutrient-deficiency control programs have been greatly extended at the national level in the last 10 to 15 years. However, rigorous evaluations of these are scarce, so that conclusions on impact are tentative and based mainly on indirect evidence. The coverage of vitamin A capsule distribution programs has exceeded 70% in most study countries. In countries implementing national iodized salt programs, the coverage reaches 60% to 90% of households with adequately iodized salt. Of the three micronutrients, coverage of iron tablet supplementation is the least well documented due to inadequate program monitoring systems and population survey data. Supplementation of preschool children 6 to 59 months of age with vitamin A capsules has plausibly contributed to the reduction in clinical vitamin A deficiency and its near-elimination in many countries. The impact of vitamin A capsule supplementation on children's biochemical vitamin A status (serum retinol) in national programs may be less. National data on salt iodization show a consistent relation to reduced prevalence of iodine-deficiency disorder symptoms (goiter); the rates of cretinism and other results of iodine deficiency are almost certainly falling too. The evaluation of the impact of salt iodization programs on biochemical iodine status is limited by a lack of data. Although trials have demonstrated the efficacy of iron supplementation in reducing the prevalence of anemia, the interpretation of national-level data is not so clear. Given the substantial financial and technical commitment required to implement national micronutrient-deficiency control programs, it is vital that investment enable the evaluation of the impact of these programs. It is becoming increasingly important to collect data on subclinical deficiency (e.g., biochemical data) to assess program impact.