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is a major public health problem in low- and middle-income countries&#44; affecting 190 million children&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">6</span></a> In 2013&#44; 29&#37; of the children in these countries had VAD&#46; In the same year&#44; 94&#44;500 deaths from diarrhea and 11&#44;200 deaths from measles were attributed to VAD&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">7</span></a> In Brazil&#44; data from a national survey carried out in 2006 showed a prevalence of 17&#46;4&#37; in children under 5 years of age&#44; with this prevalence being 19&#46;0&#37; in the northeast of the country&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The main consequences of VAD are blindness and immune system impairment&#44; contributing to an increase in the prevalence of diarrheal and infectious diseases&#44; mortality rate&#44; and demand for health services&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a> Additionally&#44; due to its participation in several metabolic processes&#44; VAD has been associated with other disorders&#44; such as anemia&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">10</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In 2005&#44; the National Vitamin A Supplementation Program &#40;Programa Nacional de Suplementa&#231;&#227;o de Vitamina A &#91;PNVITA&#93;&#41; was implemented in Brazil with the aim of reducing the prevalence of hypovitaminosis A in the most susceptible individuals&#44; such as children aged 6 to 59 months&#46; The program main action consists of bi-yearly supplementation with vitamin A megadoses&#46; In parallel&#44; nutrition education &#40;NE&#41; actions are recommended to improve vitamin A intake through food consumption&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">9&#44;10</span></a> However&#44; no strategies related to program evaluation activities have been defined&#44; which is why&#44; perhaps&#44; there are so few works in the literature<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">1&#44;11&#8211;13</span></a> that address this issue&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Even though PNVITA has been in operation since 2005&#44; subsequent studies have found high prevalence rates of VAD&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#44;15</span></a> In the state of Alagoas&#44; located in the semi-arid region of Brazil&#44; there was a prevalence of 45&#46;4&#37; in preschool children in 2007&#44; which suggests the existence of problems in the program&#39;s performance&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">15</span></a> Identifying these problems is of great relevance for the evaluation and reorganization of PNVITA actions&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The aim of this study was to estimate the PNVITA coverage in children from Alagoas&#44; identify factors associated with this coverage&#44; and analyze the adequacy of the nutrition education actions&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Sampling plan and data collection</span><p id="par0035" class="elsevierStylePara elsevierViewall">This was a cross-sectional study of data from a survey called &#8220;II Health Diagnosis of the Maternal-Child Population of the State of Alagoas&#44;&#8221; in which the variable of interest used in sample size calculation was food insecurity in Alagoas&#44; estimated at 34&#46;7&#37;&#46; The other parameters were&#58; population of 841&#44;117 families&#44; sampling error of 2&#46;0&#37;&#44; 120 conglomerates &#40;census sectors&#41;&#44; and 1&#46;5 for correction of the complex design effect&#46; Thus&#44; for a 95&#37; CI and after including 10&#37; to cover possible sample losses&#44; 3&#44;696 families were required&#46; A detailed description of this procedure is available elsewhere&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">For the present study&#44; all children aged 6 to 59 months residing in the randomly selected households were eligible&#44; totaling 509 children&#46; Considering this sample was not initially planned&#44; the sampling error was calculated subsequently&#44; using the StatCalc module of the EpiInfo software &#40;Epi Info&#8482;&#44; a database and statistics program for public health professionals&#46; CDC&#44; Atlanta&#44; GA&#44; USA&#44; 2011&#41;&#46; Based on the coverage rates identified in this study&#44; the analyzed sample number allowed for estimation of the coverage with errors ranging from 2&#46;3&#37; &#40;6-59 months&#41; to 4&#46;2&#37; &#40;12-59 months&#41;&#44; depending on the age group considered&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The fieldwork was carried out by a properly trained and supervised team&#44; from January 2014 to January 2015&#44; through home visits&#44; using structured forms pre-tested in a pilot study carried out in the municipality of Macei&#243; in a low-income neighborhood&#44; which was not part of the census sectors randomly selected for the survey&#46; The tools were prepared by the researchers using the PNVITA Manual of Standards<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> as a reference and critically evaluated by the team after the pilot study&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The study included the children whose mothers agreed to provide information after consenting to participate and signing the informed consent&#44; according to the terms of the project approved by the Research Ethics Committee of Universidade Federal de Alagoas &#40;process No&#46; 09093012&#46;0&#46;0000&#46;5013&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">According to Donabedian&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">18</span></a> the evaluation of a program&#39;s effectiveness can be performed by analyzing its structure&#44; its processes&#44; and the achieved results&#46; Aspects related to the program structure were not assessed in this study&#46; The coverage attained by the program was investigated as a process indicator&#44; <span class="elsevierStyleItalic">i&#46;e&#46;</span>&#44; the proportion of the target population that received vitamin A supplementation according to PNVITA recommendations&#46; Regarding the analysis of the results&#44; the mothers&#8217; level of knowledge about basic information on adequate nutrition was considered&#44; especially those related to the program focus&#58; hypovitaminosis A prevention&#46; The adequacy of this knowledge was assumed as an outcome indicator related to NE activities&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">To define the coverage rate&#44; the proportion of children from the target population who had a record of vitamin A supplementation over the past six months was considered&#44; which is specified in the Program Manual for supplementation&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> This information was obtained by consulting the respective children&#39;s &#8220;health booklets&#46;&#8221;</p><p id="par0065" class="elsevierStylePara elsevierViewall">To analyze the adequacy of the NE actions&#44; the mothers answered questions on aspects they should know about&#44; if they had participated in nutrition education activities included in the program&#44; considering that the &#8220;<span class="elsevierStyleItalic">Promotion of adequate and healthy nutrition&#44; ensuring information to encourage the consumption of foods that are sources of vitamin A by the population</span>&#8221; is part of the PNVITA Manual activities&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> as one of the most important measures for VAD prevention&#46; Aiming to avoid information bias&#44; only the mothers &#40;biological or not&#41; were included in the study&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The question about foods that are rich in vitamin A was presented openly and the interviewee could mention up to three foods&#46; To classify the adequacy of the responses&#44; the PNVITA Manual of Activities<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> was used as reference&#44; which includes the following&#58;</p><p id="par0075" class="elsevierStylePara elsevierViewall">&#8220;Vitamin A is a micronutrient found in animal &#40;retinol&#41; and vegetable &#40;provitamin A&#41; food sources&#46; Among the foods of animal origin&#44; the main sources are&#58; human milk&#44; liver&#44; egg yolk&#44; and milk&#46; Provitamin A is found in green leafy vegetables &#40;such as spinach&#44; kale&#44; purslane&#44; Indian spinach&#44; and mustard greens&#41;&#44; yellow vegetables &#40;such as pumpkin and carrots&#41; and yellow-orange fruits &#40;such as mango&#44; cashew fruit&#44; guava&#44; papaya&#44; and persimmon&#41; in addition to oils and oleaginous fruits &#40;buriti fruit oil&#44; pupunha palm&#44; dende palm oil&#44; and souari nut&#41; which are the richest sources of provitamin A&#8221;&#46;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Socioeconomic&#44; demographic and health assessment</span><p id="par0080" class="elsevierStylePara elsevierViewall">Questions were obtained that were related to demographics &#40;area of residence&#44; child&#39;s gender and age&#44; number of residents per household&#44; maternal age&#41;&#44; socioeconomic factors &#40;maternal level of schooling&#44; <span class="elsevierStyleItalic">per capita</span> monthly family income&#44; number of durable consumer goods&#44; number of rooms in the household&#44; number of rooms used for sleeping&#44; source of the water used for drinking&#44; family enrolled in the government&#39;s income transfer program&#41; and health-related factors &#40;whether the child had had diarrhea in the previous 15 days&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Data analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">The collected data were entered in duplicate in a form created using the Epi Info 3&#46;5&#46;4 software and&#44; after reviewing possible typing errors&#44; the statistical analyses were carried out using Stata software &#40;SPSS for Windows&#44; version 12&#46;0&#46; Chicago&#44; USA&#41;&#46; Categorical variables were compared based on Pearson&#39;s chi-squared test &#40;&#967;<span class="elsevierStyleSup">2</span>&#41;&#46; The prevalence of coverage &#40;dependent variable&#41; according to the different categories of independent variables was compared based on the prevalence ratio &#40;PR&#41; and its 95&#37; confidence interval &#40;95&#37; CI&#41;&#46; The independent variables of which crude PRs indicated association with coverage with a degree of significance of up to 20&#37; &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#46;2&#41; were submitted to the multivariate analysis&#44; gradually excluding those variables with no statistical significance &#40;backward elimination&#41;&#46; The final model included only the variables that reached the significance level of p &#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; The PRs and their respective 95&#37; CIs&#44; both in the crude and adjusted analyses&#44; were calculated by Poisson regression with robust variance adjustment&#46; In all situations&#44; the statistical significance was set at p &#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0090" class="elsevierStylePara elsevierViewall">The analyzed sample consisted of 509 children&#47;mothers&#46; Most of them &#40;74&#46;3&#37;&#41; lived in urban areas&#44; 6&#46;4&#37; of the mothers were adolescents&#44; 28&#46;7&#37; had no access to adequate drinking water&#44; and 12&#46;5&#37; of the families had a <span class="elsevierStyleItalic">per capita</span> monthly family income &#8804; &#189; minimum wage &#40;the minimum wage was R&#36; 724&#46;00&#44; or approximately US&#36; 272&#44; at the time of the study&#41;&#46; Approximately 2&#47;3 of the families participated in the Bolsa Fam&#237;lia Program&#44; the Brazilian government income transfer program&#46; These and other characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#44; which shows that the incidence of diarrhea in the children was 15&#46;8&#37;&#46; Regarding this aspect&#44; there was no difference between children supplemented and not supplemented with vitamin A&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">Of the 509 assessed children&#44; it was observed that 216 of them had a record of vitamin A supplementation at some time in the previous six months&#44; corresponding to a coverage of 42&#46;4&#37;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Considering the age groups with supplementation recommendation by PNVITA&#44; it was verified that the percentage of coverage by the program in children aged 6 to 11&#46;9 months was 91&#46;9&#37;&#44; whereas it was 38&#46;6&#37; in those aged 12 to 59 months of age &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> shows the coverage verified through the present investigation in relation to the results published for the year 2014 by the Ministry of Health &#40;MoH&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">By further stratifying the age groups&#44; it was possible to observe a steady decline in the coverage rate of the program as the children grew older&#59; the coverage rate in the younger children was 91&#46;9&#37;&#44; whereas it was 29&#46;5&#37; in those aged 47-59 months &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The factors that were independently associated&#44; contributing to a greater coverage of PNVITA were between age range between 6 and 11&#46;9 months &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;50&#44; 95&#37; CI&#58; 2&#46;10-2&#46;96&#41;&#44; living in rural areas &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;45&#44; 95&#37; CI&#58; 1&#46;20-1&#46;76&#41; and living in a household with four or fewer rooms &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;33&#44; 95&#37; CI&#58; 1&#46;09-1&#46;63&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the results related to the PNVITA questions applied to the mothers&#46; Only 27&#46;5&#37; had heard about the program&#44; and even so&#44; only 16&#46;5&#37; of them knew about its purpose &#40;curing or preventing vitamin A deficiency&#41;&#46; When asked if they had ever received information about vitamin A&#44; 88 of the 509 respondents answered affirmatively &#40;17&#46;7&#37;&#41;&#46; In this case&#44; the nurse was the professional responsible for providing information in 60&#46;2&#37; of cases&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">It was verified that only 18&#46;2&#37; of the interviewees mentioned at least one vitamin A food source&#44; whether of animal or vegetable origin&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a> and that 80&#46;8&#37; of them did not know of any health problems caused by VAD&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">The goal of PNVITA is to reach 75&#37; coverage for children aged 6 to 11 months and 100&#37; for the first dose and 60&#37; for the second dose in children aged 12 to 59 months&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">20</span></a> Regarding this aspect&#44; the results showed that the program exceeds the goal of coverage in the case of the younger children &#40;91&#46;9&#37;&#41;&#44; but falls short regarding children aged 12 months or older &#40;38&#46;6&#37;&#41;&#46; In this age group&#44; the program recommends supplementation every six months&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">17&#44;21</span></a> Thus&#44; a child that received 100&#37; of the doses according to this recommendation&#44; considering the period comprised between 12 and 60 months&#44; should have received eight doses&#46; Therefore&#44; this study adopted the record of supplementation that occurred in the previous six months as the criterion for defining coverage&#46; Regardless of this methodological divergence&#44; the coverage found herein for most of the assessed children demonstrates the need for investments aiming to improve the program&#39;s reach&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">As for the criterion used by the Ministry of Health when considering the accomplishment of a 1<span class="elsevierStyleSup">st</span> and 2<span class="elsevierStyleSup">nd</span> dose&#44; it appears inconsistent&#44; as the Ministry itself determines that&#58;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">17</span></a><span class="elsevierStyleSup">&#8220;</span><span class="elsevierStyleItalic">Vitamin A supplementation should be offered to children aged 12 to 59 months of age every six months&#46;</span>&#8221; This recommendation is based on the assumption that megadoses are sufficient to ensure a good hepatic retinol reserve for approximately six months&#44; at which time further supplementation should occur&#46; Therefore&#44; the appropriate program implementation should ensure that each child has a recorded supplementation that occurred at most six months before&#46; Thus&#44; the comparison with the MoH data is impaired&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Nevertheless&#44; the coverage reported herein for the assessed age group &#40;38&#46;6&#37;&#41; was lower compared to that reported by the MoH&#58; 70&#46;6&#37; and 41&#46;2&#37;&#44; respectively&#44; for the 1<span class="elsevierStyleSup">st</span> and 2<span class="elsevierStyleSup">nd</span> doses&#46; Considering that this &#8220;1<span class="elsevierStyleSup">st</span> dose&#8221; may have occurred long ago &#40;its benefits would no longer be effective&#41; and that the &#8220;2<span class="elsevierStyleSup">nd</span> dose&#8221; is more likely to have been given more recently&#44; which is closer to the criterion used in this article&#44; it can be observed that the obtained values are very similar&#58; 38&#46;6&#37; and 41&#46;2&#37;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The adequate coverage observed in children aged 6 to 11 months could result from their more frequent contact with the health care services&#46; This age group comprises the target population of several actions implemented in basic health units&#44; such as childcare consultations and visits to comply with the vaccination schedule&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a></p><p id="par0145" class="elsevierStylePara elsevierViewall">As in the present investigation&#44; Almeida et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> in a study carried out in the municipality of Cabedelo &#40;state of Para&#237;ba&#44; Brazil&#41;&#44; also found greater PNVITA coverage in younger children and a declining trend with increasing age &#40;stratified by semesters&#41;&#46; The adequate coverage achieved in younger children is a very interesting aspect&#44; as it provides vitamin A protection precisely to one of the groups biologically more vulnerable to morbimortality due to infections&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">9</span></a></p><p id="par0150" class="elsevierStylePara elsevierViewall">Therefore&#44; despite the excellent coverage observed in the age group of 6 to 11 months&#44; the low coverage observed in children older than 12 months is a matter of concern&#44; which suggests failures in the program&#39;s operation&#46; According to Paiva&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a> a strategy to increase coverage would be to improve the maternal level of information about the program and reinforce actions to increase adherence to scheduled health service visits&#46; Additionally&#44; the active search strategy is an alternative to achieve coverage goals in this age group&#44; since&#44; unlike younger children&#44; those older than 12 months are generally less involved in routine visits to the health services&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">No studies were found on the economic impact of the active search strategy&#46; However&#44; the Ministry of Health itself indicates it as a way to increase program coverage&#44; as it can be incorporated into the routine of the family health teams and allows adjustments in the regularity of supplementation and the NE actions&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">11&#44;12&#44;17</span></a></p><p id="par0160" class="elsevierStylePara elsevierViewall">The present study identified greater coverage of the program in the rural area&#44; a situation that may be related to the more active search of health agents in these areas&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> There is a greater proportion of households registered in the family health units in rural areas in Brazil&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">23</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">Another variable that was associated with greater coverage of the PNVITA was living in a household with up to four rooms&#44; a condition that may reflect unfavorable socioeconomic characteristics of the family and&#44; therefore&#44; would receive greater attention from health professionals&#46; The adverse effect of living in a poor household can be mitigated when individuals receive more attention from the public authorities&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">The variables that were associated with the greater coverage of the PNVITA suggest the adequate focus of the program&#58; children in the most biologically vulnerable age group&#44; living in rural areas&#44; who belong to families with unfavorable socioeconomic characteristics&#46; Incidentally&#44; unfavorable socioeconomic characteristics can interfere in the choice of foods consumed by the families&#44; either due to their purchasing power or as a consequence of the maternal knowledge about adequate foods&#46; Therefore&#44; these children would be more susceptible to an inadequate intake of dietary vitamin A&#46;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">It is part of the regulation that created the PNVITA that&#44; during its operationalization&#44; NE activities should be reinforced&#44; with emphasis on healthy eating promotion&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> To support these activities&#44; several materials are produced &#40;leaflets&#44; posters&#41; containing information about the program&#44; VAD and its consequences&#44; and food sources high in vitamin A&#46; If these resources are reaching the target audience and if the information is being transmitted&#44; regardless of the strategies used &#40;individual guidance&#44; group meetings&#44; lectures&#44; dramatizations&#44; videos&#41;&#44; the mothers should recognize the existence of PNVITA and what its purpose is&#46; However&#44; only 27&#46;5&#37; of them reported having heard of the program&#44; and of these&#44; only 16&#46;5&#37; knew how to correctly answer about its purpose&#46; Most of them reported having watched the administration of vitamin A to the child&#59; however&#44; they were unaware of its connection with the PNVITA&#46; Considering these data and comparing them with the coverage rate observed herein&#44; it is evident that the supplementation activity occurs while dissociated from educational guidelines&#44; which&#44; in addition to being outside the scope of the program&#44; does not provide sustainability to the process&#44; since without an adequate diet&#44; the risk of VAD will always exist and&#44; consequently&#44; the need to maintain supplementation activities&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">In support of these considerations is the fact that only 17&#46;7&#37; of the mothers answered that they had received information about vitamin A&#44; 73&#46;9&#37; did not know any foods rich in vitamin A&#44; and 80&#46;8&#37; did not know at least one consequence of vitamin A deficiency&#46; Similar results were found in a sample of 2&#44;546 children from municipalities located in the state of Bahia&#44; Brazil&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> where 74&#46;6&#37; of the mothers had no knowledge about vitamin A&#46; While studying children from a municipality located in northeastern Brazil&#44; Almeida et al&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a> observed that only 43&#46;5&#37; of the mothers had heard about PNVITA&#59; however&#44; of these&#44; 86&#46;2&#37; did not know about the program&#39;s activities&#46; Moreover&#44; only 22&#46;2&#37; provided a correct answer about some function of vitamin A&#44; and among those who claimed to know the food sources of retinol &#40;40&#46;7&#37;&#41;&#44; only 33&#46;4&#37; correctly mentioned some food with this characteristic&#46; Considering these findings&#44; they stated that the lack of knowledge related to vitamin A may interfere with adherence to PNVITA actions&#44; making it difficult to achieve the established goals&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">The nutritionist is the health professional whose work aims to provide dietary care at the individual or collective level&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a> However&#44; of the mothers who answered they received some information on vitamin A&#44; none of them reported this information was provided by a nutritionist&#46; In this scenario&#44; in 60&#46;2&#37; of the cases&#44; it was the nurse who provided such information&#46; A study including professionals involved in the program operationalization in nine municipalities located in the state of Para&#237;ba identified a low participation of nurses in NE activities&#44; with health agents being the main performers of this activity&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Marques et al&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> used a qualitative approach to identify practices related to PNVITA and disclose maternal social representations about vitamin A&#44; its deficiency&#44; and the program in a municipality located in Vale do Jequitinhonha&#46; It was observed that supplementation has occurred in association with vaccination actions&#44; which may favor an increase in supplementation coverage&#44; but also may result in a passive participation in PNVITA&#44; both by the target population and by the professionals&#44; considering that supplementation is carried out as a secondary action to vaccination and is unaccompanied by an educational process&#44; leading to the formation of distorted ideas&#44; such as that vitamin A is a vaccine&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">The misinformation contributes to bad choices regarding the individuals&#8217; selection of foods&#46; Graebner et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">27</span></a> when investigating children from rural areas of the Federal District&#44; found that&#44; even when they had access to food sources of carotenoids&#44; children had a high prevalence of VAD&#44; which would not occur if these foods were regularly consumed&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Rodrigues and Roncada<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">28</span></a> have stated that&#44; since its implementation&#44; PNVITA&#39;s main emphasis is on the distribution of vitamin A megadoses and that nutrition education activities are far behind the expected due to the lack of skilled human resources and the lack of effective implementation strategies&#46; They believe that as the NE actions develop and are consolidated as part of an intersectoral public health promotion policy&#44; there will be an evolution of the proposed contents and methodologies&#44; which will be incorporated into its practice&#44; promoting healthy eating and preventing not only diseases such as VAD&#44; but also chronic noncommunicable diseases&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The results obtained allow us to conclude that the PNVITA coverage in children aged 12-59 months is below the established goals&#46; However&#44; the factors associated to greater coverage indicate an adequate focus regarding the target population&#46; The NE activities have not demonstrated satisfactory results&#44; jeopardizing the program&#39;s effectiveness&#46; This information should guide health managers and professionals when planning improvement actions for the program&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Funding</span><p id="par0210" class="elsevierStylePara elsevierViewall">This study received financial support from the Brazilian <span class="elsevierStyleItalic">Conselho Nacional de Desenvolvimento Cient&#237;fico e Tecnol&#243;gico</span> &#8211; &#40;National Council for Scientific and Technological Development - CNPq&#41; &#40;process No&#46; 474381 &#47; 2011-0&#41; and the <span class="elsevierStyleItalic">Funda&#231;&#227;o de Amparo &#224; Pesquisa</span> of the state of Alagoas &#40;Alagoas Research Support Foundation&#8211; FAPEAL&#41; under process No&#46; 60030&#46;000716&#47;2013&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interest</span><p id="par0215" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2018-05-06"
    "fechaAceptado" => "2018-08-15"
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            0 => "Public health"
            1 => "Vitamin A"
            2 => "Supplementation"
            3 => "Health evaluation"
            4 => "Brazil"
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            0 => "Sa&#250;de p&#250;blica"
            1 => "Vitamina A"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To estimate the coverage of the National Vitamin A Supplementation Program &#40;Programa Nacional de Suplementa&#231;&#227;o de Vitamina A&#41; in children from Alagoas&#44; to identify factors associated with this coverage&#44; and to analyze the adequacy of nutrition education actions&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Household survey involving a representative probabilistic sample of children aged 6 to 59 months from Alagoas and their mothers &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>509&#41;&#46; Coverage was defined by the percentage of children with supplementation records in the last semester&#46; The association between the independent variables &#40;socioeconomic&#44; demographic&#44; and health&#41; and the National Vitamin A Supplementation Program coverage was analyzed based on the prevalence ratio and its 95&#37; CI&#46; The mothers&#8217; knowledge of questions related to vitamin A was considered as an indicator of the adequacy of nutrition education actions&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Program coverage was 91&#46;9&#37; in children aged 6-11&#46;9 months and 38&#46;6&#37; in children aged 12-59 months&#46; In the adjusted analysis&#44; the factors that were associated with greater coverage were&#58; age between 6-11&#46;9 months &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;50&#44; 95&#37; CI&#58; 2&#46;10-2&#46;96&#41;&#44; living in rural areas &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;45&#44; 95&#37; CI&#58; 1&#46;20-1&#46;76&#41; and living in a house with &#8804; 4 rooms &#40;PR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;33&#44; 95&#37; CI&#58; 1&#46;09-1&#46;63&#41;&#46; Only 26&#46;1&#37; of the mothers were able to mention some food source of vitamin A and only 19&#46;2&#37; were aware of the consequences of vitamin deficiency for health&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The National Vitamin A Supplementation Program coverage is below the targets set by the Ministry of Health &#40;except for children &#60;<span class="elsevierStyleHsp" style=""></span>12 months&#41;&#46; The factors associated with greater coverage indicate an adequate focus of the program&#46; The nutrition education activities have not demonstrated satisfactory results&#46; This information should guide actions to improve the program&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Estimar a cobertura do Programa Nacional de Suplementa&#231;&#227;o de Vitamina A em crian&#231;as de Alagoas&#44; identificar fatores associados a essa cobertura e analisar a adequa&#231;&#227;o das a&#231;&#245;es das a&#231;&#245;es de educa&#231;&#227;o nutricional&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Inqu&#233;rito domiciliar que envolveu amostra probabil&#237;stica representativa das crian&#231;as de 6 a 59 meses de Alagoas e suas m&#227;es &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>509&#41;&#46; A cobertura foi definida pelo percentual de crian&#231;as com registro de suplementa&#231;&#227;o no &#250;ltimo semestre&#46; A associa&#231;&#227;o entre as vari&#225;veis independentes &#40;socioecon&#244;micas&#44; demogr&#225;ficas e de sa&#250;de&#41; e a cobertura do Programa Nacional de Suplementa&#231;&#227;o de Vitamina A foi analisada com base na raz&#227;o de preval&#234;ncia e seu IC95&#37;&#46; O conhecimento das m&#227;es sobre quest&#245;es relacionadas &#224; vitamina A foi assumido como indicador da adequa&#231;&#227;o das a&#231;&#245;es de educa&#231;&#227;o nutricional&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A cobertura do programa foi de 91&#44;9&#37; entre crian&#231;as de 6-11&#44;9 meses e de 38&#44;6&#37; entre as de 12-59 meses&#46; Na an&#225;lise ajustada&#44; os fatores que se associaram &#224; maior cobertura foram ter idade entre 6-11&#44;9 meses &#40;RP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;50&#59; IC95&#37;&#58; 2&#44;10-2&#44;96&#41;&#44; residir em zona rural &#40;RP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;45&#59; IC95&#37;&#58; 1&#44;20-1&#44;76&#41; e morar em domic&#237;lio com &#8804; 4 c&#244;modos &#40;RP<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;33&#59; IC95&#37;&#58; 1&#44;09-1&#44;63&#41;&#46; Somente 26&#44;1&#37; das m&#227;es souberam citar algum alimento fonte de vitamina A e apenas 19&#44;2&#37; conheciam as consequ&#234;ncias da defici&#234;ncia dessa vitamina para a sa&#250;de&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A cobertura do Programa Nacional de Suplementa&#231;&#227;o de Vitamina A encontra-se aqu&#233;m das metas estabelecidas pelo Minist&#233;rio da Sa&#250;de &#40;exceto para crian&#231;as &#60;<span class="elsevierStyleHsp" style=""></span>12 meses&#41;&#46; Os fatores associados &#224; maior cobertura evidenciam adequada focaliza&#231;&#227;o do programa&#46; As atividades de educa&#231;&#227;o nutricional n&#227;o ocorrem de forma satisfat&#243;ria&#46; Essas informa&#231;&#245;es devem nortear a&#231;&#245;es de aperfei&#231;oamento do programa&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0050">Please cite this article as&#58; Lima RB&#44; Ferreira HS&#44; Cavalcante AL&#44; Santos LG&#44; Vieira RC&#44; Assun&#231;&#227;o ML&#46; Coverage and educational actions related to the national vitamin A supplementation program&#58; a study in children from the state of Alagoas&#46; J Pediatr &#40;Rio J&#41;&#46; 2020&#59;96&#58;184&#8211;92&#46;</p>"
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        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0055">Study conducted at Universidade Federal de Alagoas &#40;UFAL&#41;&#44; Faculdade de Nutri&#231;&#227;o&#44; Macei&#243;&#44; AL&#44; Brazil&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0060">Article based on Riquelane Bezerra Menezes Lima&#39;s Master&#39;s Degree Dissertation&#44; from the Postgraduate Program in Nutrition&#44; Universidade Federal de Alagoas&#44; Macei&#243;&#44; AL&#44; Brasil&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">National Vitamin A Supplementation Program coverage in the state of Alagoas&#44; Brazil&#44; in 2014&#44; according to data from the Ministry of Health and a household survey involving children aged 6 to 59 months&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Source&#58; Ministry of Health &#40;Brazil&#44; 2014&#41;&#59; Household survey&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">The results obtained through the household survey in the state of Alagoas for the age group of 12 to 59 months were obtained using a different method from those published by the Ministry of Health&#46; The latter considered the coverage in relation to the accomplishment of a 1<span class="elsevierStyleSup">st</span> and 2<span class="elsevierStyleSup">nd</span> doses of vitamin A supplementation&#46; In the household survey&#44; coverage was defined according to the supplementation record in the child&#39;s &#8220;health booklet&#8221; dated up to six months before the interview&#46;</p>"
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                  \t\t\t\t" scope="col">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">37 &#40;7&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">34 &#40;91&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>12 to 59&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">472 &#40;92&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">182 &#40;38&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">102 &#40;40&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;09 &#40;0&#46;89-1&#46;34&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;377&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Child with diarrhea in the last 15 days &#40;12 mothers &#91;2&#46;4&#37;&#93; could not answer&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;42&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;00 &#40;0&#46;75-1&#46;32&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;985&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">181 &#40;42&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Maternal age &#40;years&#41; &#40;28 mothers &#91;5&#46;5&#37;&#93; did not know&#47;did not want to answer&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 20&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;41&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">450 &#40;93&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Maternal education &#40;in years of study&#41; &#40;32 mothers &#91;6&#46;3&#37;&#93; did not know&#47;did not want to answer&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">238 &#40;49&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">97 &#40;40&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;543&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#62; 8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">239 &#40;50&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">104 &#40;43&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Area of residence</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">131 &#40;25&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">71 &#40;54&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">74 &#40;37&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Family is enrolled in the government&#39;s income transfer program</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">178 &#40;35&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;43&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Per capita monthly family income in number of minimum wages &#40;R&#36;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">&#40;39 mothers &#91;7&#46;7&#37;&#93;&#37; did not know&#47;did not want to answer&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; &#189; MW&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">59 &#40;12&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">24 &#40;40&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;07 &#40;0&#46;77-1&#46;48&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#62; &#189; MW&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">179 &#40;43&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Number of durable consumer goods</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">279 &#40;54&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;04 &#40;0&#46;85-1&#46;28&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;666&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805; 6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">230 &#40;45&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100 &#40;43&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="6" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Number of rooms in the house</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">139&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">In your opinion&#44; what is the purpose of the National Vitamin A Supplementation Program&#63;</span><a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Has the child ever failed to receive the dose of vitamin A because they did not have it in the basic health unit&#63;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">181&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&#47;does not remember&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">318&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Among other things&#44; during this program&#44; has someone from Health Care cut a capsule like this &#40;SHOW IT&#41; containing vitamin A and put it in the child&#39;s mouth&#63; Has your child received this vitamin A in the last 6 months&#46;&#63;</span><a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&#47;does not remember&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">339&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Time since the administration of the last dose &#40;coverage rate&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0040"><span class="elsevierStyleSup">c</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>&#62; 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">293&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8804; 6 months&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">216&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Have you ever received information about vitamin A&#63;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&#47;does not remember&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">409&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Which professional gave you the information&#63;</span><a class="elsevierStyleCrossRef" href="#tblfn0045"><span class="elsevierStyleSup">d</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nurse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Physician&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Nutritionist&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pharmacist&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Health agent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Does not remember&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Which foods are rich in vitamin A&#63;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3 correct answers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2 correct answers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1 correct answer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Errors&#47; Does not know&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">224&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">What health problems can occur when our body lacks vitamin A&#63;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3 correct answers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2 correct answers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1 correct answer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Errors&#47;does not know&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">411&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Frequency of responses given by mothers of children aged 6 to 59 months to questions related to the National Vitamin A Supplementation Program&#46; Alagoas&#44; Brazil&#44; 2015&#46;</p>"
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