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1.1 BACKGROUND<br />

1.1.1 Introduction<br />

CHAPTER 1.<br />

LITERATURE REVIEW<br />

1<br />

1. Literature review<br />

Vitamin A deficiency is a major public health issue in developing countries; with<br />

children <strong>and</strong> pregnant/lactating women the most vulnerable (FAO/WHO 2002). Sub-<br />

Saharan Africa is one <strong>of</strong> the most affected areas with 33 million pre-school children who<br />

are deficient, which accounts for a third <strong>of</strong> the world cases (West 2002).<br />

There are different strategies to tackle vitamin A deficiency. Traditional interventions<br />

consist <strong>of</strong> administration <strong>of</strong> vitamin A capsules. Although a single dose can be given<br />

every six months or every year, these medical interventions are costly (Nestel et al.<br />

2006). Food fortification is another approach used to reduce vitamin A deficiency that<br />

works by adding vitamin A to food commodities (e.g. sugar). An alternative approach is<br />

bi<strong>of</strong>ortification, which consists <strong>of</strong> breeding staple crops to increase their content <strong>of</strong><br />

vitamins <strong>and</strong>/or minerals. Compared to the two other strategies, bi<strong>of</strong>ortification is<br />

considered a more sustainable approach because it has the potential to provide vitamins<br />

or minerals throughout the year with a one-<strong>of</strong>f intervention <strong>and</strong> in the longer term at<br />

lower cost (Kósambo et al. 1998). For the same level <strong>of</strong> impact on public health, the cost<br />

<strong>of</strong> bi<strong>of</strong>ortification is estimated to be half that <strong>of</strong> vitamin A supplementation (Nestel et al.<br />

2006). Moreover, rural <strong>and</strong> low-income communities, which have been shown to be<br />

more at risk, can be reached by this approach <strong>and</strong> it also creates opportunities for income<br />

generation from production <strong>and</strong> marketing <strong>of</strong> these crops.<br />

Sweet potato is a very important crop that is widely consumed in sub-Saharan Africa <strong>and</strong><br />

Ug<strong>and</strong>a one <strong>of</strong> the major producers (Woolfe 1992). In sub-Saharan Africa the majority<br />

<strong>of</strong> sweet potato that is consumed is white-fleshed <strong>and</strong> has low levels <strong>of</strong> provitamin A (β-<br />

carotene) (Ameny <strong>and</strong> Wilson 1997). There are efforts through the Vitamin A<br />

Partnership for Africa (VITAA) Initiative <strong>and</strong> also through a Bill <strong>and</strong> Melinda Gates

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