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Key elements of programme success have included (a) evidence of a 26\u201330% reduction in child mortality from two, in\u2010country randomized trials; (b) strong political and donor support; (c) positioning local female community health volunteers as key operatives; (d) nationwide community mobilization and demand creation for the programme; and (e) gradual expansion of the programme over a period of several years, conducting and integrating delivery research, and monitoring to allow new approaches to be tested and adapted to available resources. The VAS network has served as a platform for delivering other services, including anthelmintic treatment and screening for acute malnutrition. We estimate that VAS has saved over 45,000 young lives over the past 15 years of attained national coverage. Consumption of vitamin A\u2010 and carotenoid\u2010rich foods by children and women nationally remains low, indicating that supplementation is still needed. Current challenges and opportunities to improving vitamin A status include lower VAS coverage among younger children (infants 6\u201311 months of age), finding ways to increase availability and access to dietary vitamin A sources, and ensuring local programme investments given the recent decentralization of the government.<\/jats:p>","DOI":"10.1111\/mcn.12954","type":"journal-article","created":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T13:45:59Z","timestamp":1582897559000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["To see, hear, and live: 25 years of the vitamin A programme in Nepal"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5917-4126","authenticated-orcid":false,"given":"Andrew L.","family":"Thorne\u2010Lyman","sequence":"first","affiliation":[{"name":"Center for Human Nutrition, Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedar","family":"Parajuli","sequence":"additional","affiliation":[{"name":"Nutrition Section, Family Welfare Division Ministry of Health and Population Nepal Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Paudyal","sequence":"additional","affiliation":[{"name":"UNICEF Nepal Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Chitekwe","sequence":"additional","affiliation":[{"name":"UNICEF Nepal Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Nepali Technical Assistance Group Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dibya Laxmi","family":"Manandhar","sequence":"additional","affiliation":[{"name":"UNICEF Nepal Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9458-362X","authenticated-orcid":false,"suffix":"Jr","given":"Keith P.","family":"West","sequence":"additional","affiliation":[{"name":"Center for Human Nutrition, Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32129-3"},{"key":"e_1_2_9_3_1","unstructured":"Beaton G. 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