Objective: To demonstrate the effectiveness of the commercial introduction of red palm oil (RPO) as a source of vitamin A (VA) for mothers and children in a nonconsuming area, as a dietary diversification strategy. Design: A pre -post intervention design (no control area) was used to assess changes in VA intake and status over a 24-month pilot project. Setting and subjects: The pilot project involved RPO promotion in 10 villages and an urban area in east-central Burkina Faso, targeting approximately 10 000 women and children aged , 5 years. A random sample of 210 mother -child (12 -36-months-old) pairs was selected in seven out of the 11 pilot sites for the evaluation. Results: After 24 months, RPO was reportedly consumed by nearly 45% of mothers and children in the previous week. VA intake increased from 235^23 mg retinol activity equivalents (RAE) to 655^144 mg RAE in mothers (41 to 120% of safe intake level), and from 164^14 mg RAE to 514^77 mg RAE in children (36 to 97%). Rates of serum retinol , 0.70 mmol l 21 decreased from 61.8^8.0% to 28.2^11.0% in mothers, and from 84.5^6.4% to 66.9^11.2% in children. Those with a lower initial concentration of serum retinol showed a higher serum retinol response adjusted for VA intake. Conclusions: Commercial distribution of RPO was effective in reducing VA deficiency in the pilot sites. While it is promising as part of a national strategy, additional public health and food-based measures are needed to control VA malnutrition, which remained high in the RPO project area.

Objective: To assess the effectiveness of a behaviour change approach, with or without financial support, in improving vitamin A (VA) intake and serum retinol concentration through mango and liver consumption by children. Design: A parallel design (no control area) was used to assess changes in VA intake and serum retinol over a 15-week period. Setting and subjects: A pilot study was implemented in the Department of Kokologho, a rural area in central west Burkina Faso. One hundred and fifty children aged 2-3 years were randomly selected and assigned to two treatment groups: PA$$ (promotional activities and financial support) and PA (promotional activities). Results: The intervention significantly increased (P , 0.001) total VA intake by 56% in PA$$ and by 50% in PA. VA intake from liver increased significantly (P , 0.001) from 12.7^23.5 to 155.3^56.3 mg retinol activity equivalents (RAE) in PA$$ and from 21.6^29.7 to 135.3^44.9 mg RAE in PA. Changes in VA intake from liver were significantly higher (P ¼ 0.004) in PA$$ compared with PA. Mean serum retinol concentration increased significantly by 26% (P , 0.001) in PA$$ and 30% (P , 0.001) in PA. Changes in serum retinol concentration (0.13 mmol l 21 in PA$$ vs. 0.17 mmol l 21 and in PA) did not differ significantly (P ¼ 0.455) between groups over the intervention. Conclusion: Promotional activities on mango and liver intake effectively increased VA intake and serum retinol concentrations. Although an additional beneficial effect of financial support on liver intake was observed, this did not translate into a further increase in serum retinol concentration.