What is obaapaVita?

ObaapaVitA is a cluster-randomised, double-blind, placebo-controlled trial to evaluate the impact of weekly vitamin A supplementation on maternal mortality in rural Ghana.

Why carry out the study?

Worldwide, there are around 600,000 pregnancy-related deaths each year, and inequalities in maternal deaths between rich and impoverished nations remain as wide as ever. One of the major objectives of the United Nations’ Millennium Development Goals is to reduce maternal mortality but effective, affordable interventions to achieve this remain elusive.

Vitamin A deficiency is an important nutritional problem in many developing countries, and young children with vitamin A deficiency are known to be at a markedly increased risk of death. It has been consistently shown that vitamin A supplements dramatically reduce this risk in children between the age of 6 months and 5 years, and supplementation in these age groups is now a cornerstone of child health programmes in many countries (including Ghana).

The potential link between vitamin A deficiency and maternal mortality has received much less attention. To date, there has only been one clinical trial that has evaluated the impact of vitamin A supplementation on pregnancy-related deaths. This study, which was carried out in rural Nepal, found that giving a weekly dose of vitamin A (as either retinol or its precursor, beta-carotene) to all married women aged between 15 and 45 years reduced pregnancy-related mortality by around 40%. If the effect is real, Vitamin A supplementation could become an important part of Safe Motherhood programmes. If the effect is not real, there is a danger that other Safe Motherhood interventions could be abandoned in favour of Vitamin A.

The ObaapaVitA study therefore aims to replicate the design of the Nepal study, to enable us to provide further evidence of whether weekly vitamin A supplements have worthwhile benefits for women of childbearing age and their infants. A further study of the association is also being conducted in Bangladesh and it is hoped that the results of the three trials, when examined together, will inform Safe Motherhood policies in Ghana and worldwide.