284. The MoHS’s Directorate of Food and Nutrition, with support from WHO, UNICEF and other development partners incorporated credited nutrition sessions into allied health services training curricula which includes midwifery, nursing and community based maternal and child health workers. This is an effort to ensure that all health personnel have adequate knowledge and skills to provide nutrition services prior to their deployment. 285. Accumulatively, coverage of nutritional interventions has improved as a result of the innovative community-based service delivery models and children’s nutritional status, although still tenuous, has improved. 286. There has been a significant increase in Vitamin A supplementation coverage of children aged 6-59 months since 2005 from 49 percent to 91 percent in 2010. The coverage does drop off after 6 months however. The lowest coverage is recorded between the ages of 6 and 11 months (76 percent) (Statistics Sierra Leone and UNICEF, 2011). There is also variation in coverage, with coverage dropping as low as 36 percent in hard to reach areas. 287. A high coverage (>90 percent) of Vitamin A supplementation (VAS) has been achieved, particularly as a result of the MCHWs. Nevertheless, the coverage of routine VAS is insufficient (36 percent) especially in head-to-reach areas. A high number of children are breastfed in Sierra Leone – up to 97 percent of women continue breastfeeding until their children are 11 months old and up to 55 percent until the child is 23 months old. Exclusive breastfeeding rates are lower – only 32 percent of children are exclusively breastfed until the age of 6 months. However, only 24 percent are given appropriate and adequate complementary food necessary for proper growth and development between the ages of 6-23 months – a key factor in the high levels of malnutrition in children under 5 years (Statistics Sierra Leone and UNICEF, 2011) (Statistics Sierra Leone, 2014). 288. There has been a marginal drop in the rate of stunting among children. In 2005 40 percent and 20 percent of children were moderately and severely wasted. These rates dropped by 2 percent to 38 percent and 18 percent respectively in 2013 (Statistics Sierra Leone, 2006) (Statistics Sierra Leone, 2014). However, the prevalence of wasting among children has remained unchanged and consistently high – with approximately 9 percent of children under the age of 5 years wasted and 4 percent severely wasted in 2013 (Statistics Sierra Leone, 2014). 289. The MoHS is taking a number of steps to improve the nutritional status of its children. It is, with the support of its development partners, conducting a national micronutrient survey to establish the levels of micronutrient deficiencies and inform development of policies and strategies. It is also focusing on scaling up training and the roll out of mothers groups in remote areas to continually address programmatic coverage and advocacy gaps. At a more systemic level, the MoHS is in the process of developing an infant and young child feeding strategy which aims to reduce stunting through an integrated multi-sectoral food and nutrition security implementation plan. Expanded Programme on Immunization 290. 78  The MoHS’s Expanded Programme on Immunization (EPI) is aimed at children under the age of one year old, adolescents and women of childbearing age (15-49 years). Government of the Republic of Sierra Leone Initial Report on the African Charter on the Rights and Welfare of the Child 2002-2014