years of age with refractive errors (visual impairment) that would justify prescribing corrective lenses, and nearly 1,400 the number of children affected with blindness.14 264.The main causes of preventable blindness in children are vitamin A deficiency, complications of measles and neonatal infection. The EDSMD 2008-2009 estimated that 72% of children aged 6 months to under 5 years had received a dose of Vitamin A in the 6 months preceding the survey. 265.Since 1998, the fight against vitamin A deficiency is focused on the distribution of this vitamin for children from 6 months to under 5 years periodically. Biannual campaigns are organized to raise awareness, resulting in a significant reduction in childhood blindness by vitamin A deficiency from 13.7% to 0.34%. 266. The specific objectives of the National Sight Health Programme until the end of 2009 were : - Strengthening the prevention of childhood blindness in 50% of health facilities, - Ensuring the management of cases of refractive error in children aged between 10 to 15 years in 14% of primary schools in collaboration with Lion's Sight First Madagascar and Sampan'Asa Loterana Momba ny Fahasalamana (SALFA). 267.Training of refractionists began in 2008 with the support of Christoffel Blindemission (CBM). 268. The prevention of deafness, vaccines against meningitis, mumps and rubella are not yet integrated into immunization programs. They are therefore supported by families. 269.SALFA was engaged in a deafness prevention program for ten years, in partnership with the CBM. This limited program is rolled out within their centres. A collaboration with the Ministry for Health is currently underway to expand the program to public health facilities. 270.Down’s Syndrom, problems during pregnancy, perinatal accidents, various deficiency states, illnesses and accidents occurring during childhood, epilepsy are among the sources of mental retardation of children. 14 Source : Eye Health Programme 42

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