The 2005 Senegal Demographic and Health Survey estimates that 84% of children < 5 are anemic. A major cause is intestinal parasites. Starting in 2004 the Ministry of Health piloted coupling of de-worming with other child survival interventions in 2 regions with support from UNICEF. The population-based assessment of Local Vitamin A Supplementation (VAS) Days, carried out in August 2005 showed that 96% of mothers favored de-worming for their children (full results of this assessment are presented in an accompanying poster). The pilot phase and the results of the assessment led to the decision to take de-worming nationwide in the second VAS distribution in 2005. Aims: Describe steps and identify lessons learned of this first nationwide experience of coupling de-worming and VAS. Framework: National Immunization Days (NIDs) were organized in Senegal in December 2005 and were used as the delivery platform for both VAS and de-worming. Steps for national scale-up of de-worming included: development and dissemination of a technical brief, identification and ordering of medication (mebendazole), incorporating de-worming into management information system tools and training, development of communication strategy and tools covering VAS, de-worming and oral polio vaccine (OPV). Because of NIDs door-to-door distribution was used. Mapping of the intervention areas of health stations and supervision at all levels were important factors of success. Outcomes: Tally sheets show 100% coverage for deworming and VAS. Mebendazole was well accepted and tolerated by children. Anecdotal evidence indicates de-worming decreased number of cases of refusal of OPV. Management of mebendazole stocks was an added burden. Coupling of 3 interventions (de-worming, VAS, OPV), slowed down the work of the teams but did not decrease overall coverage. Conclusions: The first nation-wide experience of coupling de-worming with VAS was successful and has been adopted for future rounds, including in Local VAS Days organized in May/June 2006. In the event of future NIDs, de-worming will be added to the first round of OPV and VAS to the second, in order to reduce logistic burden. An assessment of the impact on anemia is planned in 2007.