Determinants of successful vitamin A supplementation coverage among children aged 6–59 months in thirteen sub-Saharan African countries. Issue 11 (23rd May 2017)

• Record Type: Journal Article
• Authors: Janmohamed, Amynah; Klemm, Rolf DW; Doledec, David
• Is Part Of: Public health nutrition. Volume 20:Issue 11(2017)
• Page Start: 2016
• Page End: 2022
• Publication Date: 2017-05-23
• Subjects: Vitamin A, -- Supplementation, -- Coverage, -- Children, -- Africa; Nutrition -- Periodicals; Nutrition policy -- Periodicals; Public health -- Periodicals; 613.2
• DOI: 10.1017/S1368980017000684
• Languages: English
• ISSNs: 1368-9800

Abstract

Abstract: Objective: Vitamin A supplementation (VAS) for children aged 6–59 months occurs regularly in most sub-Saharan African countries. The present study aimed to explore child, household and delivery platform factors associated with VAS coverage and identify barriers to compliance in thirteen African countries. Design: We pooled data ( n ~60 000) from forty-four household coverage surveys and used bivariate and multivariable regression analyses to assess the effects of supplementation strategy, rural v . urban residence, child sex, child age, caregiver education and campaign awareness on child VAS status. Setting/Subjects: Primary caregivers of children aged 6–59 months in thirteen countries. Results: Door-to-door distribution resulted in higher VAS coverage than fixed-site plus outreach approaches (91 v . 63 %) and was a significant predictor of supplementation in the adjusted model (OR=19·0; 95 % CI 17·2, 21·1; P <0·001). Having been informed about the campaign was the main predictor of VAS in the door-to-door (OR=6·8; 95 % CI 5·8, 7·9; P <0·001) and fixed-site plus outreach (OR=72·5; 95 % CI 66·6, 78·8; P <0·001) groups. Conclusions: Door-to-door provision of VAS may achieve higher coverage than fixed-site models in the African context. However, the phase-out of door-to-door polio immunization campaigns in most sub-Saharan African countries threatens the main distribution vehicle for VAS. Our findings suggest well-informed communities are key to attaining higher coverage using fixed-site delivery alternatives.