Coverage and factors associated with vitamin A supplementation among children aged 6-59 months in twenty-three sub-Saharan African countries

Abstract

Objective: The present study aimed to give an overall view of the pattern of highdose vitamin A supplementation (VAS) coverage in twenty-three sub-Saharan African countries and factors associated with receipt of VAS among children aged 6–59 months. Design: Cross-sectional data from the twenty-three Demographic and Health Surveys conducted from 2011 to 2015 in twenty-three sub-Saharan African countries were pooled. A multilevel logistic regression model was used to explore factors associated with VAS. Setting: Twenty-three sub-Saharan African countries. Participants: Children (n 215 511) aged 6–59 months. Results: The overall coverage of VAS among children aged 6–59 months for the surveys included was 59·4 %. In the multivariable analysis, children whose mothers had primary (adjusted OR (aOR)=1·43; 95 % CI 1·39, 1·47) or secondary or above (aOR=1·72; 95 % CI 1·67, 1·77) educational status were more likely to receive VAS than children whose mothers had no formal education. Other factors associated with significantly increased likelihood of VAS were: living in urban areas; children of working mothers; children whose mothers had higher media exposure; children of older mothers v. children of mothers aged 15–19 years; and older children v. children aged 6–11 months. At the country level, lower media exposure was significant and negatively associated with VAS. Conclusions: Broader VAS coverage is needed according to our data. More efforts are needed to scale up coverage, focusing mostly on groups at risk of non-receipt of vitamin A