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Shifts in Social Determinants of Vitamin A Supplementation Among Children Under Five in Kenya, 2003–2014.
- Source :
- Maternal & Child Health Journal; Jul2023, Vol. 27 Issue 7, p1284-1292, 9p, 3 Charts
- Publication Year :
- 2023
-
Abstract
- Objectives: In Africa and Asia, 190 million preschoolers are vitamin A deficient. This study examined the social determinants of intake of vitamin A supplementation (VAS) among children aged 6–59 months during three different time periods in Kenya to identify those most vulnerable to vitamin A deficiency and highlight the varied targeting and outreach efforts; before the onset of a national restructuring and targeted distribution of VAS in children below 5 years through a twice-yearly door-to-door campaign called Child Health Weeks, during the implementation period, and several years later. Methods: The cross-sectional, national Demographic and Health Surveys were administered in Kenya in 2003, 2008-09, and 2014. Bivariate and multivariable logistic regression analyses were used to assess variables associated with VAS among children (n = 28,239). Results: An overall two-fold increase in VAS was recorded between 2003 (31.8%) and 2014 (67.5%). In 2008-09, children aged 6–11 months were the most likely to receive VAS. In 2003 and 2014, geographical regions and settings, birth order of the child, educational level of the mother, religion, wealth index, number of antenatal visits, and access to a radio were identified as being significantly associated with VAS, in at least one of the years. These determinants were not significant in 2008-09 during the initial Child Health Weeks promotion campaign. The determinants of VAS varied during the three study periods, particularly in 2008-09 when the Child Health Weeks was first implemented. Conclusion: As efforts to increase VAS continue, addressing child-specific determinants will be essential to reduce health disparities. Significance: Childhood vitamin A deficiency has been identified as one of the public health priorities in Kenyan children below 5 years that causes severe malnutrition. The importance of VAS was identified as a cost-effective strategy of combating and eradicating childhood malnutrition based on a previous national micronutrient survey. However, Kenya's VAS inequities are exacerbated by the social and economic differences of women. The WHO defines these disproportionate differences as the social determinants of health. Identifying these factors will be influential for policy makers to make targeted efforts towards increasing VAS supplementation and contribution towards reducing child mortality. [ABSTRACT FROM AUTHOR]
- Subjects :
- THERAPEUTIC use of vitamin A
STATISTICS
SOCIAL determinants of health
CONFIDENCE intervals
CROSS-sectional method
BIRTH order
PSYCHOLOGY of mothers
POPULATION geography
VITAMIN A deficiency
DIETARY supplements
INCOME
MEDICAL care use
HEALTH literacy
QUESTIONNAIRES
DESCRIPTIVE statistics
CHI-squared test
LOGISTIC regression analysis
DATA analysis software
ODDS ratio
PRENATAL care
EDUCATIONAL attainment
RELIGION
DISEASE risk factors
CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 10927875
- Volume :
- 27
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Maternal & Child Health Journal
- Publication Type :
- Academic Journal
- Accession number :
- 164005772
- Full Text :
- https://doi.org/10.1007/s10995-023-03663-y