Differentials in vitamin A supplementation among preschool-aged children in Ethiopia: evidence from the 2011 Ethiopian Demographic and Health Survey.

Background: Vitamin A supplementation is one of the best proven, safest and most cost-effective interventions in public health. However, childhood vitamin A supplementation has not reached adequate levels of coverage in developing countries. This study aimed to identify factors associated with childhood vitamin A supplementation in Ethiopia.

Study Design: Cross-sectional study with stratified, two-stage cluster design.

Methods: Analysis of data from the 2011 Ethiopian Demographic and Health Survey (EDHS) was used to identify factors associated with childhood vitamin A supplementation. Data for 9276 children aged 6-59 months were included in the analysis. Binary and multivariable logistic regression models were used.

Results: Over half [54.5%, 95% confidence interval (CI) 53.48-55.51%] of children aged 6-59 months had received vitamin A supplementation in the last six months. Regional differences were found, ranging from 28.1% in Somali to 83.2% in Tigray (P < 0.001). Children in the poorest wealth index category [adjusted odds ratio (AOR) 0.60, 95% CI 0.47-0.77], children with mothers who did not attend any antenatal care (ANC) appointments (AOR 0.56, 95% CI 0.48-0.67), infants aged 6-11 months (AOR 0.52, 95% CI 0.42-0.65), children with mothers who did not have a postnatal medical check-up (AOR 0.69, 95% CI 0.56-0.86) and children with mothers who had not worked in the last year (AOR 0.86, 95% CI 0.76-0.97) were less likely to have received vitamin A supplementation in the last six months.

Conclusion: Coverage of childhood vitamin A supplementation was not optimum in Ethiopia and regional differences were found. Lack of a maternal postnatal medical check-up, lack of ANC attendance, poorest wealth index, mother who had not worked in the last year and infant in youngest age group were associated with lower odds of receiving vitamin A supplementation over the last six months. Provision and promotion of ANC and postnatal care, and strengthening routine immunization activity, especially among infants in the youngest age group, are recommended to increase coverage of childhood vitamin A supplementation.