Evaluating equity dimensions of infant and child vitamin A supplementation programmes using Demographic and Health Surveys from 49 countries.

Autor:	Tang K; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK kevin.tang1@lshtm.ac.uk.; Programme Division, UNICEF, New York City, New York, USA., Eilerts H; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK., Imohe A; Programme Division, UNICEF, New York City, New York, USA., Adams KP; Institute for Global Nutrition, University of California Davis, Davis, California, USA., Sandalinas F; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK., Moloney G; Programme Division, UNICEF, New York City, New York, USA., Joy E; Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK., Hasman A; Programme Division, UNICEF, New York City, New York, USA.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Mar 14; Vol. 13 (3), pp. e062387. Date of Electronic Publication: 2023 Mar 14.
DOI:	10.1136/bmjopen-2022-062387
Abstrakt:	Objectives: Vitamin A deficiency affects an estimated 29% of all children under 5 years of age in low/middle-income countries, contributing to child mortality and exacerbating severity of infections. Biannual vitamin A supplementation (VAS) for children aged 6-59 months can be a low-cost intervention to meet vitamin A needs. This study aimed to present a framework for evaluating the equity dimensions of national VAS programmes according to determinants known to affect child nutrition and assist programming by highlighting geographical variation in coverage. Methods: We used open-source data from the Demographic and Health Survey for 49 countries to identify differences in VAS coverage between subpopulations characterised by various immediate, underlying and enabling determinants of vitamin A status and geographically. This included recent consumption of vitamin A-rich foods, access to health systems and services, administrative region of the country, place of residence (rural vs urban), socioeconomic position, caregiver educational attainment and caregiver empowerment. Results: Children who did not recently consume vitamin A-rich foods and who had poorer access to health systems and services were less likely to receive VAS in most countries despite potentially having a greater vitamin A need. Differences in coverage were also observed when disaggregated by administrative regions (88% of countries) and urban versus rural residence (35% of countries). Differences in vitamin A coverage between subpopulations characterised by other determinants of vitamin A status varied considerably between countries. Conclusion: VAS programmes are unable to reach all eligible infants and children, and subpopulation differences in VAS coverage characterised by various determinants of vitamin A status suggest that VAS programmes may not be operating equitably in many countries. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu