Childhood Vitamin A Capsule Supplementation Coverage in Nigeria: A Multilevel Analysis of Geographic and Socioeconomic Inequities
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Date
2010
Journal Title
Journal ISSN
Volume Title
Publisher
The Scientific World JOURNAL
Abstract
Vitamin A deficiency (VAD) is a huge public health burden among preschool-aged
children in sub-Saharan Africa, and is associated with a high level of susceptibility to
infectious diseases and pediatric blindness. We examined the Nigerian national vitamin
A capsule (VAC) supplementation program, a short-term cost-effective intervention for
prevention of VAD-associated morbidity for equity in terms of socioeconomic and
geographic coverage. Using the most current, nationally representative data from the
2008 Nigerian Demographic and Health Survey, we applied multilevel regression analysis
on 19,555 children nested within 888 communities across the six regions of Nigeria. The
results indicate that there was variability in uptake of VAC supplement among the
children, which could be attributed to several characteristics at individual, household,
and community levels. Individual-level characteristics, such as maternal occupation,
were shown to be associated with receipt of VAC supplement. The results also reveal
that household wealth status is the only household-level characteristic that is
significantly associated with receipt of VAC, while neighborhood socioeconomic
disadvantage and geographic location were the community-level characteristics that
determined receipt of VAC. The findings from this study have shown that both individual
and contextual socioeconomic status, together with geographic location, is important for
uptake of VAC. These findings underscore the need to accord the VAC supplementation
program the much needed priority with focus on characteristics of neighborhoods
(communities), in addition to individual-level characteristics.
Description
Keywords
Childhood, Community, Coverage, Geographic variation, Inequity, Multilevel analysis, Nigeria, Neighborhood socioeconomic disadvantage, Pediatric blindness, Preschool, Socioeconomic, Supplementation, Vitamin A capsule, Vitamin A deficiency
Citation
Aremu, O., Lawoko, S., & Dalal, K. (2010). Childhood vitamin A capsule supplementation coverage in Nigeria: a multilevel analysis of geographic and socioeconomic inequities. The Scientific World JOURNAL, 10, 1901-1914. DOI 10.1100/tsw.2010.188