Factors associated with coverage of vitamin a supplementation among Bangladeshi children: mixed modelling approach

Abstract

Background Vitamin A deficiency (VAD) is a prominent and widespread public health problem in developing countries, including Bangladesh. About 2% of all deaths among under-five children are attributable to VAD. Evidence-based information is required to understand the influential factors to increase vitamin A supplementation (VAS) coverage and reduce VAD. We investigated the potential factors affecting VAS coverage and its significant predictors among Bangladeshi children aged 6 to 59 months using the VAS clustered data extracted from the latest Bangladesh Demographic and Health Survey 2014. Methods Data were analysed using mixed logistic regression (MLR) modelling approach in the generalised linear mixed model framework. The MLR model performs better than logistic regression for analysing the clustered data because of its minimum Akaike information criterion value. The likelihood ratio test showed that the variance component was significant. Therefore, the clustering effect among children was inevitable to use. Results VAS coverage among under-five children was 63.6%, which is not optimal and below the WHO’s recommendation and the country’s target of 90%. Children aged 25 to 36 months (AOR = 2.07, 95% CI: 1.711 to 2.513), who had higher educated mothers (AOR = 1.37, p = 0.033, 95% CI: 1.026–1.820) and fathers (AOR = 1.32, p = 0.027, 95% CI: 1.032–1.683), whose mothers had media exposure (AOR = 1.22, p = 0.006, 95% CI: 1.059–1.408) and NGO membership (AOR = 1.24, p = 0.002, 95% CI: 1.089–1.422) were more likely to consume VAS. Conclusion The relevant authorities should create proactive awareness programs for highly vulnerable local communities, specifically targeted to educate the children’s mothers about the necessity and benefits of childhood nutrition.

Assessing the potential determinants of national vitamin A supplementation among children aged 6–35 months in Ethiopia: further analysis of the 2019 Ethiopian Mini Demographic and Health Survey

“…Age of the child was found to be significantly associated with VAS, children with older age were more likely to have VAS as compared to younger children, a finding which is consistent with studies done in Bangladesh [20,21] and Nigeria [29]. This could be due to the fact that older children have a longer window for receiving VAS, whereas younger children may have been ineligible (age less than 6 months) for VAS in the 6 months prior to the survey.…”

“…The mother's education, maternal age, child age, household wealth index, religion, place of residence, region of residency, professional antenatal and postnatal care, place of delivery, mode of delivery, type of birth, sex of child, mother's marital status, and parity were the primary independent variables. They were selected from the available similar studies on the subject [19][20][21].…”

Rural-urban determinants of vitamin a deficiency among under 5 children in Bangladesh: Evidence from National Survey 2017–18

“…Muliyil et al (2019) mention that the educational status of the household head was significantly associated with an increased risk of VAD among children [ 28 ]. Other studies across the world also reveal that age, sex, BMI, religion, age of mother, mother’s education, family type, occupation, income, food habits, type of residence, access to media, wealth index, and social development status of their state of residence are associated with recent receipt of VAS [ 2 , 29 – 35 ].…”

Assessing the potential determinates of national vitamin A supplementation in Ethiopia.

“…The mother's education, maternal age, child age, household wealth index, religion, place of residence, region of residency, professional antenatal and postnatal care, place of delivery, mode of delivery, type of birth, sex of child, mother's marital status, and parity were the primary independent variables. They were selected from the available similar studies on the subject [18][19][20].…”