Determinants of Vitamin A Uptake in Nigeria: The Role of Contextual Factors
Tukur Dahiru *
Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
Khadija Hamza Liman
Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
Suleiman Sa’id Bashir
Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
Nura Mohammad Suleiman
Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Zara Zambuk
Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Mairo Mu’azu
Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.
John-Camillus Igboanusi
Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Ruth Oguntunde
Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Muhammad Bello Garba
Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
Umar Mohammed Umar
Department of Community Medicine, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Vitamin A deficiency (VAD) is a public health problem in many low-income countries including Nigeria. Worldwide, it can be estimated that 190 million preschool-age children are Vitamin A deficient causing 1–2 million deaths annually. In Nigeria the prevalence of VAD is 29.5% with significant variations across the agro-ecological zones; and that only 43% of children aged 6-59months have received Vitamin A supplementation (VAS) in the past six months. We conducted a secondary analysis using the 2013 Nigeria DHS data with the objective of determining factors associated with receipt of VAS using a multi-level technique in which cluster characteristics were regarded as the community-level factors. The analysis involved a weighted sample of 25, 617 children aged between 6 and 59 months whom receipt of vitamin A supplementation was reported by their mothers. A number of individual, household and community level factors were found to be significant determinants of receipt of VAS: maternal education, working status of the mother, place of delivery of child, ANC visits, household wealth index and community levels of maternal education. These community-level factors are significant contextual determinants of VAS uptake contributing up to 96% of variation across the communities. Therefore, these factors should be considered in policy-formulation and programming aimed at improving VAS coverage in Nigeria that will lead to improved child health status and survival.
Keywords: Vitamin A, supplementation, state, multi-level