Trends and inequalities in children aged 6–59 months who received Vitamin A supplementation: evidence from the 2003, 2008 and 2014 Ghana Demographic and Health Survey

Okyere, Joshua, Azure, Simon Agongo, Budu, Eugene, Mensah, Felix, Ahinkorah, Bright Opoku, Ameyaw, Edward Kwabena, and Seidu, Abdul-Aziz (2022) Trends and inequalities in children aged 6–59 months who received Vitamin A supplementation: evidence from the 2003, 2008 and 2014 Ghana Demographic and Health Survey. Tropical Medicine and Health, 50 (1). 99.

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Background: Vitamin A deficiency is considered a public health issue, particularly among children under 5 years. Vitamin A supplementation is among the ten key essential nutrition actions put in place to tackle malnutrition in children and helps to reduce under-five mortality by almost a quarter in Vitamin A deficient areas. We, therefore, examined inequalities in Vitamin A uptake among children 6–59 months in Ghana.

Methods: We used data from the 2003, 2008, and 2014 Ghana Demographic and Health Surveys. The WHO’s HEAT version 3.1 software was used for all the analyses. We adopted six equity stratifiers (maternal age, economic status, level of education, place of residence, sex of the child, and region) to disaggregate Vitamin A supplementation among children 6–59 months. Four measures were used to compute inequality, namely, Difference (D), Population Attributable Risk (PAR), Population Attributable Fraction (PAF) and Ratio (R).

Results: Over the 11-year period, the proportion of children who received Vitamin A supplementation declined from 78.6% to 65.2%. There were inequalities by maternal age, particularly in 2003 (D = 13.1, CI: 2.3, 23.9; PAF = 0.5, CI: − 12.3, 13.2). The widest inequality in Vitamin A supplementation by economic status was noted in 2003 (D = 8.8, CI: 3.3–14.2; PAF = 8.3, CI: 5, 11.5). In terms of sex, the indices revealed mild inequality in Vitamin A supplementation throughout the period studied. For education, the highest inequality was observed in 2014 (D = 11.6, CI: 6.0, 17.1), while the highest inequality in terms of place of residence was observed in 2003 (D = 4.0, CI: − 0.1–8.4). In the case of region, substantial inequality was noted in 2014 (D = 34.7, CI: 22.6, 46.8; PAF = 21.1, CI: 15.3, 27).

Conclusions: We conclude that there is a need for the government of Ghana to deploy targeted interventions to enhance the uptake of Vitamin A supplementation among the most disadvantaged subpopulations. Interventions targeted at these disadvantaged populations should be pro-poor in nature. In addition, the inequalities in the dimension of place of residence were mixed, favoring both rural and urban children at different points. This calls for a comprehensive and all-inclusive approach that enhances Vitamin A supplementation uptake in an equitable manner in both areas of residence. Empowerment of women through formal education could be an important step toward improving Vitamin A supplementation among children in Ghana.

Item ID: 77547
Item Type: Article (Research - C1)
ISSN: 1349-4147
Keywords: Children, Demographic and Health Survey, Ghana, Trends, Vitamin A supplementation
Copyright Information: © The Author(s) 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Date Deposited: 07 Mar 2023 23:14
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420601 Community child health @ 100%
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