Vitamin A supplementation in children aged 12 to 59 months in Amajuba Health District in 2016.

Abstract

Background: Vitamin A is required for normal development, defence of the immune system and for maintaining good eye health in infants and children. Vitamin A deficiency is a major public health problem globally and in South Africa. Routine supplementation with high-dose Vitamin A has been a strategy employed to reduce the burden of Vitamin A deficiency in children aged from six to 59 months. Coverage of vitamin A supplementation (VAS) however remains low in older children in South Africa particularly in Amajuba Health District. Objectives: The objectives of this study were to measure VAS coverage and factors associated with poor VAS uptake in this District. Methods An analytic cross sectional study design was used. A two-stage cluster-sample method was used to select the participants. The study population involved mothers and caregivers of children aged 12 to 59 months residing in Madadeni, a township in the District. The study sample of 198 participants was obtained from 33 randomly selected clusters within each of which 6 households were approached. Data was collected using a field-worker administered structured questionnaire. The study received ethical approval (BE 368/15) and was conducted with participant’s consent. Results The coverage of VAS amongst these children was 57% (95% CI: 49 - 63). Younger children (18 to 23 months) had better (Prevalence Ratio (PR) 1.2 (95% CI: 0.8 - 1.6) coverage than older children. Children who were up to date with VAS coverage were significantly more likely to have received a measles vaccine (p<0.01). A significant association was found between VAS status of children and caregivers being able to identify the blue capsules as the 6 to 11-month dose and the red capsules as the 12 to 59-month Vitamin dose capsule. There was a non- iii significant but positive association of a child having received VAS and higher level of education of the caregivers, shorter distance from health facilities, living in an urban area and having received information about VAS from a health worker Conclusion and Recommendations Amajuba Health District had a VAS coverage of 57%, which is below the national target of 65%. The low levels of knowledge about Vitamin A among caregivers is a concern, despite knowledge being weakly associated with VAS uptake in children. Health workers need to provide better education for caregivers about Vitamin A. Focus should also be placed on accessing older children as they are more likely miss VAS doses. (385 words)