Frontiers in nutrition · 2026
Determinants and socioeconomic inequalities in vitamin A-rich food consumption among children aged 6-23 months in Somalia: a multilevel analysis of the 2020 Somalia Health and Demographic Survey (SHDS).
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Abdillahi Asma Mahamoud, Abokor Abdirizak Hassan, Farih Omer Adam, Ali Mustafe Abdillahi, Mohamed Saeed Hassan, Abdi Ahmed Adan, Omer Awale Ali, Mohamed Hafsa, Muse Abdisalam Hassan, Abdikarim Hodo
Аннотация
INTRODUCTION: Vitamin A deficiency (VAD) remains a public health concern, particularly among children in resource-limited settings. This study aimed to evaluate the consumption of vitamin A-rich foods and associated socioeconomic inequalities among children aged 6-23 months in Somalia.
METHODS: Data from the 2020 Somalia Health and Demographic Survey (SHDS were analyzed, including a sample of 1,839 children. Multilevel binary logistic regression was used to identify determinants of vitamin A-rich food consumption. Concentration indices (CIX) were employed to assess socioeconomic inequalities. Statistical analyses were conducted using Stata 17 and R Studio.
RESULTS: Only 29.7% of children consumed vitamin A-rich foods. Significant regional variations were observed. Multilevel analysis revealed that household wealth (AOR = 3.60, 95% CI: 2.23-5.78 for highest vs. lowest quintile), media access (AOR = 2.05, 95% CI: 1.41-2.98), paternal education (AOR = 1.83, 95% CI: 1.35-2.49), and antenatal care (ANC) attendance (AOR = 1.69, 95% CI: 1.09-2.62 for ≥1 visit) were significantly associated with vitamin A-rich food consumption. The relative CIX indicated substantial wealth-related (0.2533, p < 0.001) and education-related (0.1438, p < 0.001) inequalities.
CONCLUSION: Vitamin A-rich food consumption among young children in Somalia is low, with significant socioeconomic inequalities. Interventions should target low-income households, promote maternal education, improve access to media, and strengthen antenatal care services to enhance vitamin A intake. Furthermore, regional-specific interventions to promote vitamin A food are recommended.
RECOMMENDATIONS: Policymakers should prioritize nutrition-sensitive social protection programs, strengthen antenatal care services, and implement targeted behavior change communication to improve vitamin A-rich food consumption. Vitamin A supplementation programs must be strengthened to ensure high coverage among children aged 6-59 months, especially in regions with the lowest intake. Future research should focus on longitudinal studies to assess the long-term impact of these interventions.
METHODS: Data from the 2020 Somalia Health and Demographic Survey (SHDS were analyzed, including a sample of 1,839 children. Multilevel binary logistic regression was used to identify determinants of vitamin A-rich food consumption. Concentration indices (CIX) were employed to assess socioeconomic inequalities. Statistical analyses were conducted using Stata 17 and R Studio.
RESULTS: Only 29.7% of children consumed vitamin A-rich foods. Significant regional variations were observed. Multilevel analysis revealed that household wealth (AOR = 3.60, 95% CI: 2.23-5.78 for highest vs. lowest quintile), media access (AOR = 2.05, 95% CI: 1.41-2.98), paternal education (AOR = 1.83, 95% CI: 1.35-2.49), and antenatal care (ANC) attendance (AOR = 1.69, 95% CI: 1.09-2.62 for ≥1 visit) were significantly associated with vitamin A-rich food consumption. The relative CIX indicated substantial wealth-related (0.2533, p < 0.001) and education-related (0.1438, p < 0.001) inequalities.
CONCLUSION: Vitamin A-rich food consumption among young children in Somalia is low, with significant socioeconomic inequalities. Interventions should target low-income households, promote maternal education, improve access to media, and strengthen antenatal care services to enhance vitamin A intake. Furthermore, regional-specific interventions to promote vitamin A food are recommended.
RECOMMENDATIONS: Policymakers should prioritize nutrition-sensitive social protection programs, strengthen antenatal care services, and implement targeted behavior change communication to improve vitamin A-rich food consumption. Vitamin A supplementation programs must be strengthened to ensure high coverage among children aged 6-59 months, especially in regions with the lowest intake. Future research should focus on longitudinal studies to assess the long-term impact of these interventions.