Prevalence and Determinants of Vitamin A Supplementation Among Somali Children (6-59 Months): A Cross-Sectional Study Using Insights From the SDHS 2020.

BACKGROUND AND AIMS: Vitamin A deficiency (VAD) is a pressing public health issue for young children in low- and middle-income countries like Somalia, significantly increasing risks of morbidity, mortality, and impaired development. High-dose Vitamin A supplementation (VAS) is a crucial preventative intervention, yet data on its coverage in Somalia's complex humanitarian context are scarce. This study aims to assess the prevalence of VAS and identify its sociodemographic determinants among Somali children aged 6-59 months.

METHODS

This study utilized a quantitative, cross-sectional design, analyzing data from 15,456 children aged 6-59 months from the nationally representative Somalia Demographic and Health Survey (SDHS) 2020. The outcome was maternal report of a child receiving a Vitamin A supplement in the preceding 6 months. To ensure the results were nationally representative, weighted descriptive statistics and multivariate logistic regression were performed in Stata to account for the complex survey design.

RESULTS

The prevalence of VAS receipt was critically low at 11.2%. Multivariate analysis revealed significant and unexpected disparities. Contrary to expectations, compared to children of mothers with no education, those with primary (AOR = 0.453, p < 0.001), secondary (AOR = 0.302, p < 0.001), or higher education (AOR = 0.327, p < 0.001) had significantly lower odds of their child receiving VAS. Children in nomadic households had significantly lower odds than those in rural households (AOR = 0.626, 95% CI: 0.549-0.714, p < 0.001). Compared to mothers aged 15-19, older mothers (≥ 35 years) had significantly lower odds of their child receiving VAS. Children of divorced mothers also had lower odds than those of married mothers (AOR = 0.799, p = 0.028).

CONCLUSION

VAS coverage among young Somali children is alarmingly inadequate. The counterintuitive finding regarding maternal education suggests that conventional assumptions about health-seeking behaviors may not apply in this context. Targeted interventions and strengthened health system delivery are urgently needed to address these disparities.