To determine if socio-demographic factors influence vitamin A supplementation in children aged under five, researchers from the Karolinska Institute in Stockholm, Sweden carried out a cross-sectional demographic survey examining the use of vitamin A supplementation by 10,906 Pakistani mothers belonging to various age groups, regions, economic status and educational attainment.
This is the largest household-based survey ever conducted in Pakistan, researchers said..
Access to vitamin A supplementation for children in different provinces of Pakistan varied from approximately 8% to 79%. On a national level, the coverage was found to be 68.5%, however this is below the 80% coverage that has been considered necessary for reducing child mortality.
The findings then revealed that maternal age, place of residence and region showed as the strongest predictors for vitamin A supplementation.
Older mothers in age ranges 25-34 and 35-49 years were more likely to give vitamin A supplements to their children, compared to younger mothers (15-24 years old).
Surprisingly, rural mothers were more likely to give vitamin A supplementation to their children, compared to mothers living in urban areas.
This is because more urban parents have access to and offers food that contain vitamin A, instead of relying on supplementation, said the study.
Compared to mothers in the Gilgit Baltistan, mothers in the other regions, namely Punjab, Sindh, Khyber Pakhtunkhwa and Balochisan were more likely to give vitamin A supplements.
Wealth index
Other findings revealed that mothers with a primary education were also likely to give their children vitamin A supplements compared to mothers without education.
Referring to the wealth index, middle class mothers had a higher probability of giving vitamin A to their children compared to poor mothers.
However, the current study’s 68.5% coverage of distributed vitamin supplementation was below the 80% coverage target needed for reducing child mortality in Pakistan. The mortality rate in infants and children age less than five years old in Pakistan is high – primarily due to undernutrition from lack of food, micronutrients and poverty.
The survey also highlighted the importance of regular follow-ups to identify gaps in health services provision that can change over time.
“To improve vitamin A status in Pakistan, new approaches for implementation may be required to reach young mothers in urban areas or those living in sparsely populated areas,” the researchers wrote. “Fortifying commonly consumed foods such as flours, cereals, sugar, margarine and oils with vitamin A may help.”
Regions and communities with high levels of vitamin A deficiency need targeted vitamin A supplementation programmes, they added.
“Health professionals and policy makers should develop effective strategies aimed at delivering nutritional supplements to all children in the community, especially children with the highest risk for deficiency,” the study concluded.
Source: Journal of Human Nutrition and Dietetics
“Socio-economic determinants of vitamin A intake in children under 5 years of age: evidence from Pakistan”
Authors: F. Changezi and L. Lindberg