We used open-source data from the Demographic and Health Survey for 49 countries to identify differences in VAS coverage between subpopulations characterised by various immediate, underlying and enabling determinants of vitamin A status and geographically. This included recent consumption of vitamin A-rich foods, access to health systems and services, administrative region of the country, place of residence (rural vs urban), socioeconomic position, caregiver educational attainment and caregiver empowerment.
Children who did not recently consume vitamin A-rich foods and who had poorer access to health systems and services were less likely to receive VAS in most countries despite potentially having a greater vitamin A need. Differences in coverage were also observed when disaggregated by administrative regions (88% of countries) and urban versus rural residence (35% of countries). Differences in vitamin A coverage between subpopulations characterised by other determinants of vitamin A status varied considerably between countries.
VAS programmes are unable to reach all eligible infants and children, and subpopulation differences in VAS coverage characterised by various determinants of vitamin A status suggest that VAS programmes may not be operating equitably in many countries.
方法:我们使用了来自49个国家的人口与健康调查的开源数据,以确定不同即时数据特征的亚人群之间的VAS覆盖率差异。维生素A状况和地理上的潜在和有利决定因素。这包括最近食用富含维生素A的食物,获得卫生系统和服务,国家行政区域,居住地(农村vs城市),社会经济地位,护理人员教育程度和护理人员赋权。
结果:在大多数国家,最近没有食用富含维生素A的食物以及获得卫生系统和服务的机会较差的儿童接受VAS的可能性较小,尽管可能有更大的维生素A需求。按行政区(88%的国家)和城市与农村居住地(35%的国家)分类时,也观察到了覆盖率的差异。以维生素A状况的其他决定因素为特征的亚群之间的维生素A覆盖率差异很大。
结论:VAS计划无法覆盖所有符合条件的婴儿和儿童,以维生素A状况的各种决定因素为特征的VAS覆盖率的亚种群差异表明,在许多国家,VAS计划可能无法公平运行。