Evaluating equity dimensions of infant and child vitamin A supplementation programmes using Demographic and Health Surveys from 49 countries

This study used open-source Demographic and Health Survey (DHS) data from 49 countries to identify inequities in vitamin A supplementation (VAS) programme coverage across subpopulations characterized by immediate, underlying, and enabling determinants of vitamin A status. Analyses disaggregated VAS coverage by recent consumption of vitamin A-rich foods, healthcare access, administrative region, place of residence, socioeconomic position, caregiver education, and caregiver empowerment. Children who did not recently consume vitamin A-rich foods and had poorer access to health systems were less likely to receive VAS in most countries despite potentially greater need. Differences were observed by administrative region in 88% of countries and by urban versus rural residence in 35% of countries. The study is limited by reliance on caregiver recall for VAS receipt, with less than half of respondents in 69% of countries providing home-based vaccination records as proof, and by dietary data restricted to a single 24-hour recall of vitamin A-rich food consumption for complementary feeding children only.