{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:22:49Z","timestamp":1794244969092,"version":"4.9.0"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T00:00:00Z","timestamp":1495497600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Public Health Nutr."],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1368980017000684_abs1\" sec-type=\"general\"><jats:title>Objective<\/jats:title><jats:p>Vitamin A supplementation (VAS) for children aged 6\u201359 months occurs regularly in most sub-Saharan African countries. The present study aimed to explore child, household and delivery platform factors associated with VAS coverage and identify barriers to compliance in thirteen African countries.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017000684_abs2\" sec-type=\"general\"><jats:title>Design<\/jats:title><jats:p>We pooled data (<jats:italic>n<\/jats:italic> ~60 000) from forty-four household coverage surveys and used bivariate and multivariable regression analyses to assess the effects of supplementation strategy, rural <jats:italic>v<\/jats:italic>. urban residence, child sex, child age, caregiver education and campaign awareness on child VAS status.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017000684_abs3\" sec-type=\"general\"><jats:title>Setting\/Subjects<\/jats:title><jats:p>Primary caregivers of children aged 6\u201359 months in thirteen countries.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017000684_abs4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Door-to-door distribution resulted in higher VAS coverage than fixed-site plus outreach approaches (91 <jats:italic>v<\/jats:italic>. 63 %) and was a significant predictor of supplementation in the adjusted model (OR=19\u00b70; 95 % CI 17\u00b72, 21\u00b71; <jats:italic>P<\/jats:italic>&lt;0\u00b7001). Having been informed about the campaign was the main predictor of VAS in the door-to-door (OR=6\u00b78; 95 % CI 5\u00b78, 7\u00b79; <jats:italic>P<\/jats:italic>&lt;0\u00b7001) and fixed-site plus outreach (OR=72\u00b75; 95 % CI 66\u00b76, 78\u00b78; <jats:italic>P<\/jats:italic>&lt;0\u00b7001) groups.<\/jats:p><\/jats:sec><jats:sec id=\"S1368980017000684_abs5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Door-to-door provision of VAS may achieve higher coverage than fixed-site models in the African context. However, the phase-out of door-to-door polio immunization campaigns in most sub-Saharan African countries threatens the main distribution vehicle for VAS. Our findings suggest well-informed communities are key to attaining higher coverage using fixed-site delivery alternatives.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1368980017000684","type":"journal-article","created":{"date-parts":[[2017,5,23]],"date-time":"2017-05-23T05:08:37Z","timestamp":1495516117000},"page":"2016-2022","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":25,"title":["Determinants of successful vitamin A supplementation coverage among children aged 6\u201359 months in thirteen sub-Saharan African countries"],"prefix":"10.1017","volume":"20","author":[{"given":"Amynah","family":"Janmohamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf DW","family":"Klemm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Doledec","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2017,5,23]]},"reference":[{"key":"S1368980017000684_ref31","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8598.109322"},{"key":"S1368980017000684_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14411-X"},{"key":"S1368980017000684_ref21","volume-title":"Mali Demographic and Health Survey","year":"2014"},{"key":"S1368980017000684_ref20","volume-title":"Kenya Demographic and Health Survey","year":"2015"},{"key":"S1368980017000684_ref22","volume-title":"Mozambique Demographic and Health Survey","year":"2013"},{"key":"S1368980017000684_ref7","doi-asserted-by":"publisher","DOI":"10.1177\/15648265100313S304"},{"key":"S1368980017000684_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980007687138"},{"key":"S1368980017000684_ref16","volume-title":"Burkina Faso Demographic and Health Survey","year":"2012"},{"key":"S1368980017000684_ref18","volume-title":"Congo Demographic and Health Survey","year":"2012"},{"key":"S1368980017000684_ref30","first-page":"CD004015","article-title":"Lay health workers in primary and community health care for maternal and child health and the management of infectious diseases","author":"Lewin","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"S1368980017000684_ref1","volume-title":"Vitamin A Supplementation: A Statistical Snapshot","year":"2016"},{"key":"S1368980017000684_ref17","volume-title":"C\u00f4te d\u2019Ivoire Demographic and Health Survey","year":"2013"},{"key":"S1368980017000684_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/1472-698X-9-28"},{"key":"#cr-split#-S1368980017000684_ref11.1","unstructured":"1. The DHS Program (2015) Demographic Health Survey"},{"key":"#cr-split#-S1368980017000684_ref11.2","unstructured":"2. (DHS) model household questionnaire. http:\/\/dhsprogram.com\/publications\/publication-dhsq7-dhs-questionnaires-and-manuals.cfm (accessed June 2016)."},{"key":"S1368980017000684_ref4","first-page":"CD008524","article-title":"Vitamin A supplementation for preventing morbidity and mortality in children from 6 months to 5 years of age","author":"Imdad","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"S1368980017000684_ref27","first-page":"134","article-title":"Factors influencing vitamin A supplementation among mothers of children under five years old at Mbagathi District Hospital, Kenya","volume":"89","author":"Kamau","year":"2012","journal-title":"East Afr Med J"},{"key":"S1368980017000684_ref29","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-847"},{"key":"S1368980017000684_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0058629"},{"key":"S1368980017000684_ref5","unstructured":"UNICEF (2016) Vitamin A deficiency: current status and progress. http:\/\/data.unicef.org\/nutrition\/vitamin-a.html (accessed June 2016)."},{"key":"S1368980017000684_ref13","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-566"},{"key":"S1368980017000684_ref15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3156.2012.02989.x"},{"key":"S1368980017000684_ref14","doi-asserted-by":"publisher","DOI":"10.11604\/pamj.2013.14.3.2181"},{"key":"S1368980017000684_ref32","first-page":"2","article-title":"Factors associated with full immunization coverage amongst children aged 12\u201323 months in Zimbabwe","volume":"29","author":"Mukungwa","year":"2015","journal-title":"Afr Popul Stud"},{"key":"S1368980017000684_ref3","volume-title":"Guideline: Vitamin A Supplementation in Infants and Children 6\u201359 Months of Age","year":"2011"},{"key":"S1368980017000684_ref23","volume-title":"Niger Demographic and Health Survey","year":"2013"},{"key":"S1368980017000684_ref24","volume-title":"Nigeria Demographic and Health Survey","year":"2014"},{"key":"S1368980017000684_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)00039-X"},{"key":"S1368980017000684_ref25","volume-title":"Sierra Leone Demographic and Health Survey","year":"2014"},{"key":"S1368980017000684_ref26","volume-title":"Tanzania Demographic and Health Survey","year":"2011"},{"key":"S1368980017000684_ref6","volume-title":"Vitamin A Supplementation: A Decade of Progress","year":"2007"},{"key":"S1368980017000684_ref10","volume-title":"Immunization Coverage Cluster Survey \u2013 Reference Manual","year":"2005"},{"key":"S1368980017000684_ref33","unstructured":"Global Polio Eradication Initiative (2017) Polio eradication and endgame timeline. http:\/\/www.polioeradication.org\/ (accessed May 2017)."},{"key":"S1368980017000684_ref19","volume-title":"Guinea Demographic and Health Survey","year":"2013"}],"container-title":["Public Health Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1368980017000684","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,17]],"date-time":"2019-04-17T19:54:34Z","timestamp":1555530874000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1368980017000684\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,23]]},"references-count":34,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["S1368980017000684"],"URL":"https:\/\/doi.org\/10.1017\/s1368980017000684","relation":{},"ISSN":["1368-9800","1475-2727"],"issn-type":[{"value":"1368-9800","type":"print"},{"value":"1475-2727","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,23]]},"assertion":[{"value":"Copyright \u00a9 The Authors 2017\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}