{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:24:38Z","timestamp":1791329078577,"version":"4.3.1"},"reference-count":36,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T00:00:00Z","timestamp":1678752000000},"content-version":"unspecified","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006641","name":"UNICEF","doi-asserted-by":"publisher","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/100006641","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-002855"],"award-info":[{"award-number":["INV-002855"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,2,18]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Vitamin A deficiency affects an estimated 29% of all children under 5\u2009years of age in low\/middle-income countries, contributing to child mortality and exacerbating severity of infections. Biannual vitamin A supplementation (VAS) for children aged 6\u201359 months can be a low-cost intervention to meet vitamin A needs. This study aimed to present a framework for evaluating the equity dimensions of national VAS programmes according to determinants known to affect child nutrition and assist programming by highlighting geographical variation in coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-062387","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T10:25:15Z","timestamp":1678789515000},"page":"e062387","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluating equity dimensions of infant and child vitamin A supplementation programmes using Demographic and Health Surveys from 49 countries"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2580-3726","authenticated-orcid":false,"given":"Kevin","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK"},{"name":"Programme Division, UNICEF, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hallie","family":"Eilerts","sequence":"additional","affiliation":[{"name":"Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Imohe","sequence":"additional","affiliation":[{"name":"Programme Division, UNICEF, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1060-2473","authenticated-orcid":false,"given":"Katherine P","family":"Adams","sequence":"additional","affiliation":[{"name":"Institute for Global Nutrition, University of California Davis, Davis, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Sandalinas","sequence":"additional","affiliation":[{"name":"Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grainne","family":"Moloney","sequence":"additional","affiliation":[{"name":"Programme Division, UNICEF, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Joy","sequence":"additional","affiliation":[{"name":"Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0431-2947","authenticated-orcid":false,"given":"Andreas","family":"Hasman","sequence":"additional","affiliation":[{"name":"Programme Division, UNICEF, New York City, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,14]]},"reference":[{"key":"2025121221360749000_13.3.e062387.1","unstructured":"United Nations Children\u2019s Fund . 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