| dc.description.abstract | Nutritional deficiencies account for 3 million child deaths annually in less-developed countries. Deficiencies of vitamin A are responsible for 0:6 million deaths and 9% of global childhood Disability-Adjusted Life Years (DALY s). Vitamin A supplementation will help achieve one of the millennium development goals of reducing mortality among children by two thirds by 20l5.Vitamin A will reduce mortality because it boosts the immune system. However, vitamin A supplementation coverage is low in many parts of the world for example in India (37.6%), Mozambique (46%) and Kenya (33%). Gucha district is a malaria endemic region yet there is evidence that vitamin A supplementation reduces all cause mortality among children living in such regions. The main objective of this study was to identify factors related to vitamin A supplementation coverage to preschool children in Gucha District. A cross-sectional survey design was used and the study population consisted of 4840 caregivers from 4840 households, 85 health workers, 5 members of the district health management team and 3 key informants (divisional heads) giving a total population of 4933. Using multi-stage cluster sampling, 3 divisions were randomly selected out of the 5 divisions in Gucha District. Subsequently.. 1 location was randomly selected from each of the 3 divisions. Finally, 1 sub-location was randomly selected from each of the 3 locations. After this, simple random sampling was used to select 334 households out of the total 4840 households with caregivers with a preschool child. Since there were 85 health workers in Gucha district, 25 health workers were included in the study to give a 30% representative sample. Allthe 5 members of the district health management team and 3 key informants were also included in the study giving a total sample of 367 respondents. An interview schedule on caregivers, questionnaires on health workers and a focus group discussion with the district health management team and the key informants were used to collect data. Chi square test and odds ratio were used for analysis to establish the relationship and strength respectively, between the dependent variable (vitamin A supplementation coverage) and the independent variables (household factors). The relationship was statistically significant when the p-value obtained was less than 0.05. Data from health workers and the district health management team were thematically analyzed using narrative approach. The study showed that the level of vitamin A supplementation coverage was low (41.2%). There was a statistically significant relationship between vitamin A supplementation coverage and the age of preschool children (p=O.OOO),education level of caregivers (p=0.008), and distance covered by caregivers to health facilities (p=0.009). Out of 25 health workers, 24(96%) knew the importance of vitamin A supplements, 12(48%) are trained on vitamin A supplementation, 3(12%) recorded in tally sheets after giving vitamin A supplements and 6(24%) explained to caregivers the reason for giving vitamin A supplements. The roles of the District Health Management Team on vitamin A supplementation are planning, training, supervision and awareness creation. The age of the preschool child, distance covered by caregivers to health facilities, education level of caregivers, poor documentation by health workers and reduced number of times of supervision by the district health management team are related to the low vitamin A supplementation coverage in Gucha District. The Ministry of Health should increase the number of health facilities, employ more staff, train more staff on supplementation and emphasize on the importance of documentation to its staff. This study will be important in improving child health nutrition and safeguarding human power development. | en_US |
