Knowledge Attitudes and Practices Regarding Vitamin A Supplementation among Caregivers of Children Aged from Six to Fifty-Nine Months in Vihiga County, Kenya

Abstract

Vitamin A is an essential micronutrient needed in small amounts for, among other uses, the normal functioning of the visual and immune systems. The deficiency of this vital nutrient, therefore, compromises a children's ability to fight diseases and increases their risk of getting sick. The World Health Organization recommends Vitamin A Supplementation (VAS) as a strategy to combat the effects of vitamin A deficiency, but unfortunately, the coverage is low (64% in priority countries and 59% in East and Southern Africa, as reported in UNICEF global nutrition database 2000-2021). The study area recorded low coverage at 26% in 2019 and 54.9% in the year 2020. This study employed a descriptive cross-sectional study design to determine the knowledge, attitude, and practices among caregivers of children 6-59 months regarding vitamin A supplementation in Vihiga County, Kenya, and the influencing factors. In total, 393 caregivers out of the sample size of 400 (98.3%) were recruited into the study. Binary logistic regression was used to determine associations between variables and a p-value <0.05 was considered significant. High VAS awareness was reported in this study, with 90.6% of caregivers having heard of VAS. The main sources of VAS information were health workers (74.3%) and Community Health volunteers (53.2%). Other sources were Radio & TV (6.9%), Social gatherings (7.1%). There was, however, low knowledge of the benefits of VAS (30%) and the problems associated with vitamin A deficiency (30.3%). Sadly, a quarter of caregivers (24.6%) did not know any VAS benefit. A significant proportion of caregivers (77.6% p=<0.001) had adequate knowledge of VAS, scoring more than half of the 10 knowledge questions. In addition, caregivers displayed a highly positive attitude towards VAS, scoring between 88.3% and 92.6% on attitude questions. There was low VAS uptake, with only 59.5% of children having taken the supplement during the semester preceding the survey, mainly sourced from health facilities (68.4%), outreach (15.8%), CHV (10.7%) and the ECDE centres (5.1%). For children who missed VAS in the semester of reference, 38% of caregivers indicated they had no reason for missing, 20% said there was no need since the child had completed immunization, while others just forgot (9%). The key drivers of VAS uptake were knowledge (p=<0.001), availability of services at health facilities (p=0.001) and services by community health volunteers) p=0.028). Although more than three-quarters (77.6%) of caregivers demonstrated good knowledge, it did not correspond to the VAS uptake recorded in this study, pointing to a knowledge-practice gap. The VAS knowledge was shallow in terms of specific areas like benefits. The caregivers, however, had very positive attitudes towards VAS. Further, this study concludes that better knowledge is an important ingredient for VAS uptake and recommends implementing programmes to improve caregiver knowledge and optimization of the various service delivery platforms to increase both knowledge and uptake.