Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas

Lima, Riquelane B.M.; Ferreira, Haroldo S.; Cavalcante, Andressa L.; Santos, Laíse Gabrielly M.L.; Vieira, Regina Coeli S.; Assunção, Monica L.

doi:10.1016/j.jped.2018.08.006

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original articles • J. Pediatr. (Rio J.) 96 (2) • Mar-Apr 2020 • https://doi.org/10.1016/j.jped.2018.08.006 copy

Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas^☆ ☆ Please cite this article as: Lima RB, Ferreira HS, Cavalcante AL, Santos LG, Vieira RC, Assunção ML. Coverage and educational actions related to the national vitamin A supplementation program: a study in children from the state of Alagoas. J Pediatr (Rio J). 2020;96:184-92. , ^☆☆ ☆☆ Study conducted at Universidade Federal de Alagoas (UFAL), Faculdade de Nutrição, Maceió, AL, Brazil. ^☆☆☆ ☆☆☆ Article based on Riquelane Bezerra Menezes Lima's Master's Degree Dissertation, from the Postgraduate Program in Nutrition, Universidade Federal de Alagoas, Maceió, AL, Brasil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

To estimate the coverage of the National Vitamin A Supplementation Program (Programa Nacional de Suplementação de Vitamina A) in children from Alagoas, to identify factors associated with this coverage, and to analyze the adequacy of nutrition education actions.

Methods:

Household survey involving a representative probabilistic sample of children aged 6 to 59 months from Alagoas and their mothers (n = 509). Coverage was defined by the percentage of children with supplementation records in the last semester. The association between the independent variables (socioeconomic, demographic, and health) and the National Vitamin A Supplementation Program coverage was analyzed based on the prevalence ratio and its 95% CI. The mothers' knowledge of questions related to vitamin A was considered as an indicator of the adequacy of nutrition education actions.

Results:

Program coverage was 91.9% in children aged 6-11.9 months and 38.6% in children aged 12-59 months. In the adjusted analysis, the factors that were associated with greater coverage were: age between 6-11.9 months (PR = 2.50, 95% CI: 2.10-2.96), living in rural areas (PR = 1.45, 95% CI: 1.20-1.76) and living in a house with ≤ 4 rooms (PR = 1.33, 95% CI: 1.09-1.63). Only 26.1% of the mothers were able to mention some food source of vitamin A and only 19.2% were aware of the consequences of vitamin deficiency for health.

Conclusions:

The National Vitamin A Supplementation Program coverage is below the targets set by the Ministry of Health (except for children < 12 months). The factors associated with greater coverage indicate an adequate focus of the program. The nutrition education activities have not demonstrated satisfactory results. This information should guide actions to improve the program.

KEYWORDS
Public health; Vitamin A; Supplementation; Health evaluation; Brazil

Variables	Sample n (%)	Received vitamin A supplementation in the last 6 months		p-value	Adjusted PR (95% CI)
		Yes (%)	Crude PR (95%CI)
Children's age (months)
6 to 11.9	37 (7.3)	34 (91.9)	2.38 (2.05-2.76)	0.001^e e Statistically significant difference (p < 0.05) according to Pearson's chi-squared test.	2.50 (2.10-2.96)
12 to 59,9	472 (92.7)	182 (38.6)	1
Gender
Male	252 (49.5)	102 (40.5)	1.09 (0.89-1.34)	0.377
Female	257 (50.5)	114 (44.4)	1
Child with diarrhea in the last 15 days (12 mothers [2.4%] could not answer)
Yes	70 (15.8)	34 (42.5)	1.00 (0.75-1.32)	0.985
No	427 (84.2)	181 (42.4)	1
Maternal age (years) (28 mothers [5.5%] did not know/did not want to answer)
≤ 20	31 (6.4)	13 (41.9)	1.01 (0.65-1.55)	0.956
>20	450 (93.6)	191 (42.4)	1
Maternal education (in years of study) (32 mothers [6.3%] did not know/did not want to answer)
≤ 8	238 (49.9)	97 (40.8)	1.07 (0.86-1.32)	0.543
> 8	239 (50.1)	104 (43.5)	1
Area of residence
Rural	131 (25.7)	71 (54.2)	1.41 (1.15-1.73)	0.001^e e Statistically significant difference (p < 0.05) according to Pearson's chi-squared test.	1.45 (1.20-1.76)
Urban	378 (74.3)	145 (38.4)	1
Number of family members
≤ 4	312 (61.3)	142 (45.5)	1.21 (0.97-1.50)	0.083
> 4	197 (38.7)	74 (37.6)	1
Family is enrolled in the government's income transfer program
Yes	331 (65.0)	138 (41.7)	1.05 (0.85-1.30)	0.642
No	178 (35.0)	78 (43.8)	1
Per capita monthly family income in number of minimum wages (R$) ^a a Minimum wage value at the time of data collection: R$ 724.00. (39 mothers [7.7%]% did not know/did not want to answer)
≤ ½ MW	59 (12.5)	24 (40.7)	1.07 (0.77-1.48)	0.683
> ½ MW	411 (87.5)	179 (43.5)	1
Number of durable consumer goods ^b b TV set, radio, car, washing machine, videocassette, refrigerator, freezer, microcomputer, dishwasher, microwave oven, motorcycle, clothes dryer, DVD player.
< 6	279 (54.8)	116 (41.6)	1.04 (0.85-1.28)	0.666
≥ 6	230 (45.2)	100 (43.5)	1
Number of rooms in the house
≤ 4	105 (20.6)	56 (53.3)	1.35 (1.08-1.67)	0.007^e e Statistically significant difference (p < 0.05) according to Pearson's chi-squared test.	1.33 (1.09-1.63)
> 4	404 (79.4)	160 (39.6)	1
Number of rooms used for sleeping
< 2	340 (66.8)	153 (45.0)	1.22 (0.97-1.53)	0.091
≥ 2	169 (33.2)	62 (36.9)	1
Origin of drinking water
Inadequate^c c River, well, water-hole, etc.	146 (28.7)	81 (55.5)	1.49 (1.22-1.82)	0.001^e e Statistically significant difference (p < 0.05) according to Pearson's chi-squared test.
Adequate^d d General water network system or mineral water.	363 (71.3)	135 (37.2)	1

Questions/Answers	n	%
Have you heard about the National Vitamin A Supplementation Program?
No	366	72.5
Yes	139	27.5
In your opinion, what is the purpose of the National Vitamin A Supplementation Program? ^a a Applied to those who answered "yes" to the previous item.
Another answer/did not know how to answer	116	83.5
To cure/prevent vitamin A deficiency	23	16.5
Has the child ever failed to receive the dose of vitamin A because they did not have it in the basic health unit?
Yes	181	36.3
No/does not remember	318	63.7
Among other things, during this program, has someone from Health Care cut a capsule like this (SHOW IT) containing vitamin A and put it in the child's mouth? Has your child received this vitamin A in the last 6 months.? ^b b Corresponds to the mothers' answer.
No/does not remember	163	32.5
Yes	339	67.5
Time since the administration of the last dose (coverage rate) ^c c Corresponds to the dose confirmed on the child's vaccination card.
> 6 months	293	57.6
≤ 6 months	216	42.4
Have you ever received information about vitamin A?
No/does not remember	409	82.3
Yes	88	17.7
Which professional gave you the information? ^d d Corresponds to the 17.7% who reported receiving information on vitamin A.
Nurse	53	60.2
Physician	6	6.8
Nutritionist	0	0.0
Pharmacist	2	2.3
Health agent	25	28.4
Does not remember	2	2.3
Which foods are rich in vitamin A?
3 correct answers	3	1.0
2 correct answers	21	6.9
1 correct answer	55	18.2
Errors/ Does not know	224	73.9
What health problems can occur when our body lacks vitamin A?
3 correct answers	3	0.6
2 correct answers	15	2.9
1 correct answer	80	15.7
Errors/does not know	411	80.8

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:haroldo.ufal@gmail.com (H.S. Ferreira).