Spatial distribution and geographical heterogeneity factors associated with poor consumption of foods rich in vitamin A among children age 6-23 months in Ethiopia: Geographical weighted regression analysis.

introductionVitamin A deficiency is a major public health problem in poor societies. Dietary consumption of foods rich in vitamin A was low in Ethiopia. This study aimed to assess the spatial distribution and spatial determinants of dietary consumption of foods rich in vitamin A among children aged 6-23 months in Ethiopia.

methodsEthiopian 2016 demographic and health survey dataset using a total of 3055 children were used to conduct this study. The data were cleaned and weighed by STATA version 14.1 software and Microsoft Excel. Children who consumed foods rich in vitamin A (Egg, Meat, Vegetables, Green leafy vegetables, Fruits, Organ meat, and Fish) at least one food item in the last 24 hours were declared as good consumption. The Bernoulli model was fitted using Kuldorff's SaTScan version 9.6 software. ArcGIS version 10.7 software was used to visualize spatial distributions for poor consumption of foods rich in vitamin A. Geographical weighted regression analysis was employed using MGWR version 2.0 software. A P-value of less than 0.05 was used to declare statistically significant predictors spatially.

resultsOverall, 62% (95% CI: 60.56-64.00) of children aged 6-23 months had poor consumption of foods rich in vitamin A in Ethiopia. Poor consumption of foods rich in vitamin A highly clustered in Afar, eastern Tigray, southeast Amhara, and the eastern Somali region of Ethiopia. Spatial scan statistics identified 142 primary spatial clusters located in Afar, the eastern part of Tigray, most of Amhara and some part of the Oromia Regional State of Ethiopia. Children living in the primary cluster were 46% more likely vulnerable to poor consumption of foods rich in vitamin A than those living outside the window (RR = 1.46, LLR = 83.78, P < 0.001). Poor wealth status of the household, rural residence and living tropical area of Ethiopia were spatially significant predictors.

conclusionOverall, the consumption of foods rich in vitamin A was low and spatially non-random in Ethiopia. Poor wealth status of the household, rural residence and living tropical area were spatially significant predictors for the consumption of foods rich in vitamin A in Ethiopia. Policymakers and health planners should intervene in nutrition intervention at the identified hot spot areas to reduce the poor consumption of foods rich in vitamin A among children aged 6-23 months.