Spatial Distribution of Foods Rich in Vitamin A Intake Status and Associated Factors among Children aged 6–23 Months in Ethiopia: Spatial and Multilevel Analysis of 2019 Ethiopian Mini Demographic and Health Survey.

Abstract Background: Inadequate micronutrients in the diet, and vitamin A deficiency, are worldwide public health problems. In developing regions, many preschool children are undernourished, become blind every year, and died before the age of 23 months. This study was aimed to explore the spatial distribution of foods rich in vitamin A intake status among children aged 6-23 months and identify associated factors in Ethiopia.Methods: Ethiopian Mini Demographic and Health Survey 2019 dataset with a total 1407 children aged 6-23 months was used. Data management and processing were done using STATA version 15 software and Microsoft Office Excel. ArcMap version 10.7 software was used for mapping, spatial visualization. Spatial scan statistics was performed using SaTScan version 9.5 software. Multilevel mixed effect logistic regression model was employed to identify associated factors.Results: Overall, 38.99% (95% CI: 36.46–41.62) of children aged 6– 23 months had foods rich in vitamin A intake in Ethiopia. The spatial distribution of intake of foods rich in vitamin A was non-random and its hot spots were observed in Oromia and South Nations Nationalities and Peoples’ Regions. Whereas, cold spots were observed in the Harari and Dire Dawa. A total of 85 significant (84 primary, 1 secondary) clusters were identified. Children aged 6–23 months who lived in the primary cluster were 70% (RR = 1.70, LLR = 32.38, P-value < 0.001) more likely to intake foods rich in vitamin A. Primary (AOR:1.42, 95% CI: 1.05, 1.93) and higher (AOR:3.0, 95% CI: 1.59, 5.65) educational status of mother, Afar (AOR: 0.16, 95% CI: 0.07, 0.36), Amhara (AOR: 0.37, 95% CI: 0.19, 0.71), Somali (AOR: 0.02, 95% CI: 0.003, 0.08), Dire Dawa (AOR:0.49, 95% CI: 0.22, 1.12), children aged 13 to 23 months (AOR: 1.80, 95% CI: 1.28, 2.36), Media exposure (AOR: 1.41, 95% CI: 1.04, 1.92) were significant factors for intake of foods rich in vitamin A. Conclusions: Intake of foods rich in vitamin A among children aged 6-23 months is inadequate. Mother’s educational status, Region, Child age, and Media exposure are significant factors. Providing formal education, nutritional counseling to mothers, and creating awareness of mothers is important to further improvement of intake of foods rich in vitamin A among children. Agricultural sectors in Ethiopia are also use locally available natural resource for productions of vitamin A rich food items and stakeholders better to give priority for the hot spots areas.