Vitamin A supplementation coverage and associated factors among Ethiopian children under five years: a systematic...

Vitamin A deficiency remains a critical public health issue in Ethiopian children under five years, significantly contributing to increased morbidity and mortality. Despite national supplementation programs, coverage is low and regionally varied. This systematic review and meta-analysis aimed to synthesize existing evidence on vitamin A supplementation coverage and associated factors in Ethiopian children under five, crucial for enhancing child health interventions.

A comprehensive literature search was conducted across PubMed, Medline, HINARI, EMBASE, Web of Science, Scopus, and Google Scholar from March 25 to April 17, 2025, adhering to PRISMA guidelines. Additional studies were identified through reference checking. Eligibility criteria guided article selection, and study quality was assessed using the Newcastle-Ottawa Scale. Publication bias was evaluated via Funnel plot inspection and Egger's test, while heterogeneity was assessed using Cochrane Q and I² tests. A random effects meta-analysis in STATA 17 computed the pooled estimate of vitamin A supplementation practice.

Our review included a total of 11 studies, encompassing 32,361 study participants. The meta-analysis revealed that the overall coverage of vitamin A supplementation among children under the age of five years in Ethiopia was 53.43% (95% CI: 42.81-64.05). Key factors significantly associated with vitamin A supplementation coverage included family wealth status, maternal antenatal care (ANC) visits, mothers' access to vitamin A information, and mothers' educational status.

This systematic review and meta-analysis confirmed that vitamin A supplementation coverage in Ethiopia is critically low, standing at just 53.43%. This falls well below the 95% national target and the 80% WHO and UNICEF threshold, highlighting an urgent need for intensified interventions. Our findings offer clear guidance for policymakers and public health implementers: focus on empowering mothers through education and information, promoting consistent antenatal care (ANC) attendance, and addressing socioeconomic disparities to significantly boost national vitamin A supplementation coverage.

PROSPERO registration number: CRD420251017115.