Feasibility of Delivering Vitamin a Supplementation (VAS) and Deworming Through Routine Community Health Services in Siaya County, Kenya: A Cross‐Sectional Study
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Date
2024-01
Authors
Ochola, Sophie
Lelei, Asa
Korir, Julius
Ombati, Caleb
Chebet, Caroline
Doledec, David
Mutea, Fridah
Nielsen, Jennifer
Omariba, Solomon
Njeri, Esther
Journal Title
Journal ISSN
Volume Title
Publisher
John Wiley & Sons Ltd
Abstract
Vitamin A deficiency and soil‐transmitted helminth infection are serious public
health problems in Kenya. The coverage of vitamin A supplementation and
deworming medication (VASD) provided through mass campaigns is generally high,
yet with a cost that is not sustainable, while coverage offered through routine health
services is low. Alternative strategies are needed that achieve the recommended
coverage of >80% of children twice annually and can be managed by health systems
with limited resources. We undertook a study from September to December 2021 to
compare the feasibility and coverage of VASD locally delivered by community health
volunteers (CHV) (“intervention arm”) to that achieved by the bi‐annual Malezi
Bora campaign event (“control arm”). This comparative cross‐sectional study was
conducted in sub‐counties of Siaya County using both qualitative and quantitative
methods. VASD were offered through the CHS in Alego Usonga and through Malezi
Bora in Bondo Sub‐County. Coverage was assessed by a post‐event coverage survey
among caregivers of children aged 6–59 months (n = 307 intervention; n = 318
control). Key informant interviews were conducted with n = 43 personnel across
both modalities, and 10 focus group discussions were conducted with caregivers of
children aged 6–59 months to explore knowledge, attitudes and perceptions of the
two strategies. VAS coverage by CHV was 90.6% [95% CI: 87.3–93.9] compared to
70.4% [95% CI: 65.4–75.4] through the Malezi Bora, while deworming coverage was
73.9% [95% CI: 69.0–78.7] and 54.7% [95% CI: 49.2–60.2], respectively. With
sufficient training and oversight, CHV can achieve superior coverage to campaigns
Description
Article
Keywords
children, community health services, cost‐effectiveness, coverage, deworming, Kenya, vitamin A
Citation
Ochola, S., Lelei, A., Korir, J., Ombati, C., Chebet, C., Doledec, D., ... & Baker, M. M. (2024). Feasibility of delivering vitamin A supplementation (VAS) and deworming through routine community health services in Siaya County, Kenya: A cross‐sectional study. Maternal & Child Nutrition, 20(2), e13626.