Prevalence and Factors Associated with Vitamin A Rich Foods Consumption among Children Aged 6-59 Months in Hawi Gudina District, Eastern Ethiopia

Prevalence and Factors Associated with Vitamin A Rich Foods Consumption among Children Aged 6-59 Months in Hawi Gudina District, Eastern Ethiopia | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence and Factors Associated with Vitamin A Rich Foods Consumption among Children Aged 6-59 Months in Hawi Gudina District, Eastern Ethiopia Chala Namomsa Fite, Wondimye Ashenafi, Hassen Abdi, Alemayehu Deressa This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9059438/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : Vitamin A rich foods are important for children under the age of five years due to their increased physiological needs for growth and development. However, the magnitude of vitamin A rich foods consumption among children aged 6-59 months is not well studied and the determinant factors are not exhaustively identified. Objectives : To assess the prevalence and factors associated with vitamin A rich foods consumption among children aged 6-59 months in Hawi Gudina District, Eastern Ethiopia from December 1 to 30, 2024. Method: Across-sectional study was conducted among 401 randomly selected mother-child pairs in Hawi Gudina District, Eastern Ethiopia, 2024. A multistage sampling technique was used to select the study participants. Data were collected by using interviewer-administered questionnaire. Frequencies, percentages and mean score with standard deviations were generated to describe participants and report univariate outcomes. Consumption of vitamin A rich foods was assessed using a 7 days dietary recall. Logistic regression analysis was applied to identify determinant factors contributed to child vitamin A rich foods consumption practice. Results ; The overall prevalence of vitamin A rich foods consumption among children was [28.4% (95% CI: 24.2%, 33.0%)]. Family size of ≤ 4 [AOR=3.48 (95%CI: 1.15, 6.12)], child age of 48-59 months [AOR=2.59 (95%CI:1.08, 6.24), maternal age of 30-39 years [AOR=3.25 (95% CI:1.37,7.69)], maternal higher education/college or above [AOR=1.24 (95%CI: 1.07, 2.69)], medium [AOR=2.82 (95%CI: 2.10, 6.18)] and rich [AOR=3.42 (95%CI: 2.13, 7.52) household wealth index and household food security [AOR=1.97 (95%CI:1.00, 3.89) were significantly associated with higher odds of vitamin A rich foods consumption among children aged 6–59 months. Conclusions: The study indicated low magnitude of vitamin A rich foods consumption among children aged 6-59 months. Few family sizes, middle-aged mothers and higher maternal educational status, increase in child age, medium and rich wealth index, and household food security were the factors significantly and positively associated with consumption of vitamin A rich foods. Attention must be given to improve the socioeconomic status, maternal education and health care service delivery to enhance the consumption of vitamin A rich foods among children. Vitamin A vitamin A rich foods children age 6-59 months Figures Figure 1 INTRODUCTION Vitamin A is one of the essential vitamins that is vital for enhancing reproduction and vision, as well as for preventing blindness and infection (Sherwin et al., 2012 ;Song et al., 2023 ). It has also numerous important functions such as preserving the intestinal, respiratory, urinary tracts and the surface of the eyes, as well as for proper functioning of the immune system (Smith and Saul, 2012 ). Vitamin A rich foods are especially important for children under the age of five due to their increased physiological needs for growth and development. During the first five years of life, children experience rapid physical growth, organ development, and immune system maturation, all of which require adequate vitamin A for proper functioning (WHO, 2009 ). The best sources of preformed vitamin A are foods derived from animals such as breast milk, glandular meats, liver and fish liver oils, egg yolk, whole milk, and other dairy products. Plant sources rich in pro-vitamin A include dark green leafy vegetables, carrots, pumpkins, sweet potatoes, yams, watermelon, and yellow or orange fruits like papaya, mango, and squash (WHO, 2011 ;Combs Jr, 2016 ). Much of the vitamin A (provitamin A) in developing countries are obtained from plant sources, as livestock sources are inaccessible for most of the rural poor (Mbabazi et al., 2020). In developed countries, animal-source food containing vitamin A accounts for nearly 65% of total vitamin A consumption, and plant-source food accounts for 35%. However, in developing countries, 70–90% of vitamin A is consumed as a pro-vitamin A carotenoid, because plant based foods are more affordable than animal products. Several studies conducted in these regions have shown that children often did not consume enough vitamin A-rich foods (Zongo et al., 2017 ;Kananu et al., 2020 ;Wolde and Tessema, 2023 ). In 51 low and middle-income countries (LMIC) 55%, and in Africa, 49% of children consumed vitamin A rich foods (Karlsson, 2021 ;UNICEF, 2022). Studies conducted in Bangladesh and India, documented low dietary vitamin A intakes by children and that most of the vitamin A intake was derived from plant sources (Talukder et al., 2000 ;Suri et al., 2017 ). In Ethiopia, a study on children aged 6–23 months found that 38.99% of children had an intake of foods rich in vitamin A in the last 24 hours (Demsash et al., 2022 ). Another study among children aged 6–59 months in Dembia District found that 36% of them had consumed food rich in vitamin A in the last 7 days (Tariku et al., 2016 ). One in ten children consume meat, fish, shellfish, poultry or eggs (CSA, 2006). Children who did not consume vitamin A rich foods were more likely susceptible to vitamin A deficiency disorders (VADD), blindness from Keratomalacia and measles (Hussey and Klein, 1990 ), malnutrition, anemia and missing of basic child health intervention like immunization and vitamin A supplementation (Semba et al., 2010 ). Globally, around 190 (33.3%) million, in Africa 56.4 (44.4%) million preschool children were vitamin A deficient (WHO, 2009 ). About 37.6% of under five years children were suffering from subclinical vitamin A deficiencies in Ethiopia (Haidar, 2011 ). Inadequate consumption of vitamin A rich foods might be due to various interrelated factors, including having young mother’s (Semba et al., 2010 ), being male in gender, poor living standard, living in rural area and dry environment, maternal and child age (Semba et al., 2010 ), low socio-economic status (Sofia Vilela, 2019), low maternal education (Kebede et al., 2022 ). In addition to these, inadequate production of vitamin A rich foods, lack of income to purchase, unavailability of vitamin A rich foods in markets, large family size and illness (Demissie T, 2009;UNICEF, 2019), low parental media exposure were also presumed as a contributing factors to the low consumption of vitamin A rich foods (Tiruneh et al., 2021 ;UNICEF, 2022) Few studies have shown that there were poor consumption of vitamin A rich foods among 6–59 months aged children in Ethiopia (EDHS, 2019 ;Moroda et al., 2022). Most existing studies focus narrowly on under two years age children, pregnant or lactating mothers (Abebe et al., 2014;Jemberu Y, 2017;Aserese et al., 2020 ). This study, therefore, aims to assess the prevalence of vitamin A rich foods consumption and associated factors among children aged 6–59 months in Hawi Gudina District, Eastern Ethiopia. The finding helps mothers and their children in prevention and control of the risks associated with the inadequate consumptions of foods rich in vitamin A. It has paramount importance for the government, local authorities and development actors to design appropriate and effective interventions in Ethiopia and the study setting. Methods and Materials Study Area and Period A community-based cross-sectional study design was conducted among children aged 6–59 months in Hawi Gudina District from December 1–30, 2024. Hawi Gudina District was one of the pastoralist districts found in West Hararghe Zone. Rimeti town was the center of the district. It was found at 486 KM from Addis Ababa, capital city of the country and 186 KM from Chiro, capital town of the zone. The total population of the district in 2023 was 120,790 with female population 61603 (51%) and male 59187 (49%), under 1 year old children 3889, under 5 years children 19326, 6–59 months age children 18118 and 25165 households. The district had five health centers, 32 health posts and 6 private clinics that served the population of the district and neighboring districts. The major food products are grain crops like wheat, maize, sorghum, bean, and other legumes. Potato, spinach, lettuce, cabbage, kale, pumpkin, and fruits available at the study area include mango, avocado, banana and orange. Study participants and sampling All randomly selected children aged 6–59 months in the selected kebele of Hawi Gudina District were the study populations, and all children aged 6–59 months in the selected kebele and had mother or caretaker at home during data collection time were considered as inclusion criteria. Children who were very sick, had a mental problem and lived in the area for less than six months were excluded from the study. The minimum sample size required for the study was determined by using a single population proportion formula with the following assumption; 5% margin of error (d), 95% Confidence Interval (CI), 20% proportion of children age 6–59 months consuming vitamin A rich foods (Yadav et al., 2021 ), 10% non-response rate and 1.5 design effect. This resulted in a sample size of 406. The sample size for the factors associated with VARF consumption was determined by using Epi-info statcalc v 7.2 by considering the following assumption: 80% power of the study, 95% confidence level, 31.42% proportion of children age 12–17 months had not consumed vitamin A rich foods and AOR = 0.47 (Jemberu et al., 2017 ), 10% non-response rate and design effect 1.5. This resulted in a sample size 338. Finally 51% proportion of children from highest wealth quintile consumed adequate vitamin A rich foods, 0.421 AOR (Kebede et al., 2022 ) with 95% confidence level, 10% non-response rate and 1.5 design effect, minimum of 200 study participants were required. \(\) Finally, comparing the three sample sizes, the largest sample size was taken 406. Multistage sampling procedure followed by systematic random sampling procedure was implemented for sample selection. Initially, the district has 32 kebeles (small administrative unit in Ethiopia). The district was also divided into urban and rural kebeles. Accordingly, there were 30 rural and 2 urban kebeles from which 9 rural and 1 urban representative kebeles were selected by simple random sampling technique. The calculated sample (406) was proportionally distributed to the ten-selected kebeles in consideration of their population size. In the second stage, eligible households with children age 6–59 months in the selected kebele were identified from health posts family folder. Finally, the sampling fraction (k) was calculated by dividing total number of eligible households across all selected kebeles by the total sample size to calculate the sampling interval. Based on this, study participants were selected using a systematic random sampling technique at every 24th interval (K = 9796/406≈24). From each household, one study subject was selected and where there more than one eligible study subject in the household, only one child was selected by lottery method. Structured questionnaire was adapted from related different literatures used to collect data from mother-child pairs (Persson, 2001 ;EDHS, 2019 ). These questionnaires were drafted in English and translated into Afaan Oromo and then back to English. The questionnaire comprised various sections including socio-demographic characteristics, reproductive and health care related factors and dietary factors. These were analyzed to determine the prevalence and the associated factors with child vitamin A rich foods consumption. In this study, the Helen Keller International food frequency questionnaire (HKI) (Rosen et al., 1993 ) was used to evaluate frequency of intake of vitamin A rich foods with modifications to the local context. The tool has twenty-eight different food items. Among the twenty-eight food items, twenty are available in the study area and are consumed by society. Only major sources of vitamin A, ≥ 100-retinol equivalent (RE) were taken into consideration. The food items selected for the analysis of the consumption of foods rich in vitamin A were categorized into seven groups. Each food group was scored 0 if not given to the child and scored + 1 if if the respondent reported that the child had took at least one of those vitamin A rich foods item in the previous week (Persson et al., 1998 ;El-Arab et al., 2002). The child’s dietary diversity score was calculated as the sum of the number of different food groups consumed by the child in the 24 hours preceding the survey. The dietary diversity score ranges from zero to seven, where zero represents non-consumption of any of the food items and seven represents the highest level of dietary diversification. The seven food groups included 1.cereals, roots and tubers, 2.legumes and nuts, 3.dairy products (milk, yogurt), 4.flesh foods (meat, fish, poultry, and liver/organ meats), 5.eggs, 6.vitamins A rich fruits and vegetables 7.others fruits and vegetables. Children who consumed at least four out of the seven food groups within a 24-hours recall period were considered to have adequate dietary diversity (WHO, 2021 ). Nutrition knowledge of mothers was assessed using a scoring system based on responses to 9 nutrition-related standardized questionnaires. Finally, mothers with mean score of 4.5 or above were considered as having ‘good knowledge’ and those with less than the mean score were considered as having ‘poor knowledge’(Berhe, 2017 ). Similarly, mothers were asked for the history of their child illnesses include cough, diarrhea, eye and skin infections. The overall illness refers to being ill regardless of types, episode, and the severity of illness in the last two weeks preceding the survey (Andago, 2004 ;Demissie T, 2009). Household Food Insecurity Access Scale (HFIAS) measurement tool developed by the Food and Nutrition Technical Assistance (FANTA) project was used to assess the household food security status of households (Coates et al., 2007). Wealth index was computed as a measure of household wealth using principal component analysis (PCA), a method typically used to reduce the dimensionality of multiple factors in a dataset (Jolliffe and Cadima, 2016 ). Data collections were conducted over a period of four weeks by five diploma holder nurses supervised by two-health officers. Data were collected from mothers or caretakers with children aged 6–59 months by using questionnaire via face-to-face interview. Five percent of the questionnaires were pretested in areas not included in the actual study and appropriate modification was made after the pre-testing. Mothers with children aged 6–59 months were interviewed to provide information regarding child’s vitamin A rich foods consumption status and the associated factors. In a situation where eligible study subject temporarily absent at the selected house during the interview, two repeated visits were done and otherwise, an adjacent house would be substituted. The interview took around 30 minutes for each participant. Study Variables Dependent variables The consumption of vitamin A rich foods was the outcome variable, dichotomized as “yes” if participants consumed at least one among the seven vitamin A rich foods otherwise “No”. These food groups were i. Eggs, ii. Meat (beef, pork, lamb, chicken), iii. Pumpkin, carrots, and squash, iv. any dark green leafy vegetables, v. mangoes, papayas, and others with vitamin A fruits, vi. Liver, heart, and other organs and vii. Fish or shellfish (Gebremedhin et al., 2021 ;Demsash et al., 2022 ). Independent variables Socio-demographic factors Residency, family size, child age and sex, birth order, numbers of under five years children, parent’s occupation and educational level, maternal age and marital status, household head and wealth index, Reproductive and health care related factors Parity, gravidity, antenatal care, place of delivery, postnatal care, maternal knowledge on VARF, child vaccination status, deworming and morbidity in the last two weeks, Dietary factors Breast-feeding status, complementary feeding initiation time, child meal frequency, dietary diversity, food security level, and household’s home gardening were included in this study. Operational Definitions Vitamin A rich foods consumption if the respondent reported that the child had eaten’ at least one among the seven VARF, we considered “yes = 1”; otherwise “no = 0” within the previous seven days before the study (Demsash et al., 2022 ). Wealth index : Households are given scores based on the number and kinds of goods they own. These scores are derived using principal component analysis. Households were first ranked into quintiles and then regrouped into three categories: poor wealth index (lowest and second wealth quintile), medium wealth index (middle quintile), and rich (fourth and highest quintiles) (Rutstein, 2015 ;Wuneh et al., 2019 ). A detailed explanation of the weighting procedure can be found in the EDHS methodology report (EDHS, 2016 ). Maternal knowledge on vitamin A rich foods were determined using nutrition-related standardized questionnaires (nine items).Then, if the mothers correctly answer above the mean of knowledge questions, she was considered as having a good knowledge; otherwise, she has a poor knowledge (Nti et al., 2012 ;Adem et al., 2024 ). Child vaccination status was determined from the child’s immunization card or, if the record was not available, by maternal recall. Children were classified as fully vaccinated if they had received all basic vaccine in line with the national schedule, partially vaccinated if they had received some but not all and not vaccinated if they had not received any vaccine (Semba et al., 2010 ). Child dietary diversity considered adequate if the children aged 6–59 months consumed food and drink from at least four from seven food groups in the preceding 24 hours of the interview (WHO, 2021 ). Child minimum meal frequency was determined by asking the mother how many times the child took solid, semi-solid, or soft foods in the 24 h preceding the survey. Accordingly, two or more times for breastfed infants 6–8 months of age, three or more times for breastfed children 9–23 months, four times for non-breastfed children 6–23 months and for 24–59 months four and above per day were considered as the children received the minimum meal frequency (WHO, 2008 ) Household food insecurity : A situation that occurs when people lack secure access to sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life (Napoli M, 2011 ). Based on HFIAS score, household food insecurity can be categorized into four levels: Food secure, if the household scores 0 or 1, mild food insecure, if the household scores from 2 to 8, moderate food insecure, if the household scores from 9 to 16, severe food insecure, if the household scores from 17 to 27 (Coates et al., 2007). Data Quality Control In order to assured the quality of data, the following measures were undertaken. Pretest had done on 5% of the random samples (20 participants) one week before the actual study to ensure internal consistency of the instrument. After collecting the pretest data, each individual questionnaire response were checked for any potential problem and modification were made accordingly. The questionnaire was prepared in English and translated into Afaan Oromo (local language) and then back into English by language expert. Training was given to data collectors on the objective of the study, data collection process and relevance of the study prior to data collection. Each questionnaire was coded with a unique identification number. Throughout the course of the data collection, data collectors were supervised at each site. The data was checked for completeness on site and before data entry. Double data entry was performed and the data were crosschecked to ensure consistency. Finally, after checking for data completeness, Epi-Data was utilized for data entry. Data Processing and Analysis Data had been coded, entered and cleaned by using Epi-data software version 4.6 and exported to statistical software packaging for social science (SPSS) version 26.0 for analysis. Descriptive statistics were performed to compute summary statistics and information was presented in the table and text such as frequencies, percent, central tendency, and standard deviation. Household food security was analyzed using Household Food Insecurity Access Scale (HFIAS).The tool includes nine questions with frequency of occurrence responses (rarely = 1, sometimes = 2, often = 3). The total score (0–27) was calculated and household were then classified as food secure (0–1) or food insecure (2–27) based on the scale. Household wealth index was constructed by using Principal Component Analysis (PCA). Ownership of each asset was given a score of “1” and non-ownership was given a score of “0”. Principal component analyses was conducted to generate wealth index after checking all assumptions such as sample adequacy (KMO ≥ 0.5, antiimage ≥ 0.5 and communality ≥ 0.5, Bartlets test of Sphericity (P < 0.5) and absence of variable with complex structure. The wealth index score was then ranked into tertile as the highest tertile was taken as rich, the middle was the medium and the lowest tertile was taken as poor. Bivariate analysis between each explanatory variable and the outcome variable was done to determine the variables to include in the multivariable model. Explanatory variables that were significantly associated with the outcome variable at P value less than 0.25 were included in the multivariable logistic regression model, to identify independent determinants of vitamin A rich foods consumption. The model fitness was evaluated using the Hosmer and Lemeshow goodness-of-fit test (p-value = 0.256), and multicollinearity was assessed using variance inflation factor (VIF). VIF 0.1 was used as a cut-off point for no multicollinearity. To assess the significance of relationships, crude and adjusted odds ratios with the corresponding 95% confidence interval were employed, and p-value < 0.05 was regarded as statistically significant (Berhe, 2017 ). Ethical Considerations The study was conducted following the Helsinki Declaration of Research involving human subjects (CIOMS & WHO, 1993). The study was approved by Haramaya University, College of Health and Medical Sciences, Institutional Health Research Ethics Review Committee (IHRERC) Ref. No. IHRERC/088/2024. Study participants were adequately informed about the purpose, method and benefit of the study. Using a standard consent form, Informed, Voluntary, Written and Signed Consent was received from each study participant before interview. Results Sociodemographic characteristics Among 406 mothers-child pairs approached, 401 consented to take part in the study with response rate of 98.8%. The mean (± SD) age of mothers was 28.23 (± 5) years, and majority of them (79.8%) were between 20 and 39 years. Most mothers, [283 (70.6%)] had no formal education, with only [21 (5.2%)] reaching higher education and near to half [201 (50.1%)]. The mean (± SD) age of the children was 25.25(± 14.8) months, with the majority [266 (66.3%)] were between 6–35 months. About half (50.4%) of them were male and (48.9%) (Table 1 ). Table 1 Socio-demographic characteristics of mother-child pairs in Hawi Gudina District, Eastern Ethiopia, 2024(n = 401). Variables Category Frequency Percent Residency Rural 353 88 Urban 48 12 Religion Muslim 363 90.5 Orthodox 26 6.5 Protestant 12 3.0 Household family size ≤ 4 124 30.9 5–6 137 34.2 ≥ 7 140 34.9 Child sex Male 202 50.4 Female 199 49.6 Child age (in months) 6–23 185 46.1 24–35 81 20.2 36–47 73 18.2 48–59 62 15.5 Child birth order 3 196 48.9 Maternal age in years 15–19 55 13.7 20–29 171 42.6 30–39 149 37.2 40–49 26 6.5 Head of household Male 381 95.0 Female 20 5.0 Maternal educational status No formal education 283 70.6 Primary education 66 16.5 Secondary education 31 7.7 Higher education 21 5.2 Maternal marital status Single 4 1.0 Currently Married 384 95.8 Widowed 4 1.0 Divorced 9 2.2 Maternal occupational status House wife 320 79.8 Merchant 27 6.7 Employed 32 8.0 Daily labor 22 5.5 Father educational level No formal education 251 62.6 Primary education 79 19.7 Secondary education 50 12.5 Higher education 21 5.2 Father’s occupation Farmer 310 77.3 Employed 55 13.7 Daily labor 5 1.3 Merchant 31 7.7 Household wealth index Poor 201 50.1 Medium 106 26.4 Rich 94 23.5 Reproductive and health care related factors Three hundred fifty-four (88.3%) of mothers were multiparous, whereas [375 (93.5%)] were multigravida. Two hundred fifty-five (63.6%), 232 (57.8%) and 200 (49.9%) of mothers had ANC follow up, had given birth at health facility and had postnatal care follow up respectively. One hundred sixty-seven (41.6%) of mothers had claimed to have information about vitamin A of whom the majority, [104 (62.1%)] mentioned health extension workers as their source of information. Only about less than one third, [118 (29.4%)] had good knowledge about vitamin A rich foods. Concerning to the health status of the children, [45 (11.2%)] were sick during the last two weeks prior to the study and majority, [287 (71.6%)] were fully vaccinated (Table 2 ). Table 2 Reproductive and health care related factors of mother-child pairs in Hawi Gudina District, Eastern Ethiopia, 2024(n = 401) Variables Category Frequency Percent Parity ≤ 1 47 11.7 ≥ 2 354 88.3 Gravidity ≤ 1 26 6.5 ≥ 2 375 93.5 ANC Yes 255 63.6 No 146 36.4 Place of delivery Home 169 42.1 Health facility 232 57.9 Postnatal care Yes 200 49.9 No 201 50.1 Child vaccination status Fully vaccinated 287 71.6 Partially vaccinated 114 28.4 Deworming Yes 139 64.4 No 77 35.6 Morbidity in the last two weeks Yes 45 11.2 No 356 88.8 Common causes of morbidity Diarrhea 14 31.1 Cough 24 53.3 Others* 7 15.6 Walking distance to the nearest health facility in hours 3 130 32.4 Heard about vitamin A Yes 167 41.6 No 234 58.4 Sources of information on Vitamin A HEW 104 62.1 HCP 52 31.3 Others 11 6.6 Mother’s Knowledge of vitamin A Poor 283 70.6 Good 118 29.4 Notes: * Malaria, skin infection and conjunctivitis, HEW: health extension workers, HCP: health care professionals Dietary factors Majority, [166 (89.7%)] of children aged 6–23 months were breast-feeding, and among the total children, [291 (72.6%)] had started complementary feeding after six months postpartum (Table 3 ). The proportion of children who consumed foods from grains, roots and tuber was found to be the highest [335 (83.5%)] followed by legumes and nuts [263 (65.6%)], and dairy products [126 (31.4%)]. The proportion of children who were given foods from at least four food groups were [130 (32.4%)] and more than half [242 (60.3%)] had inadequate meal frequency per day. Majority of the households were food insecure (68.3%) and not engaged in home gardening (62.1%). Table 3 Dietary related factor among mother-child pairs in Hawi Gudina District, Eastern Ethiopia, (n = 401) Variables Category Frequency Percent Breast feeding currently (6–23 months) Yes 166 89.7 No 19 10.3 Continued breast feeding (12–23 months) Yes 47 52.8 No 42 47.2 Complementary feeding initiation time Before 6 months 110 27.4 After 6 months 291 72.6 Dietary diversity ≥ 4 130 32.4 4 159 39.7 < 4 242 60.3 Home gardening Yes 152 37.9 No 249 62.1 Household food security level Secure 127 31.7 Insecure 274 68.3 Prevalence of Vitamin A Rich Foods Consumption The prevalence of vitamin A rich foods consumption among children aged 6–59 months was [28.4% (95% CI: 24.2%, 33.0%)] within previous seven days before the survey. Animal sources vitamin A rich foods were consumed by [47 (11.7%)] and plant source vitamin A rich foods were consumed by [74 (18.5%)] children (Fig. 1 ). Factors Associated with Consumption of Vitamin A Rich Foods The association between the consumption of vitamin A rich foods and predictors was analyzed using binary logistic regression. In the bivariate analysis, residency, family size, child age and birth order, maternal age, maternal educational status, wealth index, child vaccination status, maternal knowledge, place of delivery, ANC and PNC follow up, household food security level, meal frequency per day and dietary diversity were associated with child vitamin A rich foods consumption at p-value < 0.25, and then fitted to multivariate analysis. However, religion, child sex, household head, parity and gravidity, walking distance to nearest health facility, breast feeding status, morbidity in the last two weeks and complementary feeding initiation time were not significant at p-value less than 0.25; hence, these variables were excluded from multivariable analysis (Table 4 ). In the multivariable logistic regression analysis, the odds of consumption of vitamin A rich foods among the children aged 6–59 months from family size ≤ 4 were 3.48 times higher as compared to children from family size ≥ 7 [AOR = 3.48 (95% CI:1.15, 6.12)]. The odds of eating vitamin A rich foods among children aged 6–59 months whose mothers’ had higher educational level was 1.24 times higher as compared to those children whose mothers’ had no formal education [AOR = 1.24(1.07, 2.69)]. The odds of consuming vitamin A rich foods among children the whose mothers age ranged 30–39 years were found to 3.25 times higher as compared to children with mothers in the youngest age category (15–19 years) [AOR = 3.25 (95% CI: 1.37, 7.69)]. As child age increases, the consumption of vitamin A rich foods was increases. Children aged 48–59 months were 2.59 times more likely of consuming vitamin A rich foods when compared with children aged 6–23 months [AOR = 2.59 (95% CI:1.08, 6.24)]. Children from the rich and medium wealth index households had significantly highest odds of consuming vitamin A rich foods relative to those from poor households [AOR = 3.42 (95% CI: 2.13, 7.52)] and [AOR = 2.82 (95% CI: 2.10, 6.18)] respectively. Children from the food secure households were consumed two times more likely of getting vitamin A rich foods as compared with those from food insecure households [AOR = 1.97 (95% CI: 1.00, 3.89)] (Table 4 ). Table 4 Binary and multivariable logistic regression analysis showing factors associated with vitamin A rich foods consumption among children aged 6–59 months in Hawi Gudina District, Eastern Ethiopia, 2024 (n = 401) Variables Vitamin A rich foods consumption COR (95% CI) AOR(95%CI) P-value Yes (%) No (%) Residency Rural 94 (23.4) 259 (64.6) 1 1 Urban 20 (5.0) 28 (7.0) 1.97 (1.06, 3.66) 2.18 (0.79, 5.98) 0.129 Household family size ≥ 7 32 (8.0) 108 (26.9) 1 1 5–6 43 (10.7) 94 (23.5) 1.54 (0.95, 2.51) 1.84 (0.81, 4.20) 0.147 ≤ 4 39 (9.7) 85 (21.2) 2.71 (1.27, 5.80) 3.48 (1.15, 6.12) 0.041 Child age in months 6–23 35 (8.7) 150 (37.5) 1 1 24–35 31 (7.7) 50 (12.5) 2.65 (1.48, 4.74) 1.31(0.58, 2.96) 0.514 36–47 21 (5.2) 52 (13.0) 1.73 (0.92, 3.23) 0.86 (0.36, 2.06) 0.730 48–59 27 (6.7) 35 (8.7) 3.30 (1.77, 6.16) 2.59 (1.08, 6.24) 0.034 Child birth order ≥ 3 49 (12.2) 147 (36.7) 1 1 < 3 65 (16.2) 140 (34.9) 1.39 (0.90, 2.15) 1.39 (0.90, 2.15) 0.324 Maternal age (in years) 15–19 35 (8.7) 20 (5.0) 1 1 20–29 26 (6.5) 145 (36.2) 0.74 (0.41,1. 32) 0.73 (0.34, 1.59) 0.431 30–39 48 (12.0) 101 (25.2) 1.71 (1.00, 2.91) 3.25 (1.37, 7.69) 0.007 40–49 5(1.2) 21 (5.2) 0.64 (0.22, 1.84) 2.29 (0.51, 10.21) 0.279 Maternal educational status No formal education 39 (9.7) 244 (60.9) 1 1 Primary education 49 (12.2) 17 (4.2) 1.17 (0.72, 1.91) 0.20 (0.15, 1.79) 0.121 Secondary education 17 (4.2) 14 (3.5) 1.82 (0.77, 4.30) 0.51 (0.18, 1.47) 0.214 Higher education 9 (2.3) 12 (3.0) 2.39 (1.15, 4.95) 1.24 (1.07, 2.69) 0.017 Wealth index Poor 53 (13.2) 148 (36.9) 1 1 Medium 24 (8.5) 72 (18.0) 2.32 (1.66,5.62) 2.82 (2.10, 6.18) 0.000 Rich 27 (6.7) 67 (16.7) 4.15 (2.03,8.46)) 3.42 (2.13, 7.52) 0.000 ANC No 41(10.2) 105 (26.2) 1 Yes 73 (18.2) 182 (45.4) 1.02 (0.65, 1.61) Place of Delivery Home 52 (12.9) 117 (29.2) 1 Health facilities 62 (15.5) 170 (42.4) 1.75 (1.13, 2.72) 1.11 (0.56, 2.19) 0.775 PNC No 59 (14.7) 142 (35.4) 1 Yes 55 (13.7) 145 (36.2) 1.09 (0.71, 1.69) Maternal knowledge on vitamin A rich foods Poor 80 (20.0) 203 (50.6) 1 1 Good 34 (8.5) 84 (26.2) 1.02 (0.63, 1.65) 1.23 (0.66, 2.29) 0.511 Child vaccination status Partial 20 (5.0) 94 (23.4) 1 1 Full 94 (23.4) 193 (48.2) 2.28 (1.33, 3.93) 1.80 (0.79, 4.11) 0.162 Child meal frequency per day < 4 48 (12.0) 194(48.4) 1 1 ≥ 4 66 (16.4 93(23.2) 2.87 (1.36, 3.28) 1.652 (0.89, 3.07) 0.112 Child dietary diversity < 4 54913.5) 217(54.1) 1 1 ≥ 4 60(14.9) 70(17.5) 3.44 (1.12, 4.68) 1.96 (0.90, 4.26) 0.090 Household food security level Insecure 54 (13.5) 220 (54.9) 1 1 Secure 60 (14.9) 67 (16.7) 1.05 (0.67, 1.64) 1.97 (1.00, 3.89) 0.040 DISCUSSION The study revealed that the consumption of vitamin A rich foods among children aged 6–59 months in Hawi Gudina District was 28.4% in the week preceding the survey. This result aligns with findings from similar studies conducted in Ethiopia (Jemberu Y, 2017;EDHS, 2019 ), indicating a consistent pattern of suboptimal vitamin A rich foods consumption among children in the country. The study result was also consistent with the review in LMIC in which Ethiopian children consumption of vitamin A rich food was as low as 26% (Karlsson, 2021 ). However, the study result was lower than the study in East Africa Countries (62.91%) (Wolde and Tessema, 2023 ). This might be due to differences in scale of the studies, socio-economic status, and feeding habits. It was also lower than the study conducted in North Shoa District of Ethiopia with prevalence report at 39.1% (Moroda et al., 2022). This discrepancy might be due to the geographic proximity of the North Shoa District to Addis Ababa, the country’s capital privileging a relatively easy physical access of different food items. The findings of the present study is also lower than the study in Gondar Town (38.94%) (Aserese et al., 2020 ). This disparity is due to difference in the study population that was among lactating mothers while ours was among children aged 6–59 months. From the studied children, [327 (81.5%)] did not consume vitamin A rich plant foods within 7 days preceding the survey. In addition, the proportion of consumption of animal sources of vitamin A, including meat, or fish was 4.2% and chicken egg was 8.5%. This low consumption of animal sources of vitamin A is in agreement with other studies in Dembia, Northern Ethiopia (Tariku et al., 2016 ), Aleta wondo Southern Ethiopia (Dafursa and Gebremedhin, 2019 b) and other study somewhere in Ethiopia (Woldegebriel et al., 2020 ) in which flesh foods were the least consumed by the studied children. However, as compared to the very low consumption of flesh foods in the current study, studies conducted in Oshana and Oshikoto regions in Namibia reported a much higher consumption of chicken (98%), beef (96%) and fresh fish (95%) (Angula et al., 2024 ). Similarly, study conducted in Kenya reported a higher consumption of flesh foods (33.8%) and eggs (52.1%) among study participated children (Kananu et al., 2020 ). The disparities in results can be explained by the effect of differences in the study settings, socio-economic status and cultural variances. According to WHO (2003), children are recommended to consume vitamin A rich foods on a daily basis to prevent VAD. Similarly, the HKI method suggested that the level of inadequate intake should not exceed 70% of the community (Rosen et al., 1993 ). However, the present study revealed that a substantial proportion of children failed to meet the recommendation, indicating that they are at considerable rick of VAD. This finding underscores the seriousness of the problem and highlights the need for targeted nutritional interventions to improve children’s access to and consumption of vitamin A rich foods. A striking finding of this study is that the great majority of the study participated children, [287 (71.6%)] did not consume Vitamin A rich foods, which might be paralleled with a high prevalence of food insecurity in the study area (68.3%) according to our study. Food insecurity is known to limit the availability and access to diverse and nutritious foods, including fruits and vegetables (Estibel, 2022 ;Bolka et al., 2024 ). Fewer families in the household were significantly associated with the child intake of vitamin A rich foods. The existence of a strong association between vitamin A rich foods consumption and family size was documented by previous studies (Semba et al., 2010 ;Aserese et al., 2020 ). For the present study 69.1% of children were from households’ with family size of five or more, that might be among attributing factors to the poor consumptions of vitamin A rich foods in the study area. Additionally, the timing of the data collection, which was conducted during the dry season, may have contributed to the observed low intake. During this period, the availability of fresh fruits and vegetables typically declines, making it more difficult for households to access these foods (Abizari et al., 2017 ). In this study, the consumption of plant source vitamin A rich foods among children was higher than that of animal source. This finding is in agreement with earlier studies conducted in Ethiopia (Muhye et al., 2022 ;Mekisso et al., 2024 ), Kenya (Kananu et al., 2020 ) and Bangladesh (Begum et al., 2021) in which most of the vitamin A intake of children was reported to be obtained from plant sources. It was also reported that in developing countries, above 80% of the dietary vitamin A intake is obtained from Pro-vitamin A carotenoids (McLaren and Frigg, 1997 ;Ramakrishnan et al., 1999 ). Previous studies have shown that, in general, bioefficacy of carotenoids from a range of plant sources is very scarce (Bloem et al., 1998 ;Arimond and Ruel, 2003 ). However, such a greater dependency on plant foods as major sources vitamin A was not observed in the present study, it could have its own negative aspects due to low bioavailability of vitamin A from these foods. Overall, the relatively low percentage of children consuming vitamin A rich foods suggests that more efforts are needed to improve dietary diversity and access to vitamin A rich foods in Ethiopia. A number of factors are contributing to the adequate consumption of vitamin A rich foods among children in the study area. Socio-demographic factors like family size, maternal age and educational status, age of the child, household wealth index and food security level were found to be significantly associated (p < 0.05) with children consumption of vitamin A rich foods (Table 4 ). Children those in age group 48–59 months were 2.59 times more likely of consuming vitamin A rich foods than those children in age group 6–23 months. This finding was in line with the study conducted in Kachabira and Wolaita Sodo, Southern Ethiopia (Jemberu Y, 2017;Mekisso et al., 2024 ). This could be attributed to a better awareness of mothers to increase and diversify children’s foods as age increased. This might also be the result of the existing health care access and nutrition programs in the study area. Middle age mothers (30–39 years old) were 3.25 times more likely to feed their children vitamin A rich foods compared to younger mothers (15–19 years old). The result is similar with the study in India (Semba et al., 2010 ). This might be explained by education, economic stability, health care access and maternal experiences in rearing children that lead them to better feeding practices than younger age mothers. However, the study was in contrast to the study in South Ethiopia (Jemberu Y, 2017). This might be due to disparities in geographic location, socio-demographic factors, social norms and cultural traditions. Children from mothers who had completed higher education were 1.24 times more likely of consuming vitamin A rich foods when compared to those children from mothers who had no formal education [AOR = 1.24 (95%CI:1.07, 2.69)]. This indicated that maternal education plays a great role in child nutrition in general. This finding is supported by different studies conducted in Ethiopia (Demsash et al., 2022 ;Muhye et al., 2022 ) and DHS surveys from 11 countries (Arimond and Ruel, 2004 ). It could be because educated mothers are more likely to have access to more information through reading and more aware of the necessity of complementary feeding, dietary consumption of vitamin A rich foods, and the causes of vitamin A deficiency. Household socioeconomic status has also determined children vitamin A rich food consumption status. Children belonging to rich and medium wealth index household’s intake 3.5 and 3 times, more likely of vitamin A rich foods than those belongs to poor households respectively. This align with study conducted in Addis Ababa (Kebede et al., 2022 ) and North Shoa, Ethiopia (Moroda et al., 2022). The dietary consumption pattern showed a marked improvement as the wealth status of the household improves (Woldegebriel et al., 2020 ;de Juras et al., 2022 ). This suggests that wealthier households are better able to afford a variety of nutrient-dense foods. This study also indicated that children from food secure household were about two times more likely of vitamin A rich foods intake as compared to those children from food insecure households [AOR = 1.97 (95% CI;1.00, 3.89)]. This result was consistent with studies in other areas like East Badawacho District (Betebo et al., 2017 ), Aleta Wondo District, Southern Ethiopia (Dafursa and Gebremedhin, 2019 a) and Nepal (Chitekwe et al., 2022 ). This might be because of children from the food secure households have higher DDS when compared with children from food insecure households (Ali et al., 2019 ). Our study has several strengths including uses of large sample sizes; community-based study represent target population and focused on children aged 6–59 months in under researched setting, offering valuable insights for local governance and stakeholders. It might help to promote program intervention related to improved vitamin A rich food consumption within these communities. However, this study was a cross-sectional study, thus it is difficult to identify cause effect relationship, and there might be recall and social desirability biases due to the data were based on the respondent memory. To minimize these biases, we employed trained enumerators, incorporated multiple questions, created nonjudgmental environment during the interview and assured the confidentiality of their responses. We also did not consider seasonal variation in food consumption, which might affect food consumption pattern. In addition, information on the amount of consumption of vitamin A rich foods was not collected. Despite these constraints, our study contributes valuable baseline data to guide effective nutritional interventions in the study area and in the region. Future studies could consider longitudinal designs, multiple seasonal assessments and biomarkers to overcome these limitations. Conclusions This study revealed low prevalence of consumption of vitamin A rich foods among children aged 6–59 months, which was less than three out of ten mothers fed vitamin A rich foods to their children in the past seven days before the survey in Hawi gudina District, Eastern Ethiopia. Plant based vitamin A rich foods were more commonly consumed than animal-based sources, which need particular concerning. Children in the study area are at considerable risk of vitamin A deficiency. Multivariable analysis underscores key socio-demographic determinants: children aged 48–59 months, mothers aged 30–39 years, higher maternal education, ≤ 4 family sizes, greater household wealth, and food-secure households all significantly increased the likelihood of vitamin A rich foods intake among children aged 6–59 months in the study area. These results indicated the critical influence of maternal education, economic stability, and household resilience on child nutrition. Government should improving socio economic status, food security level, maternal education and health care service delivery. We also recommend Regional Health Bureau to giving more attention to food-based strategies to enhance the consumption of vitamin A rich foods among children. Health sector of the study setting should have to educate mothers through health extension workers and different media on vitamin A rich foods. The agricultural sector should have to encourage kitchen gardening and animal rearing, hence the community could easily accessed vitamin A rich foods for their children. The family has to feed their children vitamin A rich foods particularly for infants less than two years of age. We also recommend researchers that it would be valuable to conduct further year round assessments to understand the seasonal variations in the consumption of vitamin A rich foods and tailored interventions. Abbreviations ANC Antenatal Care AOR Adjusted Odds Ratio COR Crude Odds Ratio DDS Dietary Diversity Score DGLV Dark Green Leafy Vegetables FFQ Food Frequency Questionnaire HKI Hellen Keller International PNC Post Natal Care VARF Vitamin A Rich Foods Declarations Conflict of Interest The authors declare that they have no conflict of interests. Clinical trial number Not applicable Funding The authors declare that no financial support was received for the research. Author Contribution All authors had substantial involvement in the conception and designing of the research, fieldwork, data analysis, interpretation, and manuscript drafting, revising, and final approval for submission. C.N initiated the research, wrote the research proposal, conducted the fieldwork, did the data entry, analysis, and report write up and prepared the first draft of this manuscript. W.A and H.A involved in the write up of the research proposal, data analysis, interpretation, and manuscript writing. A.D participated in the statistical analysis, report write up, and manuscript writing and revision. All authors read and approved the final manuscript. Acknowledgement We would like to extend our sincere gratitude to Haramaya University, College of Health and Medical Sciences, School of Public Health, for granting us the opportunity to conduct this study. Our heartfelt thanks also go to all the mother-child pairs who participated, as well as the data collectors and supervisors for their valuable contributions Data Availability All data supporting the findings of this study are available upon request. References Abebe H, Abebe Y, Loha E, &Stoecker. BJ,2014. Consumption of vitamin A rich foods and dark adaptation threshold of pregnant women at Damot Sore District, Wolayita, Southern Ethiopia. Ethiop J health Sci, 24, 219–26. Abizari A-R, Azupogo F, Nagasu M, Creemers N, &Brouwer ID. 2017. Seasonality affects dietary diversity of school-age children in northern Ghana. PLoS ONE, 12, e0183206. Adem NA, Mezmur H, Jemal M, Firdisa D, &Gebremichael B. Consumption of vitamin A-rich foods among lactating mothers in Girawa district, Eastern Ethiopia. BMC Nutr. 2024;10:167. Ali NB, Tahsina T, Hoque DME, Hasan MM, Iqbal A, Huda TM et al. 2019. Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6–59 months in rural Bangladesh. PLoS ONE, 14, e0221929. Andago AA. Household food consumption patterns in relation to dietary adequacy of Vitamin A and Iron in Awasi. Nyando District, Kenya. University of NAIROBI; 2004. Angula M, Ishola A, Tjiurutue M, Chigonga N, Sulyok M, Krska R, et al. Association of food consumption patterns and nutritional status of children under 5 years from rural households in Northern regions. Namibia BMC Nutr. 2024;10:51. Arimond M, Ruel MT. 2003. Generating indicators of appropriate feeding of children 6 through 23 months from the KPC 2000+. Arimond M, Ruel MT. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr. 2004;134:2579–85. Aserese AD, Atenafu A, Sisay M, Sorrie MB, Yirdaw BW, Zegeye MK. 2020. Adequate vitamin A rich food consumption and associated factors among lactating mothers visiting child immunization and post-natal clinic at health institutions in Gondar Town, Northwest Ethiopia. PLoS ONE, 15, e0239308. Begum R, Rahman MN, Islam R, Hasan MR, Jamil MY, Tamanna. SA,2021. Vitamin A knowledge and household consumption frequency of vitamin A–rich foods in Tangail, Bangladesh. Malaysian J Nutr, 27. Berhe G, Nega. Dietary diversity practice and associated factors among infants and young children in Haramaya town, Ethiopia. Int J Public Health Sci. 2017;6:243–50. Betebo B, Ejajo T, Alemseged F, &Massa D. 2017. Household food insecurity and its association with nutritional status of children 6–59 months of age in east Badawacho District, south Ethiopia. Journal of environmental and public health, 2017, 6373595. Bloem MW, De Pee S, Darnton-Hill I. New issues in developing effective approaches for the prevention and control of vitamin A deficiency. FoodNutr Bull. 1998;19:137–48. Bolka A, Sikuare S, Dona A, &Philipos A. Dietary Vitamin A Intake and Associated Factors among Lactating Women in Wondo Genet District. Sidama Region, Southern Ethiopia; 2024. Chitekwe S, Parajuli KR, Paudyal N, Haag KC, Renzaho A, Issaka A, et al. Individual, household and national factors associated with iron, vitamin A and zinc deficiencies among children aged 6–59 months in Nepal. Volume 18. Maternal & Child Nutrition; 2022. e13305. Cioms & Who. International ethical guidelines for biomedical research involving human subjects. CIOMS, OMS Genebra; 1993. Coates J, Swindale A, Bilinsky. P,2007. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide: version 3. Combs GF Jr, Mcclung JP. The vitamins: fundamental aspects in nutrition and health. Academic; 2016. Csa,2006. Ethiopia Demographic and Health Survey 2006: Final Report. Rockville, Maryland, USA: EPHI and ICF. journal article. Dafursa K, Gebremedhin. S,2019a. Dietary diversity among children aged 6–23 months in Aleta Wondo District, Southern Ethiopia. J Nutr metabolism, 2019, 2869424. Dafursa K, Gebremedhin. S,2019b. Dietary diversity among children aged 6–23 months in Aleta Wondo District, Southern Ethiopia. J Nutr metabolism, 2019. De Juras AR, Hsu W-C, &Hu SC. Dietary patterns and their association with sociodemographic and lifestyle factors in Filipino adults. Nutrients. 2022;14:886. Demissie TAA, Mekonnen Y, Haider J, &Umeta M. Demographic and health-related risk factors of subclinical vitamin A deficiency in Ethiopia. J Health Popul Nutr. 2009;27:666. Demsash AW, Chereka AA, Kassie SY, Donacho DO, Ngusie HS, Tegegne MD, et al. Spatial distribution of vitamin A rich foods intake and associated factors among children aged 6–23 months in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey. BMC Nutr. 2022;8:77. Edhs. Ethiopia demographic and health survey. Addis: CSA and ICF; 2016. Ababa E, Rockville. Maryland, USA, 2016. Edhs. 2019. Ethiopia Mini Demographic and Health. Survey 2019: Final Report. Rockville, Maryland, USA: EPHI and ICF. El-Arab AE, Khalil F, &Hussein. L,2002. Vitamin A deficiency among preschool children in a rural area of Egypt: the results of dietary assessment and biochemical assay. Int J Food Sci Nutr, 53, 465–74. Estibel DM. 2022. Determinants Of Household Food Security In Addis Ababa City Administration. Gebremedhin T, Aschalew AY, Tsehay CT, Dellie E, &Atnafu A. 2021. Micronutrient intake status and associated factors among children aged 6–23 months in the emerging regions of Ethiopia: A multilevel analysis of the 2016 Ethiopia demographic and health survey. PLoS ONE, 16, e0258954. Haidar J. Common micronutrient deficiencies among food aid beneficiaries: evidence from refugees in Ethiopia. Ethiop J Health Dev. 2011;25:222–9. Hussey GD, Klein M. A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med. 1990;323:160–4. Jemberu Y, Zegeye M, Singh P, &Abebe H. Consumption of vitamin a rich foods and associated factors among children aged 6–23 months in Kachabira District, southern Ethiopia. Int J Food Sci Nutr Eng. 2017;7:1–10. Jemberu YZM, Singh P, &Abebe H. 2017,2017. Consumption of vitamin a rich foods and associated factors among children aged 6–23 months in Kachabira District, southern Ethiopia. Int J Food Sci Nutr Eng, 7, 1–10. Jolliffe IT, Cadima J. Principal component analysis: a review and recent developments. Philosophical Trans royal Soc A: Math Phys Eng Sci. 2016;374:20150202. Kananu NC, Waudo J, &Njogu E. Vitamin A rich Foods consumed for dietary intake and supplementation among children aged 12 to 59 months in Gatunga Ward, Tharaka Nithi County, Kenya. SciencePG [Internet]; 2020. pp. 71–9. Karlsson KR, Hasman a &Subramanian S. Consumption of vitamin-A-rich foods and vitamin A supplementation for children under two years old in 51 low-and middle-income countries. Nutrients. 2021;14:188. Kebede A, Jirström M, Worku A, Alemu K, Berhane HY, Turner C, et al. Residential food environment, household wealth and maternal education association to preschoolers’ consumption of plant-based vitamin A-rich foods: the EAT Addis survey in Addis Ababa. Nutrients. 2022;14:296. Mbabazi R, Harding R, Khanna H, Namanya P, Arinaitwe G, Tushemereirwe W et al. 2020. Pro-vitamin A carotenoids in East African highland banana and other Musa cultivars grown in Uganda. Food science & nutrition, 8, 311–21. Mclaren DS, Frigg M. 1997. Sight and life manual on vitamin A deficiency disorders (VADD), Task Force Sight and Life Basel, Switzerland. Mekisso SM, Dake SK, Haile DT, Nane D. Inadequate consumption of vitamin A-rich foods among preschool children in Wolaita Sodo, Southern Ethiopia. Front Nutr. 2024;11:1503040. Moroda M, Goyomsa GG, Shukure R, Negiye. SN,2022. Consumption of Vitamin A rich Foods and its Associated Factors among Children aged 6–59 months in North Shoa Zone, Oromia Regional State, Ethiopia: A Cross-Sectional Study in 2022. Front Nutr, 12, 1526292. Muhye AB, Assimamaw N, Tamir TT, Alemu TG, Techane MA, Wubneh CA et al. 2022. Spatial distribution and Determinates of poor consumption of foods rich in vitamin A among children aged 6–23 months in Ethiopia using data from Ethiopia Demographic and Health Survey 2019: Spatial and Multilevel Analysis. Napoli MDMP, Mazziotta M. 2011. Towards a food insecurity Multidimensional Index (FIMI). Master in human development and food security.2011:1–72. Nti CA, Hayford J, Opare-Obisaw C. Nutrition knowledge, diet quality and nutritional status of people living with HIV (PLHIV) in Ghana. Food Public Health. 2012;2:219–27. Persson V. 2001. Vitamin A intake, status and improvement using the dietary approach: studies of vulnerable groups in three Asian countries (Doctoral dissertation, Acta Universitatis Upsaliensis). Persson V, Greiner T, Islam S, Gebre-Medhin M. The Helen Keller International food-frequency method underestimates vitamin A intake where sustained breastfeeding is common. FoodNutr Bull. 1998;19:343–6. Ramakrishnan U, Martorell R, Latham MC, Abel R. Dietary vitamin A intakes of preschool-age children in South India. J Nutr. 1999;129:2021–7. Rosen D, Haselow N, &Sloan N. How to use the HKI food frequency method to assess community risk of vitamin A deficiency. New York: Helen Keller International; 1993. Rutstein SO. 2015. Steps to constructing the new DHS Wealth Index. Rockville, MD: ICF International, 6. Semba RD, De Pee S, Sun K, Campbell AA, Bloem MW, Raju V. Low intake of vitamin A–rich foods among children, aged 12–35 months, in India: association with malnutrition, anemia, and missed child survival interventions. Nutrition. 2010;26:958–62. Sherwin JC, Reacher MH, Dean WH, &Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg. 2012;106:205–14. Smith RG, Saul AW. The Vitamin Cure for Eye Disease. Basic Health; 2012. Sofia Vilela IM, Correia D, Severo M, Lopes C. 2019. of-socio-economic-factors-in-food-consumption-of-portuguese-children-and-adolescents-results-from-the-national-food-nutrition-and-physical-activity-survey-20152016.pdf . Song P, Adeloye D, Li S, Zhao D, Ye X, Pan Q, et al. The prevalence of vitamin A deficiency and its public health significance in children in low-and middle-income countries: A systematic review and modelling analysis. J Global Health. 2023;13:04084. Suri S, Kumar D, &Das R. Dietary deficiency of vitamin A among rural children: community-based survey using food frequency questionnaire. Natl Med J India. 2017;30:61–61. Talukder A, Kiess L, Huq N, De Pee S, Darnton-Hill I, Bloem MW. Increasing the production and consumption of vitamin A–rich fruits and vegetables: lessons learned in taking the Bangladesh homestead gardening programme to a national scale. FoodNutr Bull. 2000;21:165–72. Tariku A, Fekadu A, Ferede AT, Mekonnen Abebe S, Adane AA. Vitamin-A deficiency and its determinants among preschool children: a community based cross-sectional study in Ethiopia. BMC Res Notes. 2016;9:1–8. Tiruneh SA, Fentie DT, Yigizaw ST, Abebe AA, Gelaye KA. 2021. 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. PLoS ONE, 16, e0252639. UNICEF,2019. The state of the world’s children 2019. UNICEF,2022. Good nutrition, bright futures: Towards an Africa without malnutrition by 2030. WHO. Indicators for Assessing Infant & Young Child Feeding Practices. WHO; 2008. WHO. 2009. Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO global database on vitamin A deficiency. Global prevalence of vitamin A deficiency in populations at risk 1995–2005: WHO global database on vitamin A deficiency. WHO. Guideline: vitamin A supplementation in infants and children 6–59 months of age. World Health Organization; 2011. WHO. 2021. Indicators for assessing infant and young child feeding practices: definitions and. measurement methods. Wolde M, Tessema ZT. Determinants of good vitamin A consumption in the 12 East Africa Countries using recent Demographic and health survey. PLoS ONE. 2023;18:e0281681. Woldegebriel AG, Desta AA, Gebreegziabiher G, Berhe AA, Ajemu KF, Woldearegay TW. 2020. Dietary diversity and associated factors among children aged 6–59 months in Ethiopia: analysis of Ethiopian demographic and health survey 2016 (EDHS 2016). International journal of pediatrics, 2020. Wuneh AD, Medhanyie AA, Bezabih AM, Persson LÅ, Schellenberg J, Okwaraji YB. Wealth-based equity in maternal, neonatal, and child health services utilization: a cross-sectional study from Ethiopia. Int J Equity Health. 2019;18:1–9. Yadav R, Patial A, Bharti B, Attri SV, &Bhatia P. 2021. Dietary vitamin a intake, coverage of vitamin a megadose supplementation, and prevalence of vitamin a deficiency among marginalized children 6–59 months in anganwadis of Chandigarh: A multistage cluster sampling survey. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 46, 692. Zongo U, Zoungrana S, Savadogo A, Thiombiano-Coulibaly N, &Traoré A. Assessment of dietary diversity and vitamin a-rich foods consumption of pre-school children in rural community in Burkina Faso, an impact study approach. Austin J Nutr food Sci. 2017;5:1087. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9059438","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":603307756,"identity":"a1748588-c3aa-4737-a51a-b4596ae957a6","order_by":0,"name":"Chala Namomsa Fite","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5ElEQVRIie2PPQrCQBBGBwYmzWjaEUWvEAhERcGrCILVCh5AbAKp/Gk9hpV1REylva0IFlZCIKWY1comiZ3gvmL5Br7HzAIYDD8IYQgI0OLe0g/TWWr5CvW1IjVHor5WuMCat9J1QDl6zlfKhNt4PBFuwiG+nSYtBmu3X2cfRoPqKhJu+/NNR6UBeDg8ZSqNmYdMaTM8blylg7CXrZCdID+0oq6uehRSmLAUCDuhwssoKKSQWy0thCuryMNRGijvL40AzzEn3Z5t+5dYJdO6be2iTOVjo7zeonUN3r9pGwwGw//wBKOiO6yZRGtiAAAAAElFTkSuQmCC","orcid":"","institution":"Hawi Gudina District Health Office","correspondingAuthor":true,"prefix":"","firstName":"Chala","middleName":"Namomsa","lastName":"Fite","suffix":""},{"id":603307758,"identity":"6f13a3a0-170f-42a0-a8e7-e794e1c01e94","order_by":1,"name":"Wondimye Ashenafi","email":"","orcid":"","institution":"Haramaya University","correspondingAuthor":false,"prefix":"","firstName":"Wondimye","middleName":"","lastName":"Ashenafi","suffix":""},{"id":603307759,"identity":"ec798e60-2782-448d-9f01-a9ff1e389bbe","order_by":2,"name":"Hassen Abdi","email":"","orcid":"","institution":"Haramaya University","correspondingAuthor":false,"prefix":"","firstName":"Hassen","middleName":"","lastName":"Abdi","suffix":""},{"id":603307760,"identity":"3f1f90f3-e2dc-4593-becb-2893ef392cbd","order_by":3,"name":"Alemayehu Deressa","email":"","orcid":"","institution":"Haramaya University","correspondingAuthor":false,"prefix":"","firstName":"Alemayehu","middleName":"","lastName":"Deressa","suffix":""}],"badges":[],"createdAt":"2026-03-07 15:23:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9059438/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9059438/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104340262,"identity":"66dfe21b-2324-4f13-bfce-8d393d639c88","added_by":"auto","created_at":"2026-03-10 16:36:58","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":201270,"visible":true,"origin":"","legend":"\u003cp\u003eVitamin A rich foods consumption among children aged 6-59 months in Hawi Gudina District, Eastern Ethiopia, 2024 (n=401).\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9059438/v1/d622722890b9cabb2fa6cade.jpg"},{"id":104479218,"identity":"a9b53602-e84d-4a5a-b7bb-4fd14f91ca50","added_by":"auto","created_at":"2026-03-12 08:57:41","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1501092,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9059438/v1/d015b9d9-eb98-4a4b-b5d5-2fe757b456ff.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence and Factors Associated with Vitamin A Rich Foods Consumption among Children Aged 6-59 Months in Hawi Gudina District, Eastern Ethiopia","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eVitamin A is one of the essential vitamins that is vital for enhancing reproduction and vision, as well as for preventing blindness and infection (Sherwin et al., \u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e2012\u003c/span\u003e;Song et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). It has also numerous important functions such as preserving the intestinal, respiratory, urinary tracts and the surface of the eyes, as well as for proper functioning of the immune system (Smith and Saul, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eVitamin A rich foods are especially important for children under the age of five due to their increased physiological needs for growth and development. During the first five years of life, children experience rapid physical growth, organ development, and immune system maturation, all of which require adequate vitamin A for proper functioning (WHO, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2009\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe best sources of preformed vitamin A are foods derived from animals such as breast milk, glandular meats, liver and fish liver oils, egg yolk, whole milk, and other dairy products. Plant sources rich in pro-vitamin A include dark green leafy vegetables, carrots, pumpkins, sweet potatoes, yams, watermelon, and yellow or orange fruits like papaya, mango, and squash (WHO, \u003cspan citationid=\"CR66\" class=\"CitationRef\"\u003e2011\u003c/span\u003e;Combs Jr, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Much of the vitamin A (provitamin A) in developing countries are obtained from plant sources, as livestock sources are inaccessible for most of the rural poor (Mbabazi et al., 2020).\u003c/p\u003e \u003cp\u003eIn developed countries, animal-source food containing vitamin A accounts for nearly 65% of total vitamin A consumption, and plant-source food accounts for 35%. However, in developing countries, 70\u0026ndash;90% of vitamin A is consumed as a pro-vitamin A carotenoid, because plant based foods are more affordable than animal products. Several studies conducted in these regions have shown that children often did not consume enough vitamin A-rich foods (Zongo et al., \u003cspan citationid=\"CR73\" class=\"CitationRef\"\u003e2017\u003c/span\u003e;Kananu et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e;Wolde and Tessema, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In 51 low and middle-income countries (LMIC) 55%, and in Africa, 49% of children consumed vitamin A rich foods (Karlsson, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2021\u003c/span\u003e;UNICEF, 2022).\u003c/p\u003e \u003cp\u003eStudies conducted in Bangladesh and India, documented low dietary vitamin A intakes by children and that most of the vitamin A intake was derived from plant sources (Talukder et al., \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e2000\u003c/span\u003e;Suri et al., \u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). In Ethiopia, a study on children aged 6\u0026ndash;23 months found that 38.99% of children had an intake of foods rich in vitamin A in the last 24 hours (Demsash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Another study among children aged 6\u0026ndash;59 months in Dembia District found that 36% of them had consumed food rich in vitamin A in the last 7 days (Tariku et al., \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). One in ten children consume meat, fish, shellfish, poultry or eggs (CSA, 2006).\u003c/p\u003e \u003cp\u003eChildren who did not consume vitamin A rich foods were more likely susceptible to vitamin A deficiency disorders (VADD), blindness from Keratomalacia and measles (Hussey and Klein, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e1990\u003c/span\u003e), malnutrition, anemia and missing of basic child health intervention like immunization and vitamin A supplementation (Semba et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Globally, around 190 (33.3%) million, in Africa 56.4 (44.4%) million preschool children were vitamin A deficient (WHO, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2009\u003c/span\u003e). About 37.6% of under five years children were suffering from subclinical vitamin A deficiencies in Ethiopia (Haidar, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2011\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInadequate consumption of vitamin A rich foods might be due to various interrelated factors, including having young mother\u0026rsquo;s (Semba et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), being male in gender, poor living standard, living in rural area and dry environment, maternal and child age (Semba et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), low socio-economic status (Sofia Vilela, 2019), low maternal education (Kebede et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In addition to these, inadequate production of vitamin A rich foods, lack of income to purchase, unavailability of vitamin A rich foods in markets, large family size and illness (Demissie T, 2009;UNICEF, 2019), low parental media exposure were also presumed as a contributing factors to the low consumption of vitamin A rich foods (Tiruneh et al., \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2021\u003c/span\u003e;UNICEF, 2022)\u003c/p\u003e \u003cp\u003eFew studies have shown that there were poor consumption of vitamin A rich foods among 6\u0026ndash;59 months aged children in Ethiopia (EDHS, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e;Moroda et al., 2022). Most existing studies focus narrowly on under two years age children, pregnant or lactating mothers (Abebe et al., 2014;Jemberu Y, 2017;Aserese et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This study, therefore, aims to assess the prevalence of vitamin A rich foods consumption and associated factors among children aged 6\u0026ndash;59 months in Hawi Gudina District, Eastern Ethiopia. The finding helps mothers and their children in prevention and control of the risks associated with the inadequate consumptions of foods rich in vitamin A. It has paramount importance for the government, local authorities and development actors to design appropriate and effective interventions in Ethiopia and the study setting.\u003c/p\u003e"},{"header":"Methods and Materials","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Area and Period\u003c/h2\u003e \u003cp\u003eA community-based cross-sectional study design was conducted among children aged 6\u0026ndash;59 months in Hawi Gudina District from December 1\u0026ndash;30, 2024. Hawi Gudina District was one of the pastoralist districts found in West Hararghe Zone. Rimeti town was the center of the district. It was found at 486 KM from Addis Ababa, capital city of the country and 186 KM from Chiro, capital town of the zone. The total population of the district in 2023 was 120,790 with female population 61603 (51%) and male 59187 (49%), under 1 year old children 3889, under 5 years children 19326, 6\u0026ndash;59 months age children 18118 and 25165 households. The district had five health centers, 32 health posts and 6 private clinics that served the population of the district and neighboring districts. The major food products are grain crops like wheat, maize, sorghum, bean, and other legumes. Potato, spinach, lettuce, cabbage, kale, pumpkin, and fruits available at the study area include mango, avocado, banana and orange.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStudy participants and sampling\u003c/h3\u003e\n\u003cp\u003eAll randomly selected children aged 6\u0026ndash;59 months in the selected kebele of Hawi Gudina District were the study populations, and all children aged 6\u0026ndash;59 months in the selected kebele and had mother or caretaker at home during data collection time were considered as inclusion criteria. Children who were very sick, had a mental problem and lived in the area for less than six months were excluded from the study.\u003c/p\u003e \u003cp\u003eThe minimum sample size required for the study was determined by using a single population proportion formula with the following assumption; 5% margin of error (d), 95% Confidence Interval (CI), 20% proportion of children age 6\u0026ndash;59 months consuming vitamin A rich foods (Yadav et al., \u003cspan citationid=\"CR72\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), 10% non-response rate and 1.5 design effect. This resulted in a sample size of 406. The sample size for the factors associated with VARF consumption was determined by using Epi-info statcalc v 7.2 by considering the following assumption: 80% power of the study, 95% confidence level, 31.42% proportion of children age 12\u0026ndash;17 months had not consumed vitamin A rich foods and AOR\u0026thinsp;=\u0026thinsp;0.47 (Jemberu et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), 10% non-response rate and design effect 1.5. This resulted in a sample size 338. Finally 51% proportion of children from highest wealth quintile consumed adequate vitamin A rich foods, 0.421 AOR (Kebede et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) with 95% confidence level, 10% non-response rate and 1.5 design effect, minimum of 200 study participants were required.\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\)\u003c/span\u003e\u003c/span\u003eFinally, comparing the three sample sizes, the largest sample size was taken 406.\u003c/p\u003e \u003cp\u003eMultistage sampling procedure followed by systematic random sampling procedure was implemented for sample selection. Initially, the district has 32 kebeles (small administrative unit in Ethiopia). The district was also divided into urban and rural kebeles. Accordingly, there were 30 rural and 2 urban kebeles from which 9 rural and 1 urban representative kebeles were selected by simple random sampling technique. The calculated sample (406) was proportionally distributed to the ten-selected kebeles in consideration of their population size. In the second stage, eligible households with children age 6\u0026ndash;59 months in the selected kebele were identified from health posts family folder. Finally, the sampling fraction (k) was calculated by dividing total number of eligible households across all selected kebeles by the total sample size to calculate the sampling interval. Based on this, study participants were selected using a systematic random sampling technique at every 24th interval (K\u0026thinsp;=\u0026thinsp;9796/406\u0026asymp;24). From each household, one study subject was selected and where there more than one eligible study subject in the household, only one child was selected by lottery method.\u003c/p\u003e \u003cp\u003eStructured questionnaire was adapted from related different literatures used to collect data from mother-child pairs (Persson, \u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e2001\u003c/span\u003e;EDHS, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). These questionnaires were drafted in English and translated into Afaan Oromo and then back to English. The questionnaire comprised various sections including socio-demographic characteristics, reproductive and health care related factors and dietary factors. These were analyzed to determine the prevalence and the associated factors with child vitamin A rich foods consumption.\u003c/p\u003e \u003cp\u003eIn this study, the Helen Keller International food frequency questionnaire (HKI) (Rosen et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e1993\u003c/span\u003e) was used to evaluate frequency of intake of vitamin A rich foods with modifications to the local context. The tool has twenty-eight different food items. Among the twenty-eight food items, twenty are available in the study area and are consumed by society. Only major sources of vitamin A, \u0026ge; 100-retinol equivalent (RE) were taken into consideration. The food items selected for the analysis of the consumption of foods rich in vitamin A were categorized into seven groups. Each food group was scored 0 if not given to the child and scored\u0026thinsp;+\u0026thinsp;1 if if the respondent reported that the child had took at least one of those vitamin A rich foods item in the previous week (Persson et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e1998\u003c/span\u003e;El-Arab et al., 2002).\u003c/p\u003e \u003cp\u003eThe child\u0026rsquo;s dietary diversity score was calculated as the sum of the number of different food groups consumed by the child in the 24 hours preceding the survey. The dietary diversity score ranges from zero to seven, where zero represents non-consumption of any of the food items and seven represents the highest level of dietary diversification. The seven food groups included 1.cereals, roots and tubers, 2.legumes and nuts, 3.dairy products (milk, yogurt), 4.flesh foods (meat, fish, poultry, and liver/organ meats), 5.eggs, 6.vitamins A rich fruits and vegetables 7.others fruits and vegetables. Children who consumed at least four out of the seven food groups within a 24-hours recall period were considered to have adequate dietary diversity (WHO, \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNutrition knowledge of mothers was assessed using a scoring system based on responses to 9 nutrition-related standardized questionnaires. Finally, mothers with mean score of 4.5 or above were considered as having \u0026lsquo;good knowledge\u0026rsquo; and those with less than the mean score were considered as having \u0026lsquo;poor knowledge\u0026rsquo;(Berhe, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSimilarly, mothers were asked for the history of their child illnesses include cough, diarrhea, eye and skin infections. The overall illness refers to being ill regardless of types, episode, and the severity of illness in the last two weeks preceding the survey (Andago, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2004\u003c/span\u003e;Demissie T, 2009).\u003c/p\u003e \u003cp\u003eHousehold Food Insecurity Access Scale (HFIAS) measurement tool developed by the Food and Nutrition Technical Assistance (FANTA) project was used to assess the household food security status of households (Coates et al., 2007).\u003c/p\u003e \u003cp\u003eWealth index was computed as a measure of household wealth using principal component analysis (PCA), a method typically used to reduce the dimensionality of multiple factors in a dataset (Jolliffe and Cadima, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eData collections were conducted over a period of four weeks by five diploma holder nurses supervised by two-health officers. Data were collected from mothers or caretakers with children aged 6\u0026ndash;59 months by using questionnaire via face-to-face interview. Five percent of the questionnaires were pretested in areas not included in the actual study and appropriate modification was made after the pre-testing.\u003c/p\u003e \u003cp\u003eMothers with children aged 6\u0026ndash;59 months were interviewed to provide information regarding child\u0026rsquo;s vitamin A rich foods consumption status and the associated factors. In a situation where eligible study subject temporarily absent at the selected house during the interview, two repeated visits were done and otherwise, an adjacent house would be substituted. The interview took around 30 minutes for each participant.\u003c/p\u003e\n\u003ch3\u003eStudy Variables\u003c/h3\u003e\n\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eDependent variables\u003c/h2\u003e \u003cp\u003eThe consumption of vitamin A rich foods was the outcome variable, dichotomized as \u0026ldquo;yes\u0026rdquo; if participants consumed at least one among the seven vitamin A rich foods otherwise \u0026ldquo;No\u0026rdquo;. These food groups were i. Eggs, ii. Meat (beef, pork, lamb, chicken), iii. Pumpkin, carrots, and squash, iv. any dark green leafy vegetables, v. mangoes, papayas, and others with vitamin A fruits, vi. Liver, heart, and other organs and vii. Fish or shellfish (Gebremedhin et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2021\u003c/span\u003e;Demsash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eIndependent variables\u003c/h3\u003e\n\u003cp\u003e \u003cstrong\u003eSocio-demographic factors\u003c/strong\u003e \u003cp\u003eResidency, family size, child age and sex, birth order, numbers of under five years children, parent\u0026rsquo;s occupation and educational level, maternal age and marital status, household head and wealth index,\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eReproductive and health care related factors\u003c/strong\u003e \u003cp\u003eParity, gravidity, antenatal care, place of delivery, postnatal care, maternal knowledge on VARF, child vaccination status, deworming and morbidity in the last two weeks,\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eDietary factors\u003c/strong\u003e \u003cp\u003eBreast-feeding status, complementary feeding initiation time, child meal frequency, dietary diversity, food security level, and household\u0026rsquo;s home gardening were included in this study.\u003c/p\u003e \u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eOperational Definitions\u003c/h2\u003e \u003cp\u003e \u003cstrong\u003eVitamin A rich foods consumption\u003c/strong\u003e \u003cp\u003eif the respondent reported that the child had eaten\u0026rsquo; at least one among the seven VARF, we considered \u0026ldquo;yes\u0026thinsp;=\u0026thinsp;1\u0026rdquo;; otherwise \u0026ldquo;no\u0026thinsp;=\u0026thinsp;0\u0026rdquo; within the previous seven days before the study (Demsash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eWealth index\u003c/b\u003e: Households are given scores based on the number and kinds of goods they own. These scores are derived using principal component analysis. Households were first ranked into quintiles and then regrouped into three categories: poor wealth index (lowest and second wealth quintile), medium wealth index (middle quintile), and rich (fourth and highest quintiles) (Rutstein, \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2015\u003c/span\u003e;Wuneh et al., \u003cspan citationid=\"CR71\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). A detailed explanation of the weighting procedure can be found in the EDHS methodology report (EDHS, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eMaternal knowledge\u003c/strong\u003e \u003cp\u003eon vitamin A rich foods were determined using nutrition-related standardized questionnaires (nine items).Then, if the mothers correctly answer above the mean of knowledge questions, she was considered as having a good knowledge; otherwise, she has a poor knowledge (Nti et al., \u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e2012\u003c/span\u003e;Adem et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eChild vaccination status\u003c/strong\u003e \u003cp\u003ewas determined from the child\u0026rsquo;s immunization card or, if the record was not available, by maternal recall. Children were classified as fully vaccinated if they had received all basic vaccine in line with the national schedule, partially vaccinated if they had received some but not all and not vaccinated if they had not received any vaccine (Semba et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eChild dietary diversity\u003c/strong\u003e \u003cp\u003econsidered adequate if the children aged 6\u0026ndash;59 months consumed food and drink from at least four from seven food groups in the preceding 24 hours of the interview (WHO, \u003cspan citationid=\"CR67\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eChild minimum meal frequency\u003c/strong\u003e \u003cp\u003ewas determined by asking the mother how many times the child took solid, semi-solid, or soft foods in the 24 h preceding the survey. Accordingly, two or more times for breastfed infants 6\u0026ndash;8 months of age, three or more times for breastfed children 9\u0026ndash;23 months, four times for non-breastfed children 6\u0026ndash;23 months and for 24\u0026ndash;59 months four and above per day were considered as the children received the minimum meal frequency (WHO, \u003cspan citationid=\"CR64\" class=\"CitationRef\"\u003e2008\u003c/span\u003e)\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eHousehold food insecurity\u003c/b\u003e: A situation that occurs when people lack secure access to sufficient amounts of safe and nutritious food for normal growth and development and an active and healthy life (Napoli M, \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Based on HFIAS score, household food insecurity can be categorized into four levels: Food secure, if the household scores 0 or 1, mild food insecure, if the household scores from 2 to 8, moderate food insecure, if the household scores from 9 to 16, severe food insecure, if the household scores from 17 to 27 (Coates et al., 2007).\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eData Quality Control\u003c/h3\u003e\n\u003cp\u003eIn order to assured the quality of data, the following measures were undertaken. Pretest had done on 5% of the random samples (20 participants) one week before the actual study to ensure internal consistency of the instrument. After collecting the pretest data, each individual questionnaire response were checked for any potential problem and modification were made accordingly. The questionnaire was prepared in English and translated into Afaan Oromo (local language) and then back into English by language expert.\u003c/p\u003e \u003cp\u003eTraining was given to data collectors on the objective of the study, data collection process and relevance of the study prior to data collection. Each questionnaire was coded with a unique identification number. Throughout the course of the data collection, data collectors were supervised at each site. The data was checked for completeness on site and before data entry. Double data entry was performed and the data were crosschecked to ensure consistency. Finally, after checking for data completeness, Epi-Data was utilized for data entry.\u003c/p\u003e\n\u003ch3\u003eData Processing and Analysis\u003c/h3\u003e\n\u003cp\u003eData had been coded, entered and cleaned by using Epi-data software version 4.6 and exported to statistical software packaging for social science (SPSS) version 26.0 for analysis. Descriptive statistics were performed to compute summary statistics and information was presented in the table and text such as frequencies, percent, central tendency, and standard deviation.\u003c/p\u003e \u003cp\u003eHousehold food security was analyzed using Household Food Insecurity Access Scale (HFIAS).The tool includes nine questions with frequency of occurrence responses (rarely\u0026thinsp;=\u0026thinsp;1, sometimes\u0026thinsp;=\u0026thinsp;2, often\u0026thinsp;=\u0026thinsp;3). The total score (0\u0026ndash;27) was calculated and household were then classified as food secure (0\u0026ndash;1) or food insecure (2\u0026ndash;27) based on the scale.\u003c/p\u003e \u003cp\u003eHousehold wealth index was constructed by using Principal Component Analysis (PCA). Ownership of each asset was given a score of \u0026ldquo;1\u0026rdquo; and non-ownership was given a score of \u0026ldquo;0\u0026rdquo;. Principal component analyses was conducted to generate wealth index after checking all assumptions such as sample adequacy (KMO\u0026thinsp;\u0026ge;\u0026thinsp;0.5, antiimage\u0026thinsp;\u0026ge;\u0026thinsp;0.5 and communality\u0026thinsp;\u0026ge;\u0026thinsp;0.5, Bartlets test of Sphericity (P\u0026thinsp;\u0026lt;\u0026thinsp;0.5) and absence of variable with complex structure. The wealth index score was then ranked into tertile as the highest tertile was taken as rich, the middle was the medium and the lowest tertile was taken as poor.\u003c/p\u003e \u003cp\u003eBivariate analysis between each explanatory variable and the outcome variable was done to determine the variables to include in the multivariable model. Explanatory variables that were significantly associated with the outcome variable at P value less than 0.25 were included in the multivariable logistic regression model, to identify independent determinants of vitamin A rich foods consumption. The model fitness was evaluated using the Hosmer and Lemeshow goodness-of-fit test (p-value\u0026thinsp;=\u0026thinsp;0.256), and multicollinearity was assessed using variance inflation factor (VIF). VIF\u0026thinsp;\u0026lt;\u0026thinsp;5 and tolerance test\u0026thinsp;\u0026gt;\u0026thinsp;0.1 was used as a cut-off point for no multicollinearity. To assess the significance of relationships, crude and adjusted odds ratios with the corresponding 95% confidence interval were employed, and p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was regarded as statistically significant (Berhe, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eEthical Considerations\u003c/h2\u003e \u003cp\u003eThe study was conducted following the Helsinki Declaration of Research involving human subjects (CIOMS \u0026amp; WHO, 1993). The study was approved by Haramaya University, College of Health and Medical Sciences, Institutional Health Research Ethics Review Committee (IHRERC) Ref. No. IHRERC/088/2024.\u003c/p\u003e \u003cp\u003eStudy participants were adequately informed about the purpose, method and benefit of the study. Using a standard consent form, Informed, Voluntary, Written and Signed Consent was received from each study participant before interview.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic characteristics\u003c/h2\u003e \u003cp\u003eAmong 406 mothers-child pairs approached, 401 consented to take part in the study with response rate of 98.8%. The mean (\u0026plusmn;\u0026thinsp;SD) age of mothers was 28.23 (\u0026plusmn;\u0026thinsp;5) years, and majority of them (79.8%) were between 20 and 39 years. Most mothers, [283 (70.6%)] had no formal education, with only [21 (5.2%)] reaching higher education and near to half [201 (50.1%)].\u003c/p\u003e \u003cp\u003eThe mean (\u0026plusmn;\u0026thinsp;SD) age of the children was 25.25(\u0026plusmn;\u0026thinsp;14.8) months, with the majority [266 (66.3%)] were between 6\u0026ndash;35 months. About half (50.4%) of them were male and (48.9%) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-demographic characteristics of mother-child pairs in Hawi Gudina District, Eastern Ethiopia, 2024(n\u0026thinsp;=\u0026thinsp;401).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eReligion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e363\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOrthodox\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProtestant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHousehold family size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild sex\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e202\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e199\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eChild age (in months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e185\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u0026ndash;47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild birth order\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e205\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e196\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal age in years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHead of household\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e381\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal educational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal marital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCurrently Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e95.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal occupational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHouse wife\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e320\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFather educational level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e251\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eFather\u0026rsquo;s occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e77.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDaily labor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMerchant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHousehold wealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eReproductive and health care related factors\u003c/h2\u003e \u003cp\u003eThree hundred fifty-four (88.3%) of mothers were multiparous, whereas [375 (93.5%)] were multigravida. Two hundred fifty-five (63.6%), 232 (57.8%) and 200 (49.9%) of mothers had ANC follow up, had given birth at health facility and had postnatal care follow up respectively. One hundred sixty-seven (41.6%) of mothers had claimed to have information about vitamin A of whom the majority, [104 (62.1%)] mentioned health extension workers as their source of information. Only about less than one third, [118 (29.4%)] had good knowledge about vitamin A rich foods.\u003c/p\u003e \u003cp\u003eConcerning to the health status of the children, [45 (11.2%)] were sick during the last two weeks prior to the study and majority, [287 (71.6%)] were fully vaccinated (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eReproductive and health care related factors of mother-child pairs in Hawi Gudina District, Eastern Ethiopia, 2024(n\u0026thinsp;=\u0026thinsp;401)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eParity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e354\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGravidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e375\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e93.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eANC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e63.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth facility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e232\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e57.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePostnatal care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e200\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e50.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild vaccination status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFully vaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e287\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePartially vaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDeworming\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e64.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMorbidity in the last two weeks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e356\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e88.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCommon causes of morbidity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCough\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e53.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWalking distance to the nearest health facility in hours\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2\u0026ndash;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHeard about vitamin A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSources of information on Vitamin A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHEW\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHCP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOthers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMother\u0026rsquo;s Knowledge of vitamin A\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e283\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e70.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e118\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eNotes: * Malaria, skin infection and conjunctivitis, HEW: health extension workers, HCP: health care professionals\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eDietary factors\u003c/h2\u003e \u003cp\u003eMajority, [166 (89.7%)] of children aged 6\u0026ndash;23 months were breast-feeding, and among the total children, [291 (72.6%)] had started complementary feeding after six months postpartum (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe proportion of children who consumed foods from grains, roots and tuber was found to be the highest [335 (83.5%)] followed by legumes and nuts [263 (65.6%)], and dairy products [126 (31.4%)]. The proportion of children who were given foods from at least four food groups were [130 (32.4%)] and more than half [242 (60.3%)] had inadequate meal frequency per day. Majority of the households were food insecure (68.3%) and not engaged in home gardening (62.1%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDietary related factor among mother-child pairs in Hawi Gudina District, Eastern Ethiopia, (n\u0026thinsp;=\u0026thinsp;401)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCategory\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBreast feeding currently (6\u0026ndash;23 months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e89.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eContinued breast feeding (12\u0026ndash;23 months)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e47.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eComplementary feeding initiation time\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBefore 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAfter 6 months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e291\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eDietary diversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e130\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e271\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeal frequency per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e39.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e60.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHome gardening\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e152\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e249\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHousehold food security level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e127\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsecure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e274\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of Vitamin A Rich Foods Consumption\u003c/h2\u003e \u003cp\u003eThe prevalence of vitamin A rich foods consumption among children aged 6\u0026ndash;59 months was [28.4% (95% CI: 24.2%, 33.0%)] within previous seven days before the survey. Animal sources vitamin A rich foods were consumed by [47 (11.7%)] and plant source vitamin A rich foods were consumed by [74 (18.5%)] children (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eFactors Associated with Consumption of Vitamin A Rich Foods\u003c/h2\u003e \u003cp\u003eThe association between the consumption of vitamin A rich foods and predictors was analyzed using binary logistic regression. In the bivariate analysis, residency, family size, child age and birth order, maternal age, maternal educational status, wealth index, child vaccination status, maternal knowledge, place of delivery, ANC and PNC follow up, household food security level, meal frequency per day and dietary diversity were associated with child vitamin A rich foods consumption at p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.25, and then fitted to multivariate analysis. However, religion, child sex, household head, parity and gravidity, walking distance to nearest health facility, breast feeding status, morbidity in the last two weeks and complementary feeding initiation time were not significant at p-value less than 0.25; hence, these variables were excluded from multivariable analysis (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the multivariable logistic regression analysis, the odds of consumption of vitamin A rich foods among the children aged 6\u0026ndash;59 months from family size\u0026thinsp;\u0026le;\u0026thinsp;4 were 3.48 times higher as compared to children from family size\u0026thinsp;\u0026ge;\u0026thinsp;7 [AOR\u0026thinsp;=\u0026thinsp;3.48 (95% CI:1.15, 6.12)]. The odds of eating vitamin A rich foods among children aged 6\u0026ndash;59 months whose mothers\u0026rsquo; had higher educational level was 1.24 times higher as compared to those children whose mothers\u0026rsquo; had no formal education [AOR\u0026thinsp;=\u0026thinsp;1.24(1.07, 2.69)]. The odds of consuming vitamin A rich foods among children the whose mothers age ranged 30\u0026ndash;39 years were found to 3.25 times higher as compared to children with mothers in the youngest age category (15\u0026ndash;19 years) [AOR\u0026thinsp;=\u0026thinsp;3.25 (95% CI: 1.37, 7.69)]. As child age increases, the consumption of vitamin A rich foods was increases. Children aged 48\u0026ndash;59 months were 2.59 times more likely of consuming vitamin A rich foods when compared with children aged 6\u0026ndash;23 months [AOR\u0026thinsp;=\u0026thinsp;2.59 (95% CI:1.08, 6.24)]. Children from the rich and medium wealth index households had significantly highest odds of consuming vitamin A rich foods relative to those from poor households [AOR\u0026thinsp;=\u0026thinsp;3.42 (95% CI: 2.13, 7.52)] and [AOR\u0026thinsp;=\u0026thinsp;2.82 (95% CI: 2.10, 6.18)] respectively. Children from the food secure households were consumed two times more likely of getting vitamin A rich foods as compared with those from food insecure households [AOR\u0026thinsp;=\u0026thinsp;1.97 (95% CI: 1.00, 3.89)] (Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBinary and multivariable logistic regression analysis showing factors associated with vitamin A rich foods consumption among children aged 6\u0026ndash;59 months in Hawi Gudina District, Eastern Ethiopia, 2024 (n\u0026thinsp;=\u0026thinsp;401)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eVitamin A rich foods consumption\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCOR (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAOR(95%CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eResidency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 (23.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e259 (64.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28 (7.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.97 (1.06, 3.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.18 (0.79, 5.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eHousehold family size\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e108 (26.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94 (23.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.54 (0.95, 2.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.84 (0.81, 4.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85 (21.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.71 (1.27, 5.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.48 (1.15, 6.12)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.041\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eChild age in months\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6\u0026ndash;23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e150 (37.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24\u0026ndash;35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (7.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e50 (12.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.65 (1.48, 4.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.31(0.58, 2.96)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.514\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36\u0026ndash;47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52 (13.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.73 (0.92, 3.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.86 (0.36, 2.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.730\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e48\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.30 (1.77, 6.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.59 (1.08, 6.24)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.034\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild birth order\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e147 (36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65 (16.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e140 (34.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.39 (0.90, 2.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.39 (0.90, 2.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.324\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal age (in years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u0026ndash;19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20\u0026ndash;29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (6.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e145 (36.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.74 (0.41,1. 32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.73 (0.34, 1.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.431\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30\u0026ndash;39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e101 (25.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.71 (1.00, 2.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.25 (1.37, 7.69)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21 (5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.64 (0.22, 1.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.29 (0.51, 10.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.279\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMaternal educational status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e244 (60.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (12.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.17 (0.72, 1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.20 (0.15, 1.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.121\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (4.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (3.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.82 (0.77, 4.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.51 (0.18, 1.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigher education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.39 (1.15, 4.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.24 (1.07, 2.69)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eWealth index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (13.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e148 (36.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24 (8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72 (18.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.32 (1.66,5.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e2.82 (2.10, 6.18)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRich\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27 (6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.15 (2.03,8.46))\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e3.42 (2.13, 7.52)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.000\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eANC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(10.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105 (26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73 (18.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e182 (45.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.02 (0.65, 1.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePlace of Delivery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52 (12.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e117 (29.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHealth facilities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62 (15.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e170 (42.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.75 (1.13, 2.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.11 (0.56, 2.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.775\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePNC\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59 (14.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e142 (35.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55 (13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e145 (36.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.09 (0.71, 1.69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMaternal knowledge on vitamin A rich foods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80 (20.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e203 (50.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (8.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84 (26.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.02 (0.63, 1.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.23 (0.66, 2.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.511\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild vaccination status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePartial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (5.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94 (23.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFull\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e94 (23.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e193 (48.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.28 (1.33, 3.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.80 (0.79, 4.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.162\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild meal frequency per day\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e194(48.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66 (16.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e93(23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.87 (1.36, 3.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.652 (0.89, 3.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.112\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eChild dietary diversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54913.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e217(54.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e70(17.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.44 (1.12, 4.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.96 (0.90, 4.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.090\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHousehold food security level\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInsecure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54 (13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e220 (54.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSecure\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60 (14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67 (16.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.05 (0.67, 1.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e1.97 (1.00, 3.89)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.040\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThe study revealed that the consumption of vitamin A rich foods among children aged 6\u0026ndash;59 months in Hawi Gudina District was 28.4% in the week preceding the survey. This result aligns with findings from similar studies conducted in Ethiopia (Jemberu Y, 2017;EDHS, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), indicating a consistent pattern of suboptimal vitamin A rich foods consumption among children in the country. The study result was also consistent with the review in LMIC in which Ethiopian children consumption of vitamin A rich food was as low as 26% (Karlsson, \u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). However, the study result was lower than the study in East Africa Countries (62.91%) (Wolde and Tessema, \u003cspan citationid=\"CR69\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This might be due to differences in scale of the studies, socio-economic status, and feeding habits. It was also lower than the study conducted in North Shoa District of Ethiopia with prevalence report at 39.1% (Moroda et al., 2022). This discrepancy might be due to the geographic proximity of the North Shoa District to Addis Ababa, the country\u0026rsquo;s capital privileging a relatively easy physical access of different food items. The findings of the present study is also lower than the study in Gondar Town (38.94%) (Aserese et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). This disparity is due to difference in the study population that was among lactating mothers while ours was among children aged 6\u0026ndash;59 months.\u003c/p\u003e \u003cp\u003eFrom the studied children, [327 (81.5%)] did not consume vitamin A rich plant foods within 7 days preceding the survey. In addition, the proportion of consumption of animal sources of vitamin A, including meat, or fish was 4.2% and chicken egg was 8.5%. This low consumption of animal sources of vitamin A is in agreement with other studies in Dembia, Northern Ethiopia (Tariku et al., \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), Aleta wondo Southern Ethiopia (Dafursa and Gebremedhin, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003eb) and other study somewhere in Ethiopia (Woldegebriel et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) in which flesh foods were the least consumed by the studied children. However, as compared to the very low consumption of flesh foods in the current study, studies conducted in Oshana and Oshikoto regions in Namibia reported a much higher consumption of chicken (98%), beef (96%) and fresh fish (95%) (Angula et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Similarly, study conducted in Kenya reported a higher consumption of flesh foods (33.8%) and eggs (52.1%) among study participated children (Kananu et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). The disparities in results can be explained by the effect of differences in the study settings, socio-economic status and cultural variances.\u003c/p\u003e \u003cp\u003eAccording to WHO (2003), children are recommended to consume vitamin A rich foods on a daily basis to prevent VAD. Similarly, the HKI method suggested that the level of inadequate intake should not exceed 70% of the community (Rosen et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e1993\u003c/span\u003e). However, the present study revealed that a substantial proportion of children failed to meet the recommendation, indicating that they are at considerable rick of VAD. This finding underscores the seriousness of the problem and highlights the need for targeted nutritional interventions to improve children\u0026rsquo;s access to and consumption of vitamin A rich foods.\u003c/p\u003e \u003cp\u003eA striking finding of this study is that the great majority of the study participated children, [287 (71.6%)] did not consume Vitamin A rich foods, which might be paralleled with a high prevalence of food insecurity in the study area (68.3%) according to our study. Food insecurity is known to limit the availability and access to diverse and nutritious foods, including fruits and vegetables (Estibel, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2022\u003c/span\u003e;Bolka et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2024\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eFewer families in the household were significantly associated with the child intake of vitamin A rich foods. The existence of a strong association between vitamin A rich foods consumption and family size was documented by previous studies (Semba et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e;Aserese et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). For the present study 69.1% of children were from households\u0026rsquo; with family size of five or more, that might be among attributing factors to the poor consumptions of vitamin A rich foods in the study area.\u003c/p\u003e \u003cp\u003eAdditionally, the timing of the data collection, which was conducted during the dry season, may have contributed to the observed low intake. During this period, the availability of fresh fruits and vegetables typically declines, making it more difficult for households to access these foods (Abizari et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2017\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study, the consumption of plant source vitamin A rich foods among children was higher than that of animal source. This finding is in agreement with earlier studies conducted in Ethiopia (Muhye et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2022\u003c/span\u003e;Mekisso et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), Kenya (Kananu et al., \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) and Bangladesh (Begum et al., 2021) in which most of the vitamin A intake of children was reported to be obtained from plant sources. It was also reported that in developing countries, above 80% of the dietary vitamin A intake is obtained from Pro-vitamin A carotenoids (McLaren and Frigg, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e1997\u003c/span\u003e;Ramakrishnan et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e1999\u003c/span\u003e). Previous studies have shown that, in general, bioefficacy of carotenoids from a range of plant sources is very scarce (Bloem et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e1998\u003c/span\u003e;Arimond and Ruel, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). However, such a greater dependency on plant foods as major sources vitamin A was not observed in the present study, it could have its own negative aspects due to low bioavailability of vitamin A from these foods. Overall, the relatively low percentage of children consuming vitamin A rich foods suggests that more efforts are needed to improve dietary diversity and access to vitamin A rich foods in Ethiopia.\u003c/p\u003e \u003cp\u003eA number of factors are contributing to the adequate consumption of vitamin A rich foods among children in the study area. Socio-demographic factors like family size, maternal age and educational status, age of the child, household wealth index and food security level were found to be significantly associated (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) with children consumption of vitamin A rich foods (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eChildren those in age group 48\u0026ndash;59 months were 2.59 times more likely of consuming vitamin A rich foods than those children in age group 6\u0026ndash;23 months. This finding was in line with the study conducted in Kachabira and Wolaita Sodo, Southern Ethiopia (Jemberu Y, 2017;Mekisso et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). This could be attributed to a better awareness of mothers to increase and diversify children\u0026rsquo;s foods as age increased. This might also be the result of the existing health care access and nutrition programs in the study area.\u003c/p\u003e \u003cp\u003eMiddle age mothers (30\u0026ndash;39 years old) were 3.25 times more likely to feed their children vitamin A rich foods compared to younger mothers (15\u0026ndash;19 years old). The result is similar with the study in India (Semba et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). This might be explained by education, economic stability, health care access and maternal experiences in rearing children that lead them to better feeding practices than younger age mothers. However, the study was in contrast to the study in South Ethiopia (Jemberu Y, 2017). This might be due to disparities in geographic location, socio-demographic factors, social norms and cultural traditions.\u003c/p\u003e \u003cp\u003eChildren from mothers who had completed higher education were 1.24 times more likely of consuming vitamin A rich foods when compared to those children from mothers who had no formal education [AOR\u0026thinsp;=\u0026thinsp;1.24 (95%CI:1.07, 2.69)]. This indicated that maternal education plays a great role in child nutrition in general. This finding is supported by different studies conducted in Ethiopia (Demsash et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e;Muhye et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and DHS surveys from 11 countries (Arimond and Ruel, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). It could be because educated mothers are more likely to have access to more information through reading and more aware of the necessity of complementary feeding, dietary consumption of vitamin A rich foods, and the causes of vitamin A deficiency.\u003c/p\u003e \u003cp\u003eHousehold socioeconomic status has also determined children vitamin A rich food consumption status. Children belonging to rich and medium wealth index household\u0026rsquo;s intake 3.5 and 3 times, more likely of vitamin A rich foods than those belongs to poor households respectively. This align with study conducted in Addis Ababa (Kebede et al., \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) and North Shoa, Ethiopia (Moroda et al., 2022). The dietary consumption pattern showed a marked improvement as the wealth status of the household improves (Woldegebriel et al., \u003cspan citationid=\"CR70\" class=\"CitationRef\"\u003e2020\u003c/span\u003e;de Juras et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). This suggests that wealthier households are better able to afford a variety of nutrient-dense foods.\u003c/p\u003e \u003cp\u003eThis study also indicated that children from food secure household were about two times more likely of vitamin A rich foods intake as compared to those children from food insecure households [AOR\u0026thinsp;=\u0026thinsp;1.97 (95% CI;1.00, 3.89)]. This result was consistent with studies in other areas like East Badawacho District (Betebo et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), Aleta Wondo District, Southern Ethiopia (Dafursa and Gebremedhin, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003ea) and Nepal (Chitekwe et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). This might be because of children from the food secure households have higher DDS when compared with children from food insecure households (Ali et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e Our study has several strengths including uses of large sample sizes; community-based study represent target population and focused on children aged 6\u0026ndash;59 months in under researched setting, offering valuable insights for local governance and stakeholders. It might help to promote program intervention related to improved vitamin A rich food consumption within these communities.\u003c/p\u003e \u003cp\u003eHowever, this study was a cross-sectional study, thus it is difficult to identify cause effect relationship, and there might be recall and social desirability biases due to the data were based on the respondent memory. To minimize these biases, we employed trained enumerators, incorporated multiple questions, created nonjudgmental environment during the interview and assured the confidentiality of their responses. We also did not consider seasonal variation in food consumption, which might affect food consumption pattern. In addition, information on the amount of consumption of vitamin A rich foods was not collected. Despite these constraints, our study contributes valuable baseline data to guide effective nutritional interventions in the study area and in the region. Future studies could consider longitudinal designs, multiple seasonal assessments and biomarkers to overcome these limitations.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study revealed low prevalence of consumption of vitamin A rich foods among children aged 6\u0026ndash;59 months, which was less than three out of ten mothers fed vitamin A rich foods to their children in the past seven days before the survey in Hawi gudina District, Eastern Ethiopia. Plant based vitamin A rich foods were more commonly consumed than animal-based sources, which need particular concerning. Children in the study area are at considerable risk of vitamin A deficiency.\u003c/p\u003e \u003cp\u003eMultivariable analysis underscores key socio-demographic determinants: children aged 48\u0026ndash;59 months, mothers aged 30\u0026ndash;39 years, higher maternal education, \u0026le;\u0026thinsp;4 family sizes, greater household wealth, and food-secure households all significantly increased the likelihood of vitamin A rich foods intake among children aged 6\u0026ndash;59 months in the study area. These results indicated the critical influence of maternal education, economic stability, and household resilience on child nutrition.\u003c/p\u003e \u003cp\u003eGovernment should improving socio economic status, food security level, maternal education and health care service delivery. We also recommend Regional Health Bureau to giving more attention to food-based strategies to enhance the consumption of vitamin A rich foods among children. Health sector of the study setting should have to educate mothers through health extension workers and different media on vitamin A rich foods. The agricultural sector should have to encourage kitchen gardening and animal rearing, hence the community could easily accessed vitamin A rich foods for their children. The family has to feed their children vitamin A rich foods particularly for infants less than two years of age. We also recommend researchers that it would be valuable to conduct further year round assessments to understand the seasonal variations in the consumption of vitamin A rich foods and tailored interventions.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eANC\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAntenatal Care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eAOR\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAdjusted Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eCOR\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCrude Odds Ratio\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eDDS\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDietary Diversity Score\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eDGLV\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDark Green Leafy Vegetables\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eFFQ\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFood Frequency Questionnaire\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eHKI\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHellen Keller International\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003ePNC\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ePost Natal Care\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003e\u003cb\u003eVARF\u003c/b\u003e\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eVitamin A Rich Foods\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflict of Interest\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no conflict of interests.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eClinical trial number\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe authors declare that no financial support was received for the research.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eAll authors had substantial involvement in the conception and designing of the research, fieldwork, data analysis, interpretation, and manuscript drafting, revising, and final approval for submission. C.N initiated the research, wrote the research proposal, conducted the fieldwork, did the data entry, analysis, and report write up and prepared the first draft of this manuscript. W.A and H.A involved in the write up of the research proposal, data analysis, interpretation, and manuscript writing. A.D participated in the statistical analysis, report write up, and manuscript writing and revision. All authors read and approved the final manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eWe would like to extend our sincere gratitude to Haramaya University, College of Health and Medical Sciences, School of Public Health, for granting us the opportunity to conduct this study. Our heartfelt thanks also go to all the mother-child pairs who participated, as well as the data collectors and supervisors for their valuable contributions\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data supporting the findings of this study are available upon request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbebe H, Abebe Y, Loha E, \u0026amp;Stoecker. BJ,2014. Consumption of vitamin A rich foods and dark adaptation threshold of pregnant women at Damot Sore District, Wolayita, Southern Ethiopia. Ethiop J health Sci, 24, 219\u0026ndash;26.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbizari A-R, Azupogo F, Nagasu M, Creemers N, \u0026amp;Brouwer ID. 2017. Seasonality affects dietary diversity of school-age children in northern Ghana. PLoS ONE, 12, e0183206.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdem NA, Mezmur H, Jemal M, Firdisa D, \u0026amp;Gebremichael B. Consumption of vitamin A-rich foods among lactating mothers in Girawa district, Eastern Ethiopia. BMC Nutr. 2024;10:167.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAli NB, Tahsina T, Hoque DME, Hasan MM, Iqbal A, Huda TM et al. 2019. Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6\u0026ndash;59 months in rural Bangladesh. PLoS ONE, 14, e0221929.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndago AA. Household food consumption patterns in relation to dietary adequacy of Vitamin A and Iron in Awasi. Nyando District, Kenya. University of NAIROBI; 2004.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAngula M, Ishola A, Tjiurutue M, Chigonga N, Sulyok M, Krska R, et al. Association of food consumption patterns and nutritional status of children under 5 years from rural households in Northern regions. Namibia BMC Nutr. 2024;10:51.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArimond M, Ruel MT. 2003. Generating indicators of appropriate feeding of children 6 through 23 months from the KPC 2000+.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArimond M, Ruel MT. Dietary diversity is associated with child nutritional status: evidence from 11 demographic and health surveys. J Nutr. 2004;134:2579\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAserese AD, Atenafu A, Sisay M, Sorrie MB, Yirdaw BW, Zegeye MK. 2020. Adequate vitamin A rich food consumption and associated factors among lactating mothers visiting child immunization and post-natal clinic at health institutions in Gondar Town, Northwest Ethiopia. PLoS ONE, 15, e0239308.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBegum R, Rahman MN, Islam R, Hasan MR, Jamil MY, Tamanna. SA,2021. Vitamin A knowledge and household consumption frequency of vitamin A\u0026ndash;rich foods in Tangail, Bangladesh. Malaysian J Nutr, 27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBerhe G, Nega. Dietary diversity practice and associated factors among infants and young children in Haramaya town, Ethiopia. Int J Public Health Sci. 2017;6:243\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBetebo B, Ejajo T, Alemseged F, \u0026amp;Massa D. 2017. Household food insecurity and its association with nutritional status of children 6\u0026ndash;59 months of age in east Badawacho District, south Ethiopia. Journal of environmental and public health, 2017, 6373595.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBloem MW, De Pee S, Darnton-Hill I. New issues in developing effective approaches for the prevention and control of vitamin A deficiency. FoodNutr Bull. 1998;19:137\u0026ndash;48.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBolka A, Sikuare S, Dona A, \u0026amp;Philipos A. Dietary Vitamin A Intake and Associated Factors among Lactating Women in Wondo Genet District. Sidama Region, Southern Ethiopia; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChitekwe S, Parajuli KR, Paudyal N, Haag KC, Renzaho A, Issaka A, et al. Individual, household and national factors associated with iron, vitamin A and zinc deficiencies among children aged 6\u0026ndash;59 months in Nepal. Volume 18. Maternal \u0026amp; Child Nutrition; 2022. e13305.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCioms \u0026amp; Who. International ethical guidelines for biomedical research involving human subjects. CIOMS, OMS Genebra; 1993.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCoates J, Swindale A, Bilinsky. P,2007. Household Food Insecurity Access Scale (HFIAS) for measurement of food access: indicator guide: version 3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCombs GF Jr, Mcclung JP. The vitamins: fundamental aspects in nutrition and health. Academic; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCsa,2006. Ethiopia Demographic and Health Survey 2006: Final Report. Rockville, Maryland, USA: EPHI and ICF.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ejournal article.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDafursa K, Gebremedhin. S,2019a. Dietary diversity among children aged 6\u0026ndash;23 months in Aleta Wondo District, Southern Ethiopia. J Nutr metabolism, 2019, 2869424.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDafursa K, Gebremedhin. S,2019b. Dietary diversity among children aged 6\u0026ndash;23 months in Aleta Wondo District, Southern Ethiopia. J Nutr metabolism, 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe Juras AR, Hsu W-C, \u0026amp;Hu SC. Dietary patterns and their association with sociodemographic and lifestyle factors in Filipino adults. Nutrients. 2022;14:886.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemissie TAA, Mekonnen Y, Haider J, \u0026amp;Umeta M. Demographic and health-related risk factors of subclinical vitamin A deficiency in Ethiopia. J Health Popul Nutr. 2009;27:666.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDemsash AW, Chereka AA, Kassie SY, Donacho DO, Ngusie HS, Tegegne MD, et al. Spatial distribution of vitamin A rich foods intake and associated factors among children aged 6\u0026ndash;23 months in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey. BMC Nutr. 2022;8:77.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEdhs. Ethiopia demographic and health survey. Addis: CSA and ICF; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbaba E, Rockville. Maryland, USA, 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEdhs. 2019. Ethiopia Mini Demographic and Health.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSurvey 2019: Final Report. Rockville, Maryland, USA: EPHI and ICF.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEl-Arab AE, Khalil F, \u0026amp;Hussein. L,2002. Vitamin A deficiency among preschool children in a rural area of Egypt: the results of dietary assessment and biochemical assay. Int J Food Sci Nutr, 53, 465\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEstibel DM. 2022. Determinants Of Household Food Security In Addis Ababa City Administration.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGebremedhin T, Aschalew AY, Tsehay CT, Dellie E, \u0026amp;Atnafu A. 2021. Micronutrient intake status and associated factors among children aged 6\u0026ndash;23 months in the emerging regions of Ethiopia: A multilevel analysis of the 2016 Ethiopia demographic and health survey. PLoS ONE, 16, e0258954.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaidar J. Common micronutrient deficiencies among food aid beneficiaries: evidence from refugees in Ethiopia. Ethiop J Health Dev. 2011;25:222\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHussey GD, Klein M. A randomized, controlled trial of vitamin A in children with severe measles. N Engl J Med. 1990;323:160\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJemberu Y, Zegeye M, Singh P, \u0026amp;Abebe H. Consumption of vitamin a rich foods and associated factors among children aged 6\u0026ndash;23 months in Kachabira District, southern Ethiopia. Int J Food Sci Nutr Eng. 2017;7:1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJemberu YZM, Singh P, \u0026amp;Abebe H. 2017,2017. Consumption of vitamin a rich foods and associated factors among children aged 6\u0026ndash;23 months in Kachabira District, southern Ethiopia. Int J Food Sci Nutr Eng, 7, 1\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJolliffe IT, Cadima J. Principal component analysis: a review and recent developments. Philosophical Trans royal Soc A: Math Phys Eng Sci. 2016;374:20150202.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKananu NC, Waudo J, \u0026amp;Njogu E. Vitamin A rich Foods consumed for dietary intake and supplementation among children aged 12 to 59 months in Gatunga Ward, Tharaka Nithi County, Kenya. SciencePG [Internet]; 2020. pp. 71\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKarlsson KR, Hasman a \u0026amp;Subramanian S. Consumption of vitamin-A-rich foods and vitamin A supplementation for children under two years old in 51 low-and middle-income countries. Nutrients. 2021;14:188.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKebede A, Jirstr\u0026ouml;m M, Worku A, Alemu K, Berhane HY, Turner C, et al. Residential food environment, household wealth and maternal education association to preschoolers\u0026rsquo; consumption of plant-based vitamin A-rich foods: the EAT Addis survey in Addis Ababa. Nutrients. 2022;14:296.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMbabazi R, Harding R, Khanna H, Namanya P, Arinaitwe G, Tushemereirwe W et al. 2020. Pro-vitamin A carotenoids in East African highland banana and other Musa cultivars grown in Uganda. Food science \u0026amp; nutrition, 8, 311\u0026ndash;21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMclaren DS, Frigg M. 1997. Sight and life manual on vitamin A deficiency disorders (VADD), Task Force Sight and Life Basel, Switzerland.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMekisso SM, Dake SK, Haile DT, Nane D. Inadequate consumption of vitamin A-rich foods among preschool children in Wolaita Sodo, Southern Ethiopia. Front Nutr. 2024;11:1503040.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoroda M, Goyomsa GG, Shukure R, Negiye. SN,2022. Consumption of Vitamin A rich Foods and its Associated Factors among Children aged 6\u0026ndash;59 months in North Shoa Zone, Oromia Regional State, Ethiopia: A Cross-Sectional Study in 2022. Front Nutr, 12, 1526292.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuhye AB, Assimamaw N, Tamir TT, Alemu TG, Techane MA, Wubneh CA et al. 2022. Spatial distribution and Determinates of poor consumption of foods rich in vitamin A among children aged 6\u0026ndash;23 months in Ethiopia using data from Ethiopia Demographic and Health Survey 2019: Spatial and Multilevel Analysis.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNapoli MDMP, Mazziotta M. 2011. Towards a food insecurity Multidimensional Index (FIMI). Master in human development and food security.2011:1\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNti CA, Hayford J, Opare-Obisaw C. Nutrition knowledge, diet quality and nutritional status of people living with HIV (PLHIV) in Ghana. Food Public Health. 2012;2:219\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePersson V. 2001. Vitamin A intake, status and improvement using the dietary approach: studies of vulnerable groups in three Asian countries (Doctoral dissertation, Acta Universitatis Upsaliensis).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePersson V, Greiner T, Islam S, Gebre-Medhin M. The Helen Keller International food-frequency method underestimates vitamin A intake where sustained breastfeeding is common. FoodNutr Bull. 1998;19:343\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRamakrishnan U, Martorell R, Latham MC, Abel R. Dietary vitamin A intakes of preschool-age children in South India. J Nutr. 1999;129:2021\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRosen D, Haselow N, \u0026amp;Sloan N. How to use the HKI food frequency method to assess community risk of vitamin A deficiency. New York: Helen Keller International; 1993.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRutstein SO. 2015. Steps to constructing the new DHS Wealth Index. Rockville, MD: ICF International, 6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSemba RD, De Pee S, Sun K, Campbell AA, Bloem MW, Raju V. Low intake of vitamin A\u0026ndash;rich foods among children, aged 12\u0026ndash;35 months, in India: association with malnutrition, anemia, and missed child survival interventions. Nutrition. 2010;26:958\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSherwin JC, Reacher MH, Dean WH, \u0026amp;Ngondi J. Epidemiology of vitamin A deficiency and xerophthalmia in at-risk populations. Trans R Soc Trop Med Hyg. 2012;106:205\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmith RG, Saul AW. The Vitamin Cure for Eye Disease. Basic Health; 2012.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSofia Vilela IM, Correia D, Severo M, Lopes C. 2019. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003eof-socio-economic-factors-in-food-consumption-of-portuguese-children-and-adolescents-results-from-the-national-food-nutrition-and-physical-activity-survey-20152016.pdf\u003c/span\u003e\u003cspan address=\"http://of-socio-economic-factors-in-food-consumption-of-portuguese-children-and-adolescents-results-from-the-national-food-nutrition-and-physical-activity-survey-20152016.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong P, Adeloye D, Li S, Zhao D, Ye X, Pan Q, et al. The prevalence of vitamin A deficiency and its public health significance in children in low-and middle-income countries: A systematic review and modelling analysis. J Global Health. 2023;13:04084.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSuri S, Kumar D, \u0026amp;Das R. Dietary deficiency of vitamin A among rural children: community-based survey using food frequency questionnaire. Natl Med J India. 2017;30:61\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTalukder A, Kiess L, Huq N, De Pee S, Darnton-Hill I, Bloem MW. Increasing the production and consumption of vitamin A\u0026ndash;rich fruits and vegetables: lessons learned in taking the Bangladesh homestead gardening programme to a national scale. FoodNutr Bull. 2000;21:165\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTariku A, Fekadu A, Ferede AT, Mekonnen Abebe S, Adane AA. Vitamin-A deficiency and its determinants among preschool children: a community based cross-sectional study in Ethiopia. BMC Res Notes. 2016;9:1\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTiruneh SA, Fentie DT, Yigizaw ST, Abebe AA, Gelaye KA. 2021. Spatial distribution and geographical heterogeneity factors associated with poor consumption of foods rich in vitamin A among children age 6\u0026ndash;23 months in Ethiopia: Geographical weighted regression analysis. PLoS ONE, 16, e0252639.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNICEF,2019. The state of the world\u0026rsquo;s children 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUNICEF,2022. Good nutrition, bright futures: Towards an Africa without malnutrition by 2030.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. Indicators for Assessing Infant \u0026amp; Young Child Feeding Practices. WHO; 2008.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. 2009. Global prevalence of vitamin A deficiency in populations at risk 1995\u0026ndash;2005: WHO global database on vitamin A deficiency. Global prevalence of vitamin A deficiency in populations at risk 1995\u0026ndash;2005: WHO global database on vitamin A deficiency.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. Guideline: vitamin A supplementation in infants and children 6\u0026ndash;59 months of age. World Health Organization; 2011.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWHO. 2021. Indicators for assessing infant and young child feeding practices: definitions and.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003emeasurement methods.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWolde M, Tessema ZT. Determinants of good vitamin A consumption in the 12 East Africa Countries using recent Demographic and health survey. PLoS ONE. 2023;18:e0281681.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWoldegebriel AG, Desta AA, Gebreegziabiher G, Berhe AA, Ajemu KF, Woldearegay TW. 2020. Dietary diversity and associated factors among children aged 6\u0026ndash;59 months in Ethiopia: analysis of Ethiopian demographic and health survey 2016 (EDHS 2016). International journal of pediatrics, 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWuneh AD, Medhanyie AA, Bezabih AM, Persson L\u0026Aring;, Schellenberg J, Okwaraji YB. Wealth-based equity in maternal, neonatal, and child health services utilization: a cross-sectional study from Ethiopia. Int J Equity Health. 2019;18:1\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYadav R, Patial A, Bharti B, Attri SV, \u0026amp;Bhatia P. 2021. Dietary vitamin a intake, coverage of vitamin a megadose supplementation, and prevalence of vitamin a deficiency among marginalized children 6\u0026ndash;59 months in anganwadis of Chandigarh: A multistage cluster sampling survey. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive \u0026amp; Social Medicine, 46, 692.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZongo U, Zoungrana S, Savadogo A, Thiombiano-Coulibaly N, \u0026amp;Traor\u0026eacute; A. Assessment of dietary diversity and vitamin a-rich foods consumption of pre-school children in rural community in Burkina Faso, an impact study approach. Austin J Nutr food Sci. 2017;5:1087.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Vitamin A, vitamin A rich foods, children age 6-59 months","lastPublishedDoi":"10.21203/rs.3.rs-9059438/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9059438/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Vitamin A rich foods are important for children under the age of five years due to their increased physiological needs for growth and development. However, the magnitude of vitamin A rich foods consumption among children aged 6-59 months is not well studied and the determinant factors are not exhaustively identified.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e: To assess the prevalence and factors associated with vitamin A rich foods consumption among children aged 6-59 months in Hawi Gudina District, Eastern Ethiopia from December 1 to 30, 2024.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod: \u003c/strong\u003eAcross-sectional study was conducted among 401 randomly selected mother-child pairs in Hawi Gudina District, Eastern Ethiopia, 2024. A multistage sampling technique was used to select the study participants. Data were collected by using interviewer-administered questionnaire. Frequencies, percentages and mean score with standard deviations were generated to describe participants and report univariate outcomes. Consumption of vitamin A rich foods was assessed using a 7 days dietary recall. Logistic regression analysis was applied to identify determinant factors contributed to child vitamin A rich foods consumption practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e; The overall prevalence of vitamin A rich foods consumption among children was [28.4% (95% CI: 24.2%, 33.0%)]. Family size of ≤ 4 [AOR=3.48 (95%CI: 1.15, 6.12)], child age of 48-59 months [AOR=2.59 (95%CI:1.08, 6.24), maternal age of 30-39 years [AOR=3.25 (95% CI:1.37,7.69)], maternal higher education/college or above [AOR=1.24 (95%CI: 1.07, 2.69)], medium [AOR=2.82 (95%CI: 2.10, 6.18)] and rich [AOR=3.42 (95%CI: 2.13, 7.52) household wealth index and household food security [AOR=1.97 (95%CI:1.00, 3.89) were significantly associated with higher odds of vitamin A rich foods consumption among children aged 6–59 months.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The study indicated low magnitude of vitamin A rich foods consumption among children aged 6-59 months. Few family sizes, middle-aged mothers and higher maternal educational status, increase in child age, medium and rich wealth index, and household food security were the factors significantly and positively associated with consumption of vitamin A rich foods. Attention must be given to improve the socioeconomic status, maternal education and health care service delivery to enhance the consumption of vitamin A rich foods among children.\u003c/p\u003e","manuscriptTitle":"Prevalence and Factors Associated with Vitamin A Rich Foods Consumption among Children Aged 6-59 Months in Hawi Gudina District, Eastern Ethiopia","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-10 16:36:53","doi":"10.21203/rs.3.rs-9059438/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2f072bea-aa57-4328-93d0-ce58e6e19d02","owner":[],"postedDate":"March 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-12T08:56:47+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-10 16:36:53","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9059438","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9059438","identity":"rs-9059438","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}