Community knowledge, attitudes, and preferences towards vitamin A supplementation in a semi-rural health zone, Kasai Oriental, Democratic Republic of the Congo: a mixed-methods study

Abstract

ABSTRACT Background Vitamin A deficiency remains a critical public health challenge and affects children under 5 years of age in the Democratic Republic of the Congo. Objective We investigated the community-level knowledge, preferences, and attitudes towards vitamin A supplementation in a semi-rural Health Zone, Kasaï-Oriental province. Methods A sequential mixed-methods approach was applied; qualitative data included in-depth interviews with community leaders and focus-group discussions with parents (n = 79); quantitative data included a multi-stage sampling survey among caregivers of children under age 5 (n = 420). Qualitative data were analysed using thematic analysis supported by NVivo 14. The primary respondents for the survey were mothers/caregivers of children under 5-years old. A negative binomial regression analysis was used to determine the factors associated with vitamin A knowledge scores using Stata 17. Results The majority (95.5%) of respondents had relatively low knowledge scores (≤4). As reported by mother/caregiver, knowledge was positively associated with the father’s level of education and information from community health workers (adjusted incidence rate ratio [95% confidence interval] = 1.35 [1.02–1.78] and 1.56 [1.08–2.23], respectively). The community members had a positive attitude regarding vitamin A supplementation. In addition, the administration of vitamin A in health centres and at households were equally denoted as the preferred approaches. Conclusion Community health workers played a key role in informing the community regarding vitamin A supplementation. Strengthening the competence and interactions of community health workers with community members is a key factor for successful vitamin A supplementation delivery.