Researchers looked at health records from 15 African countries to understand how many children aged 1-5 years old are getting two important treatments: vitamin A supplements (which prevent blindness and infections) and deworming medicine (which removes harmful parasites). They found that while most children get one or the other, only 44% get both treatments together. This is a problem because getting both treatments at the same time is much more effective than getting them separately. The study shows that wealthier families, children with educated mothers, and those living in countries with better health programs are more likely to receive both treatments.

The Quick Take

  • What they studied: How many children in Sub-Saharan Africa receive both vitamin A supplements and deworming medicine, and what factors help or prevent children from getting both treatments
  • Who participated: Over 107,000 children between 1 and 5 years old from 15 different African countries. The data came from health surveys that track family health information across these nations
  • Key finding: Only 44 out of every 100 children received both vitamin A supplements and deworming within a 6-month period. Surprisingly, 57 out of 100 children got vitamin A alone and 57 out of 100 got deworming alone, but the treatments weren’t happening together. About 30% of children got neither treatment
  • What it means for you: If you live in or care for children in Sub-Saharan Africa, this research suggests that health programs need to do a better job of giving these two treatments at the same time. Children are more likely to get both treatments if their mothers are educated, if families have more money, and if they live in countries with stronger health systems. This information can help health workers plan better ways to reach all children

The Research Details

Researchers used health survey information that was already collected from families in 15 Sub-Saharan African countries. They looked at data from over 107,000 children aged 12-59 months (1-5 years old) to see who received vitamin A supplements and deworming medicine within a 6-month time period. This type of study is called a cross-sectional study because it takes a snapshot of what happened at one point in time, rather than following children over many years.

The researchers used advanced statistical methods to understand what factors made it more or less likely for children to receive both treatments together. They looked at factors at different levels: individual child characteristics (like age and immunization status), family factors (like mother’s education and wealth), community factors (like whether they lived in cities or rural areas), and country-level differences (like which country they lived in). They used a special type of analysis that accounts for the fact that children from the same country might be more similar to each other than children from different countries.

The study was careful to use proper statistical methods that account for how the original health surveys were designed, making sure the results accurately represent the populations being studied.

This research approach is important because it shows real-world patterns of how health services are actually being delivered to children across multiple countries. By looking at data from 15 different countries at once, researchers can see which countries are doing well and which are struggling, which helps identify best practices and problem areas. Understanding the factors that help or prevent children from getting both treatments together is crucial for designing better health programs that can reach more children efficiently

This study used data from established health surveys (Demographic and Health Surveys) that are conducted regularly and use rigorous methods to collect information from representative samples of families. The large sample size of over 107,000 children makes the results reliable. The researchers used appropriate statistical methods for this type of data. However, because this is a cross-sectional study (a snapshot in time), it can show what factors are associated with receiving treatments but cannot prove that one factor directly causes another. The study relies on information that families reported, which could have some inaccuracies. Additionally, the data may not capture all reasons why children don’t receive treatments

What the Results Show

The main finding is that only 44% of children aged 12-59 months in these 15 African countries received both vitamin A supplements and deworming medicine within a 6-month period. This is much lower than the World Health Organization’s goal of 80% coverage. Interestingly, when researchers looked at each treatment separately, they found that 57% of children received vitamin A supplements and 57% received deworming—but these weren’t the same children. This means that the treatments are not being coordinated well.

The coverage varied dramatically between countries. Rwanda was the clear leader with 85% of children receiving both treatments, while Sierra Leone (10%) and Gabon (13%) had very low coverage. Other countries fell in between, with Lesotho at 58%, Tanzania at 45%, and Mozambique at 44%. This huge variation suggests that some countries have found better ways to deliver these treatments together than others.

The researchers also found that about 13% of children received only one of the two treatments, and nearly 30% received neither treatment. This means that a significant portion of children are missing out on important health protection. The children who were most likely to receive both treatments were those who were fully vaccinated, had older and more educated mothers, lived in wealthier households, and whose mothers had attended prenatal care visits and had access to media (like radio or television).

Several other important patterns emerged from the data. Children aged 24-47 months (2-4 years old) were slightly more likely to receive both treatments compared to younger children. Children whose mothers had attended antenatal care (prenatal checkups) were more likely to get both treatments, suggesting that good prenatal care is connected to better child health services overall. Families with more wealth and resources were significantly more likely to have children receiving both treatments. Interestingly, children living in urban areas were actually less likely to receive both treatments than those in rural areas, which was unexpected and suggests that rural health programs in some countries may be doing better at coordinating these services. At the country level, Rwanda, Mauritania, and Lesotho had much higher odds of providing both treatments compared to other countries, while Gabon and Sierra Leone had much lower odds

This research builds on previous studies showing that vitamin A supplementation and deworming are effective, low-cost interventions that prevent serious health problems in children. However, this study is one of the first to look comprehensively at how many children actually receive both treatments together across multiple African countries. Previous research has shown that these treatments work best when given together, but many health programs deliver them separately. This study confirms that gap and provides evidence about which factors help or prevent integrated delivery. The findings align with other research showing that maternal education, household wealth, and access to health services are important factors in child health outcomes

This study has several important limitations to keep in mind. First, it’s based on information that families reported about whether their children received treatments, which could be inaccurate—some families might forget or misremember. Second, the study only shows associations (what factors are connected to receiving treatments) but cannot prove that one factor directly causes another. For example, while the study shows that children with educated mothers are more likely to receive both treatments, it doesn’t prove that the mother’s education directly causes better treatment access. Third, the study doesn’t explain why some countries do much better than others—it just shows that differences exist. Fourth, the data is from health surveys that may not capture all children, particularly those in the hardest-to-reach areas. Finally, the study is a snapshot in time and doesn’t show whether coverage is improving or getting worse over time

The Bottom Line

Based on this research, health programs in Sub-Saharan Africa should work to deliver vitamin A supplements and deworming medicine together during the same health visit or campaign, rather than separately. This integrated approach could significantly increase the number of children receiving both treatments. Programs should learn from countries like Rwanda that have achieved high coverage rates. Health workers should prioritize reaching children in areas with lower coverage, particularly in Sierra Leone and Gabon. Programs should also focus on reaching families with less education and lower income, as these groups are less likely to access services. These recommendations have moderate to strong evidence support based on this large, multi-country study

Health officials and program managers in Sub-Saharan African countries should pay close attention to these findings, particularly those in countries with low coverage. Parents and caregivers of children aged 1-5 years in Africa should ensure their children receive both vitamin A supplements and deworming medicine. International health organizations working in Africa should use this information to design better programs. This research is less directly relevant to people living in developed countries where these health programs are already well-established, though it may interest those working in global health. The findings are particularly important for countries with low coverage like Sierra Leone, Gabon, Burkina Faso, and Côte d’Ivoire

The benefits of vitamin A supplementation and deworming appear relatively quickly—vitamin A helps prevent infections within weeks, and deworming removes parasites within days to weeks. However, the long-term benefits (like preventing blindness from vitamin A deficiency and improving growth and development) take months to years to fully appear. If health programs implement the recommendations from this study, it could take 6-12 months to see significant improvements in coverage rates, depending on how quickly programs can be reorganized and how well they reach families

Want to Apply This Research?

  • Track whether your child received both vitamin A supplementation and deworming within the last 6 months. Record the specific dates when each treatment was given and set reminders for the next scheduled doses. Note which health facility provided each treatment to help identify gaps in integrated service delivery
  • Use the app to schedule both treatments at the same health visit or campaign event. Set calendar reminders for when your child is due for vitamin A supplements and deworming, then plan to visit the health clinic on the same day for both treatments. Use the app to find health facilities in your area that offer integrated child health services
  • Track coverage over 6-month periods to see if your child consistently receives both treatments together. Monitor which health facilities in your area offer integrated services and share this information with other families. Use the app to document any barriers you face in accessing these treatments (distance, cost, availability) to help identify local health system gaps

This research describes patterns in health service delivery across African countries and should not be used as a substitute for professional medical advice. Parents and caregivers should consult with their local health care provider about whether vitamin A supplementation and deworming are appropriate for their individual child, as recommendations may vary based on local disease patterns and individual health status. The findings apply to population-level patterns and may not reflect individual circumstances. This study was published in 2026 and represents data from the time period studied; current coverage rates may differ. Always follow the guidance of your local health authorities and healthcare providers regarding child health interventions.