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Effect of Vitamin A Education on Vitamin A Supplementation Practices among Mothers of Under-Five Children in Nigeria

Abstract

Vitamin A deficiency remains an important public health and nutrition concern among young children in Nigeria and may increase susceptibility to infections, impair immune function, affect growth and development, and increase the risk of severe illness and mortality. Vitamin A supplementation is an established public health intervention for preventing vitamin A deficiency and improving child health, particularly among children in populations where dietary intake of vitamin A may be inadequate. Vitamin A education provides mothers with information about the importance and health benefits of vitamin A, dietary sources, signs and consequences of deficiency, recommended supplementation schedules, appropriate administration, and the importance of utilizing available child-health and immunization services. Vitamin A supplementation practices refer to mothers' appropriate utilization of recommended vitamin A supplements for eligible children, including awareness of supplementation schedules, timely receipt of supplements, adherence to recommended doses, and appropriate participation in supplementation programmes. In Nigeria, inadequate knowledge, misconceptions about vitamin A supplementation, limited awareness of supplementation schedules, missed opportunities during child-health services, poor access to healthcare facilities, and inadequate availability of supplements may affect supplementation practices among mothers. Effective vitamin A education may improve mothers' knowledge and encourage appropriate utilization of vitamin A supplementation services. Against this background, this study investigates the effect of vitamin A education on vitamin A supplementation practices among mothers of under-five children in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding mothers' decisions regarding vitamin A supplementation. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, behavioural capabilities, and environmental conditions in shaping maternal and child-health practices. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from vitamin A education may influence supplementation practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how vitamin A education may influence vitamin A supplementation practices among mothers of under-five children in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from mothers or primary caregivers of under-five children in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, households, and eligible mothers. Where feasible, selected participant groups or communities will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured vitamin A education covering vitamin A deficiency, health consequences of deficiency, dietary sources of vitamin A, benefits of supplementation, recommended supplementation schedules, appropriate administration, common misconceptions, and the importance of utilizing routine child-health and immunization services. Vitamin A supplementation practices will be assessed using indicators such as mothers' knowledge of supplementation schedules, receipt of recommended vitamin A doses by eligible children, timeliness of supplementation, adherence to recommended supplementation intervals, and utilization of appropriate healthcare or community supplementation services. Where feasible, supplementation status will be verified using child health cards, immunization records, supplementation registers, or healthcare facility records. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, vitamin A knowledge, exposure to education, and supplementation practices. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the effect of vitamin A education on vitamin A supplementation practices. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that vitamin A education has a significant positive effect on vitamin A supplementation practices among mothers of under-five children in Nigeria. Mothers exposed to structured vitamin A education are expected to demonstrate improved knowledge of vitamin A deficiency and greater awareness of the importance and recommended schedule of vitamin A supplementation. Education may increase timely utilization of supplementation services, improve adherence to recommended supplementation intervals, reduce misconceptions, and encourage mothers to participate in routine child-health and immunization services. However, education alone may not guarantee consistent supplementation because mothers may continue to face barriers such as distance to healthcare facilities, transportation difficulties, limited availability of supplements, competing household responsibilities, inadequate awareness of supplementation campaigns, and limited access to child-health services. Consequently, vitamin A education is expected to be most effective when supported by reliable supplement availability, accessible healthcare services, effective community mobilization, reminder systems, and integrated child-health programmes. The study is expected to contribute to the literature on vitamin A deficiency prevention, childhood nutrition, maternal and child health, nutrition education, supplementation practices, and public health in Nigeria by providing empirical evidence on the effect of vitamin A education on vitamin A supplementation practices among mothers of under-five children. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, primary healthcare facilities, child-health and nutrition programmes, community health workers, development partners, and policymakers regarding strategies for improving vitamin A supplementation coverage. The study will also provide evidence-based recommendations for strengthening maternal and community-based vitamin A education, improving awareness of supplementation schedules, integrating vitamin A education into routine child-health services, strengthening community outreach, ensuring consistent availability of vitamin A supplements, and promoting appropriate supplementation practices among mothers of under-five children across Nigeria.

Keywords: Vitamin A education, vitamin A supplementation practices, mothers, under-five children, vitamin A deficiency, childhood nutrition, nutrition education, maternal and child health, micronutrient supplementation, health promotion, public health, Nigeria.