Changes in Micronutrient Intervention in Nigeria, 2003-2008, and Implications for Intervention Scale-up

Abstract

Objectives: Nigeria is third of 34 countries that contribute 90% of the global burden of stunting, and has the third highest numbers of wasted children. Prevailing evidence emphasizes the need for effective scale-up of interventions like micronutrient supplementation. This study assessed micronutrient interventions in Nigeria and how coverage has changed over time, in order to identify modifications that may be necessary to achieve such scale-up. Methods: Data from the 2003 and 2008 Nigeria Demographic and Health Surveys (NDHS) were used. Intervention access was estimated using information about skilled health-worker-to-client contact. Descriptive and chi-square statistics were obtained using complex survey design, in Stata 11.2. Results: From 2003 to 2008, prevalence of households with adequately iodized salt decreased from 97.1% to 52.9% (p<0.0001). Prevalence of children 6-59 months who received vitamin A supplements in the 6 months preceding the NDHS also decreased (34.1% to25.1%, p<0.0001), but women receiving vitamin A postpartum increased from 19.8% to 24.9% (p=0.004). For iron, there were no changes in prevalence of zero-supplementation during pregnancy (40.0% to 43.9%, p=0.13). Similarly, there were no improvements in prevalence of health-worker-to-client contact. Skilled antenatal care prevalence was 58.1% and 58.0% in2003 and 2008 respectively (p=0.96); skilled assistance at delivery was 35.5% and 39.5% (p=0.16); and 23.4% and 33.0% respectively (p<0.0001) of children 12-59 months had received zero vaccinations. Conclusions: There were lack of improvements in already low micronutrient intervention coverage, and poor services utilization among clients. Promoting health services utilization may help scale-up micronutrient interventions in Nigeria.