Published in PLOS One on 2026-01-15, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Thomas Kidanemariam Yewodiaw, Mequanint Dessie Bitewa, Abiyu Abadi Tareke, Susan Horton
Source: PLOS One • DOI 10.1371/journal.pone.0339759
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Vitamin A supplementation (VAS) and deworming (DW) are proven, cost-effective interventions that protect children against preventable morbidity, mortality, and the burden of micronutrient deficiencies and parasitic infections. Nevertheless, many children fail to receive both interventions simultaneously, limiting the potential health gains. Assessing co-coverage and its determinants is crucial for guiding integrated child health strategies and closing persistent gaps across Sub-Saharan Africa.
We analyzed DHS data from 15 Sub-Saharan African countries, including 107,725 children aged 12–59 months. The primary outcome was co-coverage of vitamin A supplementation and deworming within six months. Weighted descriptive statistics and mixed-effects logistic regression assessed determinants at individual, household, community, and country levels, accounting for survey design and clustering. Variables with p < 0.20 or deemed theoretically relevant were included in the multilevel model (p < 0.05, 95% CI).
The pooled co-coverage of vitamin A supplementation (VAS) and deworming (DW) among children aged 12–59 months was 44.0% (95% CI: 43.4–44.6%), despite individual coverage of 57.1% for each intervention. Approximately 13% of children received either Vitamin A or deworming as a single intervention. Nearly 30% of children received neither intervention. Co-coverage was lowest in Sierra Leone (10.3%) and Gabon (13.2%), moderate in Burkina Faso (28.6%), Côte d’Ivoire (31.0%), Mozambique (44.0%), and Tanzania (44.7%), and highest in Lesotho (58.4%) and Rwanda (84.7%). Vitamin A supplementation coverage was lowest in Gabon (15.7%), Sierra Leone (16.5%) and highest in Rwanda (89.1%) and Lesotho (73.6%), while deworming alone was lowest in Sierra Leone (30.3%) and Burkina Faso (36.7%) and highest in Rwanda (89.4%) and Lesotho (62.4%). Co-coverage of vitamin A supplementation and deworming was higher among children aged 24–47 months (AOR = 1.07), fully immunized children (AOR = 1.41), and those with older, educated mothers who attended antenatal care (AORs 1.14–1.59) or had media exposure (AOR = 1.13). Household wealth also increased the likelihood (AORs 1.27–1.64), while urban residence reduced it (AOR = 0.84). At the country level, compared with Burkina Faso, Rwanda (AOR = 20.05), Mauritania (AOR = 4.30), and Lesotho (AOR = 3.92) had the highest odds, whereas Gabon (AOR = 0.36) and Sierra Leone (AOR = 0.22) had the lowest inter-country disparities in integrated child health coverage. The intraclass correlation coefficient (ICC) indicated that approximately 21.6% of the variance in concurrent coverage was attributable to between-country differences.
Co-coverage of vitamin A supplementation and deworming in 15 sub-Saharan Africa countries is low, with only 44% of children aged 12–59 months receiving both interventions, far below the WHO 80% target. Coverage varied widely, with Rwanda leading and Sierra Leone and Gabon lagging. Strengthened harmonized campaigns, routine service integration, and targeted outreach are essential to improve equitable child health outcomes.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Thomas Kidanemariam Yewodiaw, Mequanint Dessie Bitewa, Abiyu Abadi Tareke, Susan Horton. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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