Coverage of Vitamin A Supplementation Among Children Aged 12–59 Months in Bangladesh: A Multilevel Logistic Regression Approach

Background Vitamin A supplementation (VAS) is a national strategy to address vitamin A deficiency. Children aged 6–59 months receive vitamin A twice a year. Despite this, coverage of VAS remains a major public health challenge for children in Bangladesh, with multiple studies aiming to identify its primary risk factors. This study examines the relationship between various sociodemographic factors and identifies the significant risk factors for low VAS rates, suggesting recommendations to enhance supplementation coverage among children. Methods Data were derived from the Bangladesh Demographic and Health Survey (BDHS) 2022. Analysis included 6472 (male: 3316 and female: 3156) weighted children aged 12–59 months; although children aged 6–59 months are eligible to receive VAS, the analysis focused on those aged 12–59 months. This is because the survey question required caregivers to recall VAS received in the past six months, and all children in the 12–59 month age group would have been eligible for supplementation during that period. The chi‐squared test was used to assess associations, followed by multilevel logistic regression models for identifying significant risk factors. The multilevel logistic regression model outperformed logistic regression in clustered data analysis. Results A proportion of 73.1% (4731) of children had received a vitamin A capsule in the prior six months, below the World Health Organization’s (WHO) 90% target. Children in the Dhaka division were notably 1.097 times more likely not to receive VAS compared to children in other regions. Conversely, children from the wealthiest wealth quartile (AOR = 0.749, p < 0.001, 95% CI: 0.618–0.908) and those with mothers aged 30–49 years (AOR = 0.649, p < 0.001, 95% CI: 0.518–0.812) were significantly less likely to miss VAS. Furthermore, higher maternal education was associated with a reduced likelihood of a child being excluded from the VAS program. Conclusion The findings highlight the need for targeted awareness campaigns in vulnerable communities, particularly to educate parents about the benefits of VAS.