Determinants and socioeconomic inequalities in vitamin A-rich food consumption among children aged 6–23 months in Somalia: a multilevel analysis of the 2020 Somalia Health and Demographic Survey (SHDS)

Introduction Vitamin A deficiency (VAD) remains a public health concern, particularly among children in resource-limited settings. This study aimed to evaluate the consumption of vitamin A-rich foods and associated socioeconomic inequalities among children aged 6–23 months in Somalia. Methods Data from the 2020 Somalia Health and Demographic Survey (SHDS were analyzed, including a sample of 1,839 children. Multilevel binary logistic regression was used to identify determinants of vitamin A-rich food consumption. Concentration indices (CIX) were employed to assess socioeconomic inequalities. Statistical analyses were conducted using Stata 17 and R Studio. Results Only 29.7% of children consumed vitamin A-rich foods. Significant regional variations were observed. Multilevel analysis revealed that household wealth ( AOR = 3.60, 95% CI: 2.23–5.78 for highest vs. lowest quintile), media access ( AOR = 2.05, 95% CI: 1.41–2.98), paternal education ( AOR = 1.83, 95% CI: 1.35–2.49), and antenatal care (ANC) attendance ( AOR = 1.69, 95% CI: 1.09–2.62 for ≥1 visit) were significantly associated with vitamin A-rich food consumption. The relative CIX indicated substantial wealth-related (0.2533, p < 0.001) and education-related (0.1438, p < 0.001) inequalities. Conclusion Vitamin A-rich food consumption among young children in Somalia is low, with significant socioeconomic inequalities. Interventions should target low-income households, promote maternal education, improve access to media, and strengthen antenatal care services to enhance vitamin A intake. Furthermore, regional-specific interventions to promote vitamin A food are recommended. Recommendations Policymakers should prioritize nutrition-sensitive social protection programs, strengthen antenatal care services, and implement targeted behavior change communication to improve vitamin A-rich food consumption. Vitamin A supplementation programs must be strengthened to ensure high coverage among children aged 6–59 months, especially in regions with the lowest intake. Future research should focus on longitudinal studies to assess the long-term impact of these interventions.