Inequities in coverage of iron and vitamin A supplements, and anthelminthic medication among children in the Dominican Republic

Background: Delivery of key micronutrients and anthelminthic medications to children in low-and middle-income countries has reduced the burden of vitamin A and iron deficiencies, and soil-transmitted helminthic infections. However, there may be significant gaps in delivery of these interventions and there is some mixed evidence for inequitable distribution in some countries. This study examines to what extent there is an inequitable distribution of three different intervention types (vitamin A, iron and anthelminithics) among young children in the Dominican Republic.

Methods: Data on 11,149 children under the age of five were extracted from the Dominican Republic's 2007 Demographic and Health Survey. The extent to which receipt of these interventions were related to need (as index by child wasting and stunting), and socio-economic status (SES) variables (rural/urban residence, family income and maternal education) were examined using bivariate and stratified analyses.

Results: No relationships were found between wasting or stunting and the receipt of any of the three interventions on bivariate analysis or analysis stratified by SES variables. In contrast, each of the three intervention receipts were related to SES variables, with greater receipt related to higher income, greater maternal education and urban residence.

Conclusions: Inequity in intervention receipt was identified both through the lack of association with an index of need and disproportionate receipt among those with higher SES status or urban residence. This relationship was demonstrated across the three different intervention types.