Spatial variations and determinants of vitamin A and iron rich food consumption among Bangladeshi children aged 6-23 months.

Consuming foods high in vitamin A and iron is crucial for children's growth and well-being. However, deficiencies remain a public health problem in Bangladesh. This study explores spatial variation and determinants of vitamin A and iron-rich food consumption among children aged 6-23 months. In this study, data from 2528 children from the Bangladesh Demographic and Health Survey (BDHS) 2022 was used. BDHS 2022 employed a cross-sectional study design to collect data. The outcomes measured were vitamin A and iron-rich foods consumption within 24 h preceding the survey by including factors such as mother's age, education, occupation, child age, sex, Antenatal care (ANC) visits, medical illness (diarrhea, fever, cough), use of deworming drugs, wealth index, place of residence, division etc. Spatial patterns were analyzed with ArcGIS version 10.8 and associated factors were assessed using multilevel mixed effect logistic regression model. The prevalence of vitamin A and iron-rich foods consumption was 72% (95% CI 0.70-0.74) and 61.8% (95% CI 0.60-0.64) respectively. Clustering of vitamin A (Moran's I: 0.055, p < 0.001) and iron-rich food (I: 0.101, p < 0.001) consumption was observed, with hot spots in Rangpur, Rajshahi, and Khulna. From the mixed effects logistic regression analysis, maternal employment (aOR = 1.6; 95% CI 1.2-2.0), maternal education (aOR = 2.0; 95% CI 1.1-3.5), paternal education (aOR = 2.0; 95% CI 1.4-3.0), ≥ 4 ANC visits (aOR = 1.7; 95% CI 1.1-2.6), older children aged 18-23 months (aOR = 4.0; 95% CI 3.0-5.3), deworming drugs (aOR = 1.6; 95% CI 1.2-2.2) and residing in Khulna (aOR = 2.3; 95% CI 1.5-3.5), Rajshahi (aOR = 1.9; 95% CI 1.2-2.9) have shown statistically significant association with increased consumption of vitamin A and iron-rich foods. Furthermore, a lower likelihood of iron-rich food consumption was observed among children having diarrhea (aOR = 0.7; 95% CI 0.5-0.9), compared to children who didn't have diarrhea. Poor consumption of vitamin A-rich foods was found in Chittagong (aOR = 0.6; 95% CI 0.4-0.98) and Sylhet (aOR = 0.6; 95% CI 0.4-0.9). The findings revealed significant disparities both in regions and protective factors associated with vitamin A and iron-rich food intake among children in Bangladesh. Understanding these spatial variations and key determinants can guide targeted interventions, particularly in cold spot regions, to improve child nutrition in Bangladesh.