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Author ORCID Identifier


Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded


Month Degree Awarded


First Advisor

Cordeiro Lorraine

Second Advisor

Lindiwe Sibeko

Third Advisor

Fredrick Grant

Fourth Advisor

Evelyn Mercado

Subject Categories

Human and Clinical Nutrition | Nutrition


Vitamin A deficiency (VAD) remains a public health concern in low- and middle-income countries. Young children and women in the reproductive age group, particularly pregnant and lactating women, continue to experience vitamin A deficiency resulting in the risk of morbidity and mortality. Efforts to combat vitamin A deficiency have been tested with some success especially with school-based vitamin A supplementation programs. However, cost issues and reaching the most vulnerable individuals presents a formidable challenge. Globally, food-based approaches have been identified as a sustainable and effective strategy in improving vitamin A status and alleviating VAD.

This dissertation provides an overview of food-based approaches and vitamin A consumption among women and children from sweet potato growing households in selected regions in Uganda. Chapter one presents a systematic review on the effects of food-based approaches on vitamin A status of women and children. While some studies identified a positive effect of food-based approaches on vitamin A status others in this review did not find a statistically significant change in serum retinol levels. Chapter two describes vitamin A consumption and its predictors among women from sweet potato growing households from selected regions in Uganda. Plant sources of vitamin A including green leafy vegetables, were the most common dietary sources of vitamin A. Knowledge regarding vitamin A was the only identified predictor of vitamin A consumption. Based on criteria provided in the Hellen Keller International guide which was used to compute vitamin A-rich food consumption, the studied community was identified as being at high risk of vitamin A deficiency.

Finally, chapter three analytically compared three different food security indicators by vitamin A-rich food consumption for 375 mother-child dyads. This study found that mothers had higher levels of vitamin A consumption than children in the same household. This difference was qualified by a significant interaction with the household wealth index, but not with the household dietary diversity score (HDDS) and the household food insecurity access scale (HFIAS). HDDS and the wealth index were correlated with the vitamin A-rich food consumption of mothers and not with that of children. In summary, although the evidence in the literature on the effects of food-based interventions on vitamin A status is inconclusive, there is some indication of the positive benefits of food-based approaches. Further, the communities included in this study are at high risk for vitamin A deficiency and knowledge of vitamin A being a salient determinant of women and children’s consumption of vitamin A- rich food. Finally, mother’s consumption of vitamin A-rich was greater than their children, with a positive correlation with HDDS, a negative correlation with the wealth index, and no statistically significant association with HFIAS. Initiatives targeting mother-infant dyads should also consider direct programming to reach children and maximize their nutritional benefits.


Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License