Assessment of vitamin D and iron supplementation practices and their determinants in Erzincan, Türkiye: A cross-sectional study

Abstract

Objective: Vitamin D and iron are crucial micronutrients, particularly for children in phases of rapid growth and development, playing significant roles in bone and dental health, immune function, cognitive development, and energy metabolism. Despite the initiation of prophylaxis programs by the Turkish Ministry of Health, adherence and effectiveness remain variable, highlighting the need for localized research to evaluate these initiatives. This study aims to assess the prevalence and continuity of vitamin D and iron supplementation among families in Erzincan, and identify determinants influencing the sustainability of these practices.

Methods: A cross-sectional and descriptive study was conducted among 200 families with children aged 1-5 years in the districts of Erzincan. Participants were recruited from family health centers using a convenience sampling method. Inclusion criteria encompassed families with children who met the age requirement, while exclusion criteria included children with special health conditions requiring high-dose supplementation. Data were collected through structured face-to-face questionnaires assessing supplementation practices, sources of medical advice, parental attitudes, and socio-demographic factors. Descriptive statistics summarized the data. The chi-square test and independent samples t-test assessed categorical and continuous variables, respectively. Multiple logistic regression identified factors influencing adherence, while Kaplan–Meier survival analysis evaluated supplementation duration.

Results: High rates of vitamin D (98.5%) and iron (94%) supplementation were observed, albeit with decreased adherence to the recommended durations (82.5% for vitamin D, 75.5% for iron). The absence of parental concern for their children’s health and concurrent use of another type of prophylaxis had a positive effect on prophylaxis use. A pediatrician recommended vitamin D and iron prophylaxis to 33% (n=66) of the participants, a family physician to 49% (n=98), and auxiliary health personnel to 3% (n=6) only, whereas 15% (n=32) were advised by more than one health professional. (p=0.008 for vitamin D prophylaxis; p=0.014 for iron prophylaxis). The multivariable logistic regression analyses revealed that parental concern about their infants’ health significantly impacted the continuity of vitamin D prophylaxis (p=0.010). However, demographic characteristics had no significant impact on supplementation practices.

Conclusion: Although vitamin D and iron supplementation rates are high in Erzincan, challenges in sustaining recommended durations suggest areas for improvement in prophylaxis programs. This study underscores the importance of healthcare professional recommendations and parental health perceptions in influencing supplementation practices. Recommendations include enhancing health education and accessibility to prophylaxis programs to improve sustainability and adherence.