Date of Conferral





Public Health


Cheryl Anderson


Vitamin A deficiency (VAD) affects about one third of children under the age of five in Nigeria. There is low uptake of biannual Vitamin A supplementation (VAS) used since year 2010 as the national response to addressing VAD among children 6 to 59 months. Yet, there is limited research on barriers or facilitators to uptake of VAS. The purpose of this study was to examine the perspectives of stakeholders about the VAS program in Nigeria. The theoretical underpinning was the social marketing framework. The central question related to the views of stakeholders toward the VAS program, and their perception about the barriers and facilitators to VAS. This qualitative case study inquiry included a review of VAS program documents and participant interviews. Twenty-seven purposively selected stakeholders participated in face-to-face interviews that explored VAS knowledge, demands, barriers, and facilitators. Audio-recorded data were transcribed verbatim, organized with NVivo 12, and analyzed using open and axial coding. Findings showed that lack of awareness about VAS benefits by mothers, their negative attitude about VAS, nonroutine delivery of VAS that potentially excludes children 6 to 11 months, and nonpayment of transportation allowances to VAS program volunteers by the government were perceived as barriers to VAS receipt. Participants viewed mothers’ knowledge of VAS benefits as a motivation for VAS uptake. Stakeholders’ perspectives of the VAS program were mainly positive. Also, there was no explicit content of VAS messaging in program documents reviewed. The findings may contribute to positive social change by improving VAS demand and coverage if program managers use the results to guide strategies for promoting VAS.