Final Model of Vitamin A Deficiency (VAD) in Nigeria - Copy For Content Editor Application

States currently in GiveWell's model
National Adamawa Akwa Ibom Benue Ekiti Nasarawa Taraba

- North East South South North Central South West North Central North East
Most Recent
[1] National Survey of Vitamin A Deficiency
National prevalence of VAD in children under 5 (serum retinol <
70 μmol/L), 2001 survey [2] 29.5% - - - - - -
National prevalence of severe VAD in children under 5 (serum
retinol <0.35 μmol/L), 2001 survey [3] 4.7% - - - - - -
Improving Circumstances Adjustment
Implied
[4] adjustments for each proxy
Changes in low height-for-age (stunting) -4% - - - - - -
Changes in low height-for-weight (wasting/acute malnutrition) -24% - - - - - -
Changes in poverty rates/wealth -30% - - - - - -
Weight
[5] placed on each proxy
Changes in low height-for-age (stunting) 33% - - - - - -
Changes in low height-for-weight (wasting/acute malnutrition) 33% - - - - - -
Changes in poverty rates/wealth 33% - - - - - -
Overall adjustment
Weighted average improving circumstances adjustment, 2003-
2018 -19.3% - - - - - -
Additional Time Trend Adjustments
Improving circumstances over time
Approximate number of years between proxy comparison
estimates [6] 16 - - - - - -
Years since national VAD survey as of 2022 [7] 21 - - - - - -
Additional years not accounted for in proxy comparison 5.0 - - - - - -
Average annualized rate of improving circumstances -1.21% - - - - - -
Estimated additional time trend adjustment (percentage points) -6.04% - - - - - -
Final improving circumstances adjustment -13.3% - - - - - -
Estimate of Current National VAD rate
Estimated national vitamin A deficiency rate
Estimated national VAD rate for Nigeria, 2022 25.6% - - - - - -
Sanity check
Is the GiveWell VAD estimate within the bounds of the
proportion of children likely to not be consuming many vitamin-A
rich foods? Yes - - - - - -
Sub-national Variation: State-specific Adjustments
Implied adjustments for each proxy relative to national average
Variation in low height-for-age (stunting) - 108% 53% 57% 60% 85% 114%
Variation in low height-for-weight (wasting/acute malnutrition) - 62% 62% 118% 49% 82% 78%
Variation in anemia rates - 82% 110% 91% 106% 103% 104%
Variation in poverty rates/wealth - 188% 67% 80% 70% 143% 219%
Weight
[8] placed on each proxy
Variation in low height-for-age (stunting) 25% - - - - - -
Variation in low height-for-weight (wasting/acute malnutrition) 25% - - - - - -
Variation in anemia rates 25% - - - - - -
Variation in poverty rates/wealth 25% - - - - - -
Estimated state-level vitamin A deficiency rates
Weighted average state-specific adjustment for sub-national
variation 110% 73% 86% 71% 103% 129%
Final estimated state-level vitamin A deficiency rates 28% 19% 22% 18% 26% 33%
DHS summary data on anthropometrics
DHS timed closest to the most recent VAD survey [9]
Rate of stunting (height for age < -2 SD) in children under
5, 2003 [10] 38% - - - - - -
Rate of wasting (height for weight < -2 SD) in children
under 5, 2003 [11] 9% - - - - - -
Rate of underweight (weight for age < -2 SD) in children
under 5, 2003 [12] 29% - - - - - -
Most recent DHS (as of 2022)
Rates of stunting (height for age < -2 SD) in children
under 5, 2018 [13] 37% 40% 20% 21% 22% 31% 42%
Rates of wasting (height for weight < -2 SD) in children
under 5, 2018 [14] 7% 4% 4% 8% 3% 6% 5%
Rates of underweight (weight for age < -2 SD) in children
under 5, 2018 [15] 22% 19% 9% 13% 11% 21% 22%
State-level stunting rate relative to national average - 108% 53% 57% 60% 85% 114%
State-level wastng rate relative to national average - 62% 62% 118% 49% 82% 78%
Comparisons over time
Change in stunting in children under 5, 2003-2018 -3.9% - - - - - -
Change in wasting in children under 5, 2003-2018 -24.0% - - - - - -
DHS summary data on dietary intake
Nutrition measures among breastfeeding children
% of children ages 6-23 months who consumed vitamin-A
rich fruits and vegetables in past 24 hours, 2018 [16] 37% - - - - - -
Number of children, 2018 [17] 6,550 - - - - - -
% of children under 3 who consumed vitamin-A rich fruits
and vegetables in past 7 days, 2003 [20] 30% - - - - - -
Nutrition measures among non-breastfeeding children
and vegetables in past 7 days, 2003 [26] 70% - - - - - -
Number of children, 2003 [27] 980 - - - - - -
Nutrition estimates for children overall
rich fruits and vegetables in past 24 hours, 2018 42% - - - - - -
rich fruits and vegetables in past 24 hours, 2008 53% - - - - - -
and vegetables in past 7 days, 2003 43% - - - - - -
DHS summary data on anemia [28]
Anemia rate in children, 2018 [29] 68% 56% 75% 62% 72% 70% 71%
State-level anemia rate relative to national average - 82% 110% 91% 106% 103% 104%
Poverty headcount data
World Bank poverty headcount data
% of Nigerin population below international poverty line
($1.90/day), 2003 [30] 56% - - - - - -
% of Nigerin population below international poverty line
($1.90/day), 2018 [31] 39% - - - - - -
Percent decline in poverty rate since the most recent
VAD survey 30% - - - - - -
Estimated change in VAD rate over time, wealth proxy
[32] -30% - - - - - -
Poverty headcount data from national survey
% of population below poverty line [33] 40% 75% 27% 32% 28% 57% 88%
State-level poverty relative to national average - 188% 67% 80% 70% 143% 219%
[1] The most recent national VAD survey in Nigeria we are aware of took place in 2001.
"Data collection took place from

August to October 2001." Maziya-Dixon et al. 2006, p. 2257
https://academic.oup.com/jn/article/136/8/2255/4664836
[2] Maziya-Dixon et al. 2006, Table 4, p. 2259

[3] Maziya-Dixon et al. 2006, Table 4, p. 2259
[4] Note: Anemia rates are not incorporated in the improving circumstances adjustment because anemia
rates were not measured in the 2003 DHS survey.
[5] We use equivalent weights for each proxy variable since we're unsure which is most important. We may
update these weights if we do additional analysis to determine which factors are most strongly correlated
with VAD.
[6] For Nigeria, we are comparing data for nutritional and economic indicators from 2003 (the estimates
closest to the most recent national VAD survey, conducted in 2001) with later data from 2018 (the most
recent DHS and World Bank poverty estimates).
[7] The most recent VAD survey in Nigeria that we know of (Maziya-Dixon et al. 2006) took place in 2001.
[8] We place equal weight on each proxy variable since we're unsure which is most important. We may
update these weights if we do additional analysis to determine which factors are most strongly correlated
with VAD.
[9] The most recent national VAD survey in Nigeria we are aware of was conducted from August to October
2001. Maziya-Dixon et al. 2006
https://doi.org/10.1093/jn/136.8.2255
Demographic and Health Surveys (DHS) have been conducted in Nigeria in 1990, 2003, 2008, 2013, and
2018. DHS Program, "Nigeria: Country Quickstats," Nigeria table. https://dhsprogram.
com/Countries/Country-Main.cfm?ctry_id=30.
[10] Source: Nigeria DHS 2003 Final Report
https://dhsprogram.com/pubs/pdf/FR148/FR148.pdf
[11] Source: Nigeria DHS 2003 Final Report, Table 11.10, Pg. 165
[13] Source: Nigeria DHS 2018 Final Report, Table 11.1, Pgs. 271-273.
[16] Source: Nigeria DHS 2018 Final Report, Table 11.6, Pg. 278.
[28] We only include data from the 2018 DHS in Nigeria because anemia data is not reported in the 2003
DHS.
[30] Source: World Bank estimates (https://web.archive.org/web/20220706154526/https://data.worldbank.

org/indicator/SI.POV.DDAY?locations=NG)
The World Bank database does not include an estimate of poverty headcount in 2001, the year of the
national VAD survey. Consequently we use the 2003 estimate (the closest available year to 2001) to proxy
for the poverty rate at the time of the survey.
[31] Source: World Bank estimates (https://web.archive.org/web/20220706154526/https://data.worldbank.

org/indicator/SI.POV.DDAY?locations=NG)
2018 is the most recent year (as of 2022) for which a poverty headcount estimate is available. We use this
estimate to proxy for the current poverty rate.
[32] This proxy input assumes that malnutrition/vitamin A deficiency would decline 1-for-1 with decreases in
the poverty rate.
We believe that this assumption is unlikely to be accurate, and we expect that the actual relationship
between declining poverty and VAD is less literal. Households that shift above the poverty line threshold
may still be quite poor.
However, we attempt to correct for this imbalance elsewhere in the model, by assigning this proxy a weight
< 1.
[33] Data is from the 2019 Poverty and Inequality in Nigeria Summary Report, Summary Table, Pgs. 14-16.
Downloaded on Feb. 28, 2022 from https://nigerianstat.gov.ng/download/1092.

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States currently in GiveWell's model

National Adamawa Akwa Ibom Benue Ekiti Nasarawa Taraba

"Data collection took place from

[2] Maziya-Dixon et al. 2006, Table 4, p. 2259

[3] Maziya-Dixon et al. 2006, Table 4, p. 2259

[10] Source: Nigeria DHS 2003 Final Report

[30] Source: World Bank estimates (https://web.archive.org/web/20220706154526/https://data.worldbank.

[31] Source: World Bank estimates (https://web.archive.org/web/20220706154526/https://data.worldbank.

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