The Effects of Household Food Production Strategies on the Health and Nutrition Outcomes of Women and Young Children: A Systematic Review
The Effects of Household Food Production Strategies on the Health and Nutrition Outcomes of Women and Young Children: A Systematic Review
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DOI：
10.1111/j.1365-3016.2012.01282.x
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发表时间：
2012-07-01
影响因子：
2.8
通讯作者：
Olude, Olafunke
中科院分区：
文献类型：
--
作者：
Girard, Amy Webb;Self, Julie L.;Olude, Olafunke
本次审查的目的是系统地审查和总结增加家庭粮食生产的农业干预措施对妇女和幼儿营养和健康结果的影响，并为今后的研究和规划提供建议。所有符合纳入/排除标准的研究数据被提取成标准化表格。采用儿童健康流行病学参考小组改进版的建议、评估、发展和评价分级技术，对证据的质量进行评估和分级。确定了代表27个独特项目的36条文章。其中32个国家和17个国家分别报告了儿童和妇女的健康和营养状况。尽管研究的异质性太大，无法进行荟萃分析，但农业策略一致报告了妇女和儿童的饮食模式和维生素A摄入量的显著改善。尽管一些个别研究报告了儿童营养不良的显著减少，但对发育迟缓[相对危险度（RR） 0.93[95%可信区间（CI） 0.84, 1.04]]、体重不足（RR 0.80 [95% CI 0.60, 1.07]）和消瘦（RR 0.91 [95% CI 0.60, 1.38]）影响的综合估计并不显著。对维生素A状态、贫血和发病率的影响的研究结果不一致。总的来说，农业战略在改善妇女和幼儿营养和健康方面的潜力的证据基础主要是基于数量有限的高度不同的准实验研究，其中大多数在方法上有很大的局限性。虽然家庭粮食生产战略有望改善妇女和儿童的营养状况，但如果在营养学的生物和饮食指标方面进行方法上可靠和有充分动力的进一步研究，证据基础将得到加强。
The objective of this review is to systematically examine and summarise the effects of agricultural interventions to increase household food production on the nutrition and health outcomes of women and young children and provide recommendations for future research and programming. Data from all studies meeting inclusion/exclusion criteria were abstracted into a standardised form. The quality of the evidence was assessed and graded using a modified version of the Child Health Epidemiology Reference Group adaptation of the Grading of Recommendations, Assessment, Development and Evaluation technique. Thirty-six articles, representing 27 unique projects were identified. Of these 32 and 17 reported on the health and nutrition outcomes of children and women, respectively. Although studies were too heterogeneous to conduct meta-analysis, agricultural strategies consistently reported significantly improved diet patterns and vitamin A intakes for both women and children. Although some individual studies reported significant reductions in child malnutrition, summary estimates for effects on stunting [relative risk (RR) 0.93 [95% confidence interval (CI) 0.84, 1.04]], underweight (RR 0.80 [95% CI 0.60, 1.07]) and wasting (RR 0.91 [95% CI 0.60, 1.38]) were not significant. Findings for an effect on vitamin A status, anaemia and morbidity were inconsistent. Overall the evidence base for the potential of agricultural strategies to improve the nutrition and health of women and young children is largely grounded in a limited number of highly heterogeneous, quasi-experimental studies, most of which have significant methodological limitations. While household food production strategies hold promise for improving the nutrition of women and children, the evidence base would be strengthened by additional research that is methodologically robust and adequately powered for biological and dietary indicators of nutrition.