Status and determinants of intra-household food allocation in rural Nepal.
Status and determinants of intra-household food allocation in rural Nepal.
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DOI：
10.1038/s41430-017-0063-0
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发表时间：
2018-11
影响因子：
4.7
通讯作者：
Saville NM
中科院分区：
文献类型：
--
作者：
Harris-Fry HA;Paudel P;Shrestha N;Harrisson T;Beard BJ;Jha S;Shrestha BP;Manandhar DS;Costello AMDL;Cortina-Borja M;Saville NM
了解家庭内部粮食分配的模式和预测因素可以使营养方案更好地针对营养脆弱的个人。本研究旨在探讨尼泊尔家庭内部食物和营养分配的状况和决定因素。来自尼泊尔Dhanusha和Mahottari地区的孕妇，她们的岳母和男性户主对24小时饮食召回做出了回应，在非连续的日子重复三次（n = 150个家庭; 1278个个体召回）。家庭内的不平等是通过家庭成员之间的食物摄入量（食物份额）比率来衡量的;食物能量摄入比例（“食物份额与能量份额”，FS：ES）;卡路里需求比例（“相对膳食能量充足率”，RDEAR）和11种微量营养素充足的平均概率（MPA比率）。在回忆过程中收集了假设的决定因素，并使用多变量混合效应线性回归模型对其与结果的关联进行了测试。妇女的饮食（孕妇和岳母）包括较大的FS：ES的淀粉类食品，豆类，水果和蔬菜比男性户主，而男性有较大的FS：ES的动物源性食品。孕妇的MPA最低（37%），其次是婆婆（52%）和男性户主（57%）。孕妇和户主之间的RDEAR高出31%（log-RDEAR coeff=0.27（95%CI 0.12，0.42），P < 0.001），孕妇和婆婆的log-MPA比值与家庭水平热量摄入呈正相关（coeff=0.43（0.23，0.63），P < 0.001，每1000 kcal）。孕妇得到的食物和营养份额较低，这是不公平的，但这可以通过增加孕妇的现金收入和家庭粮食安全得到改善。
Understanding of the patterns and predictors of intra-household food allocation could enable nutrition programmes to better target nutritionally vulnerable individuals. This study aims to characterise the status and determinants of intra-household food and nutrient allocation in Nepal. Pregnant women, their mothers-in-law and male household heads from Dhanusha and Mahottari districts in Nepal responded to 24-h dietary recalls, thrice repeated on non-consecutive days (n = 150 households; 1278 individual recalls). Intra-household inequity was measured using ratios between household members in food intakes (food shares); food-energy intake proportions (‘food shares-to-energy shares’, FS:ES); calorie-requirement proportions (‘relative dietary energy adequacy ratios’, RDEARs) and mean probability of adequacy for 11 micronutrients (MPA ratios). Hypothesised determinants were collected during the recalls, and their associations with the outcomes were tested using multivariable mixed-effects linear regression models. Women’s diets (pregnant women and mothers-in-law) consisted of larger FS:ES of starchy foods, pulses, fruits and vegetables than male household heads, whereas men had larger FS:ES of animal-source foods. Pregnant women had the lowest MPA (37%) followed by their mothers-in-law (52%), and male household heads (57%). RDEARs between pregnant women and household heads were 31% higher (log-RDEAR coeff=0.27 (95% CI 0.12, 0.42), P < 0.001) when pregnant women earned more or the same as their spouse, and log-MPA ratios between pregnant women and mothers-in-law were positively associated with household-level calorie intakes (coeff=0.43 (0.23, 0.63), P < 0.001, per 1000 kcal). Pregnant women receive inequitably lower shares of food and nutrients, but this could be improved by increasing pregnant women’s cash earnings and household food security.
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