Understanding the Rapid Reduction of Undernutrition in Nepal, 2001-2011.
Understanding the Rapid Reduction of Undernutrition in Nepal, 2001-2011.
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DOI：
10.1371/journal.pone.0145738
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Hoddinott J
中科院分区：
文献类型：
--
作者：
Headey DD;Hoddinott J
长期以来，南亚一直是营养不良率异常高的代名词。然而，在过去十年中，尼泊尔可以说是世界上儿童发育迟缓下降速度最快的国家，而且是在内战和冲突后政治不稳定的情况下做到的。鉴于最近减少营养不良的兴趣，特别是营养敏感政策的作用，本文旨在通过分析2001年，2006年和2011年尼泊尔的人口健康调查，定量地了解这一令人惊讶的成功故事。为此，我们构建了儿童和孕产妇营养变化的中间决定因素模型，然后分解预测的营养结果随时间的变化。我们确定了四个广泛的变化驱动因素：资产积累，健康和营养干预，孕产妇教育收益，以及卫生条件的改善。其中许多变化显然受到政策决定的影响，包括增加对保健和教育的公共投资以及社区领导的保健和卫生运动。其他因素，如移民汇款的迅速增长，更多地反映了家庭对不断变化的政治和经济环境的反应。
South Asia has long been synonymous with unusually high rates of undernutrition. In the past decade, however, Nepal has arguably achieved the fastest recorded decline in child stunting in the world and has done so in the midst of civil war and post-conflict political instability. Given recent interest in reducing undernutrition–particularly the role of nutrition-sensitive policies–this paper aims to quantitatively understand this surprising success story by analyzing the 2001, 2006, and 2011 rounds of Nepal’s Demographic Health Surveys. To do so, we construct models of the intermediate determinants of child and maternal nutritional change and then decompose predicted changes in nutrition outcomes over time. We identify four broad drivers of change: asset accumulation, health and nutrition interventions, maternal educational gains, and improvements in sanitation. Many of these changes were clearly influenced by policy decisions, including increased public investments in health and education and community-led health and sanitation campaigns. Other factors, such as rapid growth in migration-based remittances, are more a reflection of household responses to changing political and economic circumstances.