An evidence review of gender-integrated interventions in reproductive and maternal-child health.
An evidence review of gender-integrated interventions in reproductive and maternal-child health.
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DOI：
10.1080/10810730.2014.918216
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发表时间：
2014
影响因子：
4.4
通讯作者：
Middlestadt SE
中科院分区：
文献类型：
--
作者：
Kraft JM;Wilkins KG;Morales GJ;Widyono M;Middlestadt SE
必须确定和传播针对性别动态的循证行为改变干预措施，以改善儿童健康结果。通过对已发表文献的系统检索和基于网络的检索（Google和实施者的网站）确定干预措施。如果干预措施涉及性别动态（即，规范，获得资源的不平等），测量相关的行为结果（例如，计划生育、产前护理、营养），至少采用了适度的评价设计，并在低收入或中等收入国家实施。在确定的23项干预措施中，22项涉及生殖和母婴健康行为（例如，生育间隔、产前护理、母乳喂养），以改善儿童健康。八项干预措施是通融的（即，承认，但不寻求改变性别动态），15个是变革性的（即，试图改变性别动态）。大多数评价（n = 12），包括让男子和妇女参与修改性别规范的干预措施，效果好坏参半。最有说服力的证据是增强权能的办法（即，参与性行动促进母婴健康;增加教育和经济资源，修改规范以减少童婚）。有两种增强权能的办法有充分的证据证明有必要扩大规模。需要进行研究，以评估有希望的办法，特别是那些让男子和妇女参与修改配偶之间沟通和决策方面的性别规范的办法。
Evidence-based behavior change interventions addressing gender dynamics must be identified and disseminated to improve child health outcomes. Interventions were identified from systematic searches of the published literature and a web-based search (Google and implementer's websites). Studies were eligible if an intervention addressed gender dynamics (i.e., norms, unequal access to resources), measured relevant behavioral outcomes (e.g., family planning, antenatal care, nutrition), used at least a moderate evaluation design, and were implemented in low- or middle-income countries. Of the 23 interventions identified, 22 addressed reproductive and maternal-child health behaviors (e.g., birth spacing, antenatal care, breastfeeding) that improve child health. Eight interventions were accommodating (i.e., acknowledged, but did not seek to change gender dynamics), and 15 were transformative (i.e., sought to change gender dynamics). The majority of evaluations (n = 12), including interventions that engaged men and women to modify gender norms, had mixed effects. Evidence was most compelling for empowerment approaches (i.e., participatory action for maternal-child health; increase educational and economic resources, and modify norms to reduce child marriage). Two empowerment approaches had sufficient evidence to warrant scaling-up. Research is needed to assess promising approaches, particularly those that engage men and women to modify gender norms around communication and decision making between spouses.