COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition
COVID-19 pandemic and mitigation strategies: implications for maternal and child health and nutrition
复制标题
DOI：
10.1093/ajcn/nqaa171
复制
发表时间：
2020-08-01
影响因子：
7.1
通讯作者：
Bhutta, Zulfiqar A.
中科院分区：
文献类型：
--
作者：
Akseer, Nadia;Kandru, Goutham;Bhutta, Zulfiqar A.
2019冠状病毒病（COVID-19）继续破坏全球的健康和经济指标，包括孕产妇和儿童营养方面的进展。尽管人们一直关注短期内儿童消瘦率的上升，但由于COVID-19及其对贫困、基本干预措施覆盖率和获得适当营养食品的影响，孕产妇和儿童营养不良率也可能上升。在COVID-19之后，特别有可能崩溃或效率降低的关键部门包括粮食系统、收入和社会保障、妇女和儿童的医疗保健服务，以及清洁水和卫生设施的服务和获取。本次审查强调了COVID-19期间和之后孕产妇和儿童营养的关键关注领域，同时为各国减少孕产妇和儿童营养不良的努力提供战略指导。基于从全球健康的减少发育迟缓范例项目中学习到的经验，我们提供了一套建议，这些建议涵盖了对营养产生持续直接和间接影响的部门的投资。这些措施包括加强粮食供应链和减少粮食不安全的干预措施，以帮助那些面临粮食短缺直接风险的人。其他战略可以包括有针对性的社会安全网计划、延期支付或减税，以及为最弱势群体提供适当的现金支持计划。可以通过部署社区保健工作者和支持妇女和社区成员，以农村人口和城市贫民窟中最边缘化的家庭为目标。社区主导的卫生项目可能是确保健康家庭环境和减少营养不良的关键。此外，若干COVID-19应对措施，如接触者追踪和自我隔离，也可用于营养保护。全球健康和营养不良状况的改善将要求各国政府、捐助者和发展伙伴为COVID-19时代的投资重新制定战略和重新确定优先次序，并需要数据驱动的决策、政治意愿和承诺以及国际团结。
Coronavirus disease 2019 (COVID-19) continues to ravage health and economic metrics globally, including progress in maternal and child nutrition. Although there has been focus on rising rates of childhood wasting in the short term, maternal and child undernutrition rates are also likely to increase as a consequence of COVID-19 and its impacts on poverty, coverage of essential interventions, and access to appropriate nutritious foods. Key sectors at particular risk of collapse or reduced efficiency in the wake of COVID-19 include food systems, incomes, and social protection, health care services for women and children, and services and access to clean water and sanitation. This review highlights key areas of concern for maternal and child nutrition during and in the aftermath of COVID-19 while providing strategic guidance for countries in their efforts to reduce maternal and child undernutrition. Rooted in learnings from the exemplars in Global Health's Stunting Reduction Exemplars project, we provide a set of recommendations that span investments in sectors that have sustained direct and indirect impact on nutrition. These include interventions to strengthen the food-supply chain and reducing food insecurity to assist those at immediate risk of food shortages. Other strategies could include targeted social safety net programs, payment deferrals, or tax breaks as well as suitable cash-support programs for the most vulnerable. Targeting the most marginalized households in rural populations and urban slums could be achieved through deploying community health workers and supporting women and community members. Community-led sanitation programs could be key to ensuring healthy household environments and reducing undernutrition. Additionally, several COVID-19 response measures such as contact tracing and self-isolation could also be exploited for nutrition protection. Global health and improvements in undernutrition will require governments, donors, and development partners to restrategize and reprioritize investments for the COVID-19 era, and will necessitate data-driven decision making, political will and commitment, and international unity.