Effectiveness of programme approaches to improve the coverage of maternal nutrition interventions in South Asia
Effectiveness of programme approaches to improve the coverage of maternal nutrition interventions in South Asia
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DOI：
10.1111/mcn.12699
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发表时间：
2018-11-01
影响因子：
3.4
通讯作者：
Busch-Hallen, Jennifer
中科院分区：
文献类型：
--
作者：
Goudet, Sophie;Murira, Zivai;Busch-Hallen, Jennifer
妇女在怀孕前、怀孕期间和分娩后的营养状况对产妇健康和儿童的生存、生长和发育具有深远的影响。在南亚，育龄妇女身材矮小、消瘦和贫血的高发率是该区域儿童营养不良高发率的原因，而超重和肥胖则日益令人关切。进行了一次系统的证据审查（2000-2017年），以确定在该区域改善孕产妇营养干预措施覆盖面的障碍和方案办法。搜索战略使用了13个电子书目数据库和14个发展和技术机构网站，并确定了2 247条引文。在孟加拉国（n = 2），印度（n = 5），尼泊尔（n = 1）和巴基斯坦（n = 1）进行的9项研究被选中进行审查，结果包括铁和叶酸和钙补充剂的接收和消费以及怀孕期间饮食摄入量的信息。这些研究表明，在个人（产妇）、家庭和保健服务提供方面存在的一系列障碍影响了怀孕期间干预措施的覆盖面。有效提高干预措施覆盖面的方案办法解决了多个层面的障碍，并有几个共同特点：利用形成性研究和客户评估为方案办法和行动的设计提供信息;以社区为基础的交付平台，以增加获得服务的机会;让家庭成员以及孕妇参与影响行为改变;采取行动，提高一线服务提供者提供信息和咨询的能力、监督、监测和动力;提供免费补充。
The nutritional status of women before pregnancy, during pregnancy, and after delivery has far reaching consequences for maternal health and child survival, growth, and development. In South Asia, the high prevalence of short stature, thinness, and anaemia among women of reproductive age underlie the high prevalence of child undernutrition in the region, whereas overweight and obesity are rising concerns. A systematic review of evidence (2000-2017) was conducted to identify barriers and programme approaches to improving the coverage of maternal nutrition interventions in the region. The search strategy used 13 electronic bibliographic databases and 14 websites of development and technical agencies and identified 2,247 citations. Nine studies conducted in Bangladesh (n = 2), India (n = 5), Nepal (n = 1), and Pakistan (n = 1) were selected for the review, and outcomes included the receipt and consumption of iron and folic acid and calcium supplements and the receipt of information on dietary intake during pregnancy. The studies indicate that a range of barriers acting at the individual (maternal), household, and health service delivery levels affects intervention coverage during pregnancy. Programme approaches that were effective in improving intervention coverage addressed barriers at multiple levels and had several common features: use of formative research and client assessments to inform the design of programme approaches and actions; community-based delivery platforms to increase access to services; engagement of family members, as well as pregnant women, in influencing behavioural change; actions to improve the capacity, supervision, monitoring, and motivation of front-line service providers to provide information and counselling; and access to free supplements.