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Building trans-disciplinary partnerships for exploring the impact of population displacement on nutrition interventions in rural Zimbabwe

建立跨学科伙伴关系，探讨人口流离失所对津巴布韦农村营养干预措施的影响

基本信息

批准号：
AH/T004428/1
负责人：
Tim Brown
金额：
$ 22.98万
依托单位：
Queen Mary University of London
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2019
资助国家：
英国
起止时间：
2019 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=AH%2FT004428%2F1
关键词：
Building trans disciplinary partnerships exploring

项目摘要

Stunting affects nearly 30% of children in southern Africa, and leads to reduced human capacity, increased long-term risk of chronic disease and an inter-generational cycle of poverty. We recently conducted the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial, which showed that stunting can be reduced by 20% through improved infant and young child feeding (IYCF). Despite this modest reduction, it is evident that current interventions are insufficient to eliminate stunting. Countries including Zimbabwe are therefore unlikely to achieve World Health Assembly targets for improving maternal, infant and young child nutrition by 2025. There is a clear need to test new and broader approaches for stunting through interdisciplinary partnerships aimed at tackling the multi-faceted determinants of this intractable problem.Analysis of SHINE trial data has identified substantial gaps in infant nutrient intake despite an intensive IYCF intervention. Greater gains in linear growth can be achieved by enhancing the nutrient quality of infant diets. We have therefore recently broadened the disciplinary scope of researchers in this partnership to further build research capacity and capability. Having shown that linear growth can be modestly improved in the first 2 years of life with an intensive IYCF intervention, our partnership has been extended to include agricultural expertise in a follow-on randomised controlled trial. Collaborating with agricultural scientists and economists from the International Maize and Wheat Improvement Centre, the ultimate goal of this partnership is to further close the nutrient gap experienced by rural households in the immediate and longer term by integrating an enhanced 'IYCF-plus' intervention with a sustainable intervention aimed at improving agriculture and animal husbandry practices.As this call identifies, the long-term success of interventions such as ours depends on better understanding the cultural and historical contexts within which they take place as well as their reception by intended beneficiaries. This is acknowledged by the researchers involved in this partnership, who have an established track-record of working closely with the communities within which their work takes place. Despite this, important gaps in knowledge remain. Zimbabwe, like other southern African countries, has been subject to considerable population displacement in the past several decades, involving rural-urban, regional (e.g. Botswana, South Africa, Zambia) as well as overseas migration (e.g. Canada and UK). Population displacement is known to have multiple influences on household food security and relatedly agricultural production capacity.In addition, the familial structure and support systems of rural households has been significantly impacted by the devastating legacies of HIV/AIDS. Of importance to nutrition interventions such as ours is the increase in the number of child-headed and elderly-headed households. It is widely acknowledged that child-headed households are especially vulnerable to food insecurity and households headed by elderly relatives are less likely to diversify crops and rely on growing cereal crops and other staples more vulnerable to adverse weather patterns (intensified with climate change) as they are less able to procure hybrid seeds and fertilizers. In order to support LMIC countries like Zimbabwe in achieving WHA targets for improving maternal, infant and young child nutrition by 2025 it is vital that interventions take account of population displacement, changing household structures and the intersection with the gender-related and household dynamics that may shape household food security and agricultural capacity. This application seeks to achieve this by extending and more effectively integrating humanities and social science perspectives into an already existing partnership and by adopting a more radical approach to inter- and trans-disciplinary working.

发育迟缓影响到南部非洲近30%的儿童，并导致人的能力下降、慢性病的长期风险增加和贫困的代际循环。我们最近开展了“环境卫生婴儿营养功效”（SHINE）试验，结果表明，通过改善婴幼儿喂养，发育迟缓率可降低20%。尽管减少幅度不大，但目前的干预措施显然不足以消除发育迟缓。因此，包括津巴布韦在内的国家不太可能在2025年之前实现世界卫生大会关于改善孕产妇、婴儿和幼儿营养的目标。显然有必要通过跨学科伙伴关系来试验新的、更广泛的治疗发育迟缓的方法，以解决这一棘手问题的多方面决定因素。SHINE试验数据的分析表明，尽管进行了强化的IYCF干预，婴儿营养摄入仍存在实质性差距。通过提高婴儿饮食的营养质量，可以实现线性生长的更大收益。因此，我们最近扩大了这一伙伴关系中研究人员的学科范围，以进一步建立研究能力。我们已经证明，通过强化IYCF干预，可以在生命的头2年适度改善线性生长，我们的合作伙伴关系已经扩展到在后续随机对照试验中包括农业专业知识。与国际玉米和小麦改良中心的农业科学家和经济学家合作，这一伙伴关系的最终目标是通过将加强的“iycf +”干预措施与旨在改善农业和畜牧业做法的可持续干预措施相结合，在近期和长期内进一步缩小农村家庭所经历的营养差距。正如这一呼吁所指出的，像我们这样的干预措施的长期成功取决于更好地理解其发生的文化和历史背景，以及预期受益者对其的接受程度。这一点得到了参与这一伙伴关系的研究人员的认可，他们在与开展工作的社区密切合作方面有着良好的记录。尽管如此，重要的知识缺口仍然存在。津巴布韦同其他南部非洲国家一样，在过去几十年中遭受了相当大的人口迁移，涉及城乡、区域（如博茨瓦纳、南非、赞比亚）以及海外移徙（如加拿大和联合王国）。众所周知，人口流离失所对家庭粮食安全和相关的农业生产能力有多重影响。此外，农村家庭的家庭结构和支助系统也受到艾滋病毒/艾滋病的破坏性影响。对我们这样的营养干预措施来说，重要的是增加以儿童为户主和以老人为户主的家庭数目。人们普遍认为，以儿童为户主的家庭特别容易受到粮食不安全的影响，而以老年亲属为户主的家庭不太可能使作物多样化，而依赖于种植谷物作物和其他更容易受到恶劣天气模式（随着气候变化而加剧）影响的主食，因为他们购买杂交种子和肥料的能力较差。为了支持津巴布韦等中低收入国家实现到2025年改善孕产妇和婴幼儿营养的卫生大会目标，至关重要的是，干预措施应考虑到人口流离失所、不断变化的家庭结构以及可能影响家庭粮食安全和农业能力的与性别有关的家庭动态的交叉。本申请旨在通过扩展和更有效地将人文和社会科学的观点整合到已经存在的伙伴关系中，并通过采用更激进的方法进行跨学科和跨学科的工作，来实现这一目标。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Child Health, Agriculture and Integrated Nutrition (CHAIN): protocol for a randomised controlled trial of improved infant and young child feeding in rural Zimbabwe.

DOI：
10.1136/bmjopen-2021-056435
发表时间：
2022-12-30
期刊：
BMJ OPEN
影响因子：
2.9
作者：
Smith, Laura E.;Chagwena, Dexter T.;Bourke, Claire;Robertson, Ruairi;Fernando, Shamiso;Tavengwa, Naume, V;Cairns, Jill;Ndhlela, Thokozile;Matumbu, Exhibit;Brown, Tim;Datta, Kavita;Mutasa, Batsirai;Tengende, Alice;Chidhanguro, Dzivaidzo;Langhaug, Lisa;Makanza, Maggie;Chasekwa, Bernard;Mutasa, Kuda;Swann, Jonathan;Kelly, Paul;Ntozini, Robert;Prendergast, Andrew
通讯作者：
Prendergast, Andrew

"Migration and the Sustainable Development Goals"

“移民与可持续发展目标”