STAMINA: Strategies to Mitigate Nutritional Risks among mothers and infants under 2 years in low income urban households in Peru during COVID-19

秘鲁在对抗营养不良方面取得的进展可能会因当前的COVID-19大流行而逆转，COVID-19大流行导致母婴营养服务中断、医疗中心关闭和失业率上升。秘鲁是南美洲COVID-19死亡率最高的国家之一。婴儿营养的恶化将导致下一代健康状况的恶化。秘鲁的政府和社区利益相关者强调了疫情对母亲及其婴幼儿营养的未知影响。本研究将研究COVID-19应对措施如何影响Huánuco和Lima两个城市低收入地区家庭环境中母亲和婴儿（0-23个月）的营养风险。这些信息将与在全国因COVID-19进入紧急状态之前在相同社区进行的详细营养评估进行比较。为了应对新出现的营养风险，我们将与利益相关者合作，共同制定提供营养服务的适应性方法，包括补铁和支持纯母乳喂养和持续母乳喂养。我们将通过检查以下方面的短期、中期和长期变化来确定COVID-19大流行导致的营养风险：-0-6个月婴儿的纯母乳喂养率; 6-23个月婴儿的持续母乳喂养率，以及世卫组织建议的补充喂养实践得到满足的程度。- 在卫生服务中断和自大流行病以来实施新的提供战略的背景下，婴儿和幼儿补充铁的摄入量-防治贫血的国家优先事项。- 家庭粮食安全、产妇心理健康以及与营养不良以及家庭一级超重和肥胖的营养风险有关的饮食质量变化。家庭饮食习惯如何适应和应对正在发生的大流行病。有了这些见解，我们将共同创建支持系统，利用信息和通信技术或社会远程医疗服务，为婴幼儿设计或提供营养咨询、生长监测和铁补充剂。我们将与儿童基金会秘鲁合作，作为项目伙伴，以确保解决营养不良问题的努力针对最弱势群体，并针对构成秘鲁大多数人口的城市社区所面临的挑战。

Peru's progress in combatting malnutrition may be reversed with the current COVID-19 pandemic which has caused disruption of maternal and infant nutrition services, closure of health centres and rising unemployment. Peru has experienced one of the highest mortality rates from COVID-19 in South America. Deteriorations in infant nutrition will lead to poorer health outcomes for the next generation. Government and community stakeholders in Peru have highlighted the unknown impacts of the pandemic on the nutrition of mothers and their infants and young children.This study will examine how the COVID-19 response is impacting on the nutritional risks of mothers and infants (aged 0-23 months) within the household setting in low-income areas of two cities, Huánuco and Lima. This information will be compared with detailed nutritional assessments conducted in the same communities immediately before the national State of Emergency due to COVID-19. To address the emerging nutritional risks, we will work with stakeholders to co-create adapted methods for the delivery of nutritional services including iron supplementation and support for exclusive and continued breastfeeding. We will identify the nutritional risks resulting from the COVID-19 pandemic by examining short, medium and longer term changes in:- exclusive breastfeeding rates for infants aged 0-6 months; continued breastfeeding for infants aged 6-23 months, and the extent to which WHO recommended complementary feeding practices are being met. - the uptake of iron supplementation in infants and young children - a national priority to combat anaemia - in the context of the disrupted health services and new delivery strategies implemented since the pandemic. - household food security, maternal psychological wellbeing, and changing quality of diet in relation to nutritional risks of undernutrition as well as overweight and obesity at the household level.- how household dietary practices adapt and respond to the ongoing pandemic.With these insights, we will co-create support systems for the design or adapted delivery of nutritional counselling, growth monitoring and iron supplementation for infants and young children using information and communication technologies or socially-distanced health services. We will work with UNICEF Peru as a project partner in order to ensure that efforts to address malnutrition target the most vulnerable groups and are tailored to the challenges experienced by urban communities which make up the majority population of Peru.