生态和地理特征可预测社区营养状况:贫困村庄的快速评估

Ecological and geographic characteristics predict nutritional status of communities: rapid assessment for poor villages.

作者信息

Kusumayati A, Gross R

机构信息

Faculty of Public Health, University of Indonesia, Jakarta, Indonesia.

出版信息

Health Policy Plan. 1998 Dec;13(4):408-16. doi: 10.1093/heapol/13.4.408.

Abstract

The quality of poverty alleviation programmes relies heavily on appropriate targeting and priority setting. Major problems in assessing poverty include identification of the indicators of poverty and the methods used for its assessment. Nutritional status, expressed by anthropometric indices, has been proposed as a poverty indicator because of its validity, objectivity, reliability and feasibility. This study was conducted to explore the application of remote sensing to poverty mapping based on nutritional status at the community level. Relationships between the nutritional status within a community and the ecological characteristics of the community were investigated. Multiple linear regression tests were executed, and the resultant equations were tested for their validity in predicting communities with poor nutritional status. Among geographical and ecological indicators used, distance to the nearest market, main soil type, rice field area, and perennial cultivation area were found to be most useful predictors for the ranking of the communities by nutritional status. Among non-ecological determinants, food consumption, health service status and living conditions were also found as predictors. The highest correlation was found if total population was also taken into account in the regression model (R2 = 0.69; p < 0.0001). In the assessment of the sensitivity and specificity of the eight models studied, 'undernutrition' was defined as a condition where a community belongs in the first quartile for nutritional status (highest prevalence of undernutrition), and the baseline nutritional survey was considered as a standard method for final diagnosis. Most models which included only ecological factors in the equations had lower sensitivity and specificity than models which included all determinant factors in the equations. All models which took into account the total population had higher sensitivity and specificity than those that did not take total population into account. The best model of those that took into account only the geographical and ecological characteristics of the community's living environment had similar sensitivity and specificity (80% and 94.1%, respectively) as the models that considered non-geographical and non-ecological variables in addition to geographical and ecological variables. In the case of West Sumatra, only four ecological and geographic characteristics were sufficient to predict poverty in village. Since these characteristics could be surveyed by remote sensing, it may well be possible to use remote sensing for a rapid method for poverty mapping.

摘要

扶贫项目的质量在很大程度上依赖于恰当的目标设定和优先级确定。评估贫困的主要问题包括贫困指标的识别以及用于评估的方法。由于其有效性、客观性、可靠性和可行性,由人体测量指数表示的营养状况已被提议作为贫困指标。本研究旨在探讨基于社区层面营养状况的遥感技术在贫困制图中的应用。研究了社区内营养状况与社区生态特征之间的关系。进行了多元线性回归测试,并对所得方程在预测营养状况较差社区方面的有效性进行了检验。在所使用的地理和生态指标中,到最近市场的距离、主要土壤类型、稻田面积和多年生种植面积被发现是按营养状况对社区进行排名最有用的预测指标。在非生态决定因素中,食物消费、卫生服务状况和生活条件也被发现是预测指标。如果在回归模型中也考虑总人口,则相关性最高(R2 = 0.69;p < 0.0001)。在评估所研究的八个模型的敏感性和特异性时,“营养不良”被定义为一个社区处于营养状况第一四分位数(营养不良患病率最高)的情况,基线营养调查被视为最终诊断的标准方法。大多数仅在方程中包含生态因素的模型的敏感性和特异性低于那些在方程中包含所有决定因素的模型。所有考虑了总人口的模型的敏感性和特异性都高于未考虑总人口的模型。仅考虑社区生活环境的地理和生态特征的最佳模型的敏感性和特异性(分别为80%和94.1%)与除地理和生态变量外还考虑非地理和非生态变量的模型相似。在西苏门答腊的情况下,仅四个生态和地理特征就足以预测村庄的贫困状况。由于这些特征可以通过遥感进行调查,很有可能将遥感用于贫困制图的快速方法。

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