Pangaribuan Rosnani, Scherbaum Veronika, Erhardt Jürgen G, Sastroamidjojo Soemilah, Biesalski Hans K
SEAMEO-TROPMED Regional Center for Community Nutrition, University of Indonesia, Jakarta, Indonesia.
J Trop Pediatr. 2004 Jun;50(3):143-8. doi: 10.1093/tropej/50.3.143.
The adherence of program participants to periodic vitamin A capsule (VAC) supplementation among children aged 1-5 years (n = 677) in Central Java, Indonesia was assessed. Fourteen villages from five sub-districts and one ward from one sub-district in Central Java were included in the study to represent rural and suburban areas. All questions about demographic factors, socioeconomic conditions, current dietary practice and healthcare-seeking attitudes for common childhood illnesses, previous breastfeeding experience, their knowledge about vitamin A and adherence to the VAC program after capsule distribution (two periods in 2000) were asked. Caretakers with limited knowledge about the health benefits of vitamin A, households with more than one preschool child, and households with older children (> 36 months) were associated with a decreased likelihood of regular participation in the program with odds ratios of 0.38, 0.55, and 0.26, respectively (p < 0.01). The percentage of caretakers who utilized community health centers, village health posts or midwives' practices in rural areas, was significantly higher (86.6 per cent, p < 0.001) than in suburban areas (62.8 per cent). Living in a rural location was associated with an increased adherence to participate in the program regularly with an odds ratio of 2.02 (p < 0.01). In conclusion, nutritional education and periodic social marketing should be re-emphasized and other potential delivery channels, such as private healthcare practices, could also contribute to an increase adherence of supplementation program.
对印度尼西亚中爪哇省1至5岁儿童(n = 677)定期补充维生素A胶囊(VAC)项目的参与度进行了评估。该研究纳入了中爪哇省五个分区的14个村庄以及一个分区的一个选区,以代表农村和郊区地区。询问了所有关于人口统计学因素、社会经济状况、当前饮食习惯、儿童常见疾病的就医态度、以往母乳喂养经历、他们对维生素A的了解以及胶囊分发后(2000年的两个时期)对VAC项目的参与度等问题。对维生素A健康益处了解有限的看护人、有不止一个学龄前儿童的家庭以及有较大儿童(> 36个月)的家庭,定期参与该项目的可能性降低,优势比分别为0.38、0.55和0.26(p < 0.01)。在农村地区利用社区卫生中心、村卫生站或助产士诊所的看护人的比例(86.6%,p < 0.001)显著高于郊区(62.8%)。居住在农村地区与定期参与该项目的依从性增加相关,优势比为2.02(p < 0.01)。总之,应重新强调营养教育和定期社会营销,其他潜在的推广渠道,如私人医疗服务机构,也有助于提高补充项目的参与度。