Khan M Mahmud, Ahmed Shakil, Protik Ali Ehsan, Dhar Badal Chandra, Roy S K
School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA.
Food Nutr Bull. 2005 Dec;26(4):330-7. doi: 10.1177/156482650502600402.
The Government of Bangladesh implemented a comprehensive nutrition intervention in 1997 to reduce the rates of malnutrition among women and children. The pilot program, the Bangladesh Integrated Nutrition Program (BINP), adopted a multisectoral approach targeting women and children through food supplementation, home gardening, and health and nutrition education.
This paper estimates the effectiveness of BINP's food supplementation and nutrition education on the nutritional status of pregnant women. Methods. Three effectiveness measures were considered: target efficiency, improvements in the nutritional status of beneficiaries, and the persistence of nutritional effects. To isolate the effects of the intervention, the nutritional status of participants and nonparticipants was compared after controlling for various demographic and socioeconomic characteristics. Data were collected in 2000 from a random sample of 3262 households in a BINP intervention area.
Thirty-nine percent of pregnant women were correctly targeted by the program's food supplementation activities. The nutrition program reduced the prevalence of thinness among participant pregnant women by about 3 percentage points per month of enrollment. The prevalence of thinness among program graduates was 62%, which was much higher than that of the matched (nonparticipant) group (35%). This finding is perplexing but it may simply imply that those who enrolled at the initial phase of the project were severely underweight and they fell back to their original status within a short period of time.
The nutrition program was intended to improve the nutritional status of women in the longer run through the provision of nutrition education during the food supplementation phase. The prevalence of thinness or severe underweight in women who exited the program after completion of the enrollment period was found to be much higher than in women of similar age and socioeconomic status in the community. This apparent lack of persistence of program benefits requires careful re-evaluation of alternative mechanisms for improving the long-term nutritional status of women.
1997年，孟加拉国政府实施了一项全面的营养干预措施，以降低妇女和儿童的营养不良率。试点项目“孟加拉国综合营养项目”（BINP）采用多部门方法，通过食品补充、家庭园艺以及健康和营养教育来针对妇女和儿童。
本文评估BINP的食品补充和营养教育对孕妇营养状况的有效性。方法：考虑了三项有效性指标：目标效率、受益者营养状况的改善以及营养效果的持续性。为了分离干预效果，在控制了各种人口和社会经济特征后，比较了参与者和非参与者的营养状况。2000年从BINP干预地区的3262户家庭中随机抽样收集了数据。
该项目的食品补充活动正确地覆盖了39%的孕妇。营养项目使参与项目的孕妇中消瘦症的患病率每月降低约3个百分点。项目毕业生中消瘦症的患病率为62%，远高于匹配的（非参与者）组（35%）。这一发现令人困惑，但可能仅仅意味着那些在项目初始阶段登记的人严重体重不足，并且在短时间内又回到了原来的状态。
营养项目旨在通过在食品补充阶段提供营养教育，从长远角度改善妇女的营养状况。研究发现，在登记期结束后退出项目的妇女中，消瘦或严重体重不足的患病率远高于社区中年龄和社会经济地位相似的妇女。项目效益明显缺乏持续性，这需要仔细重新评估改善妇女长期营养状况的替代机制。
