Hurley Kristen M, Yousafzai Aisha K, Lopez-Boo Florencia
Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
Department of Paediatrics and Child Health, Aga Khan University, Karachi, Pakistan; and.
Adv Nutr. 2016 Mar 15;7(2):357-63. doi: 10.3945/an.115.010363. Print 2016 Mar.
Poor nutrition (substandard diet quantity and/or quality resulting in under- or overnutrition) and the lack of early learning opportunities contribute to the loss of developmental potential and life-long health and economic disparities among millions of children aged <5 y. Single-sector interventions representing either early child development (ECD) or nutrition have been linked to positive child development and/or nutritional status, and recommendations currently advocate for the development and testing of integrated interventions. We reviewed the theoretical and practical benefits and challenges of implementing integrated nutrition and ECD interventions along with the evidence for best practice and benefit-cost and concluded that the strong theoretical rationale for integration is more nuanced than the questions that the published empirical evidence have addressed. For example, further research is needed to 1) answer questions related to how integrated messaging influences caregiver characteristics such as well-being, knowledge, and behavior and how these influence early child nutrition and development outcomes; 2) understand population and nutritional contexts in which integrated interventions are beneficial; and 3) explore how varying implementation processes influence the efficacy, uptake, and cost-benefit of integrated nutrition and ECD interventions.
营养不良（饮食数量和/或质量未达标准，导致营养不足或过剩）以及缺乏早期学习机会，致使数百万5岁以下儿童丧失发展潜力，出现终身健康问题和经济差距。代表早期儿童发展（ECD）或营养的单一部门干预措施已被证明与儿童的积极发展和/或营养状况相关，目前的建议主张开展和测试综合干预措施。我们回顾了实施营养与早期儿童发展综合干预措施的理论和实际益处及挑战，以及最佳实践、效益成本方面的证据，并得出结论：整合的有力理论依据比已发表的实证证据所解决的问题更为细致入微。例如，需要进一步开展研究，以：1）回答与综合信息如何影响照护者的幸福感、知识和行为等特征，以及这些特征如何影响幼儿营养和发展结果相关的问题；2）了解综合干预措施有益的人群和营养背景；3）探讨不同的实施过程如何影响营养与早期儿童发展综合干预措施的效果、接受程度和成本效益。
