Save the Children, London, UK.
Matern Child Nutr. 2018 Jan;14(1). doi: 10.1111/mcn.12457. Epub 2017 Jul 3.
Around 200 million people were affected by conflict and natural disasters in 2015. Whereas those populations are at a particular high risk of death, optimal breastfeeding and complementary feeding practices could prevent almost 20% of deaths amongst children less than 5 years old. Yet, coverage of interventions for improving infant and young child feeding (IYCF) practices in emergencies is low, partly due to lack of evidence. Considering the paucity of data generated in emergencies to inform programming, we conducted an evidence map from reviews that included low- and middle-income countries and looked at several interventions: (a) social and behavioural change interpersonal and mass communication for promoting breastfeeding and adequate complementary feeding; (b) provision of donated complementary food; (c) home-based fortification with multiple micronutrient powder; (d) capacity building; (e) cash transfers; (f) agricultural or fresh food supply interventions; and (g) psychological support to caretakers. We looked for availability of evidence of these interventions to improve IYCF practices and nutritional status of infants and young children. We identified 1,376 records and included 28 reviews meeting the inclusion criteria. The highest number of reviews identified was for behavioural change interpersonal communication for promoting breastfeeding, whereas no review was identified for psychological support to caretakers. We conclude that any further research should focus on the mechanisms and delivery models through which effectiveness of interventions can be achieved and on the influence of contextual factors. Efforts should be renewed to generate evidence of effectiveness of IYCF interventions during humanitarian emergencies despite the challenges.
2015 年,约有 2 亿人受到冲突和自然灾害的影响。这些人群特别容易死亡,但最佳的母乳喂养和补充喂养实践可以预防 5 岁以下儿童近 20%的死亡。然而,在紧急情况下改善婴儿和幼儿喂养(IYCF)实践的干预措施的覆盖范围很低,部分原因是缺乏证据。考虑到在紧急情况下为编程提供信息而生成的数据很少,我们从包括低收入和中等收入国家在内的评论中进行了证据图绘制,并研究了几种干预措施:(a)社会和行为改变人际和大众传播,以促进母乳喂养和充足的补充喂养;(b)提供捐赠的补充食品;(c)家庭强化多种微量营养素粉;(d)能力建设;(e)现金转移;(f)农业或新鲜食品供应干预;和(g)对照顾者的心理支持。我们寻找这些干预措施改善婴儿和幼儿的 IYCF 实践和营养状况的证据。我们确定了 1376 条记录,并纳入了符合纳入标准的 28 条评论。确定的评论中,促进母乳喂养的行为变化人际沟通最多,而没有确定照顾者心理支持的评论。我们的结论是,任何进一步的研究都应关注可以实现干预有效性的机制和交付模式,以及背景因素的影响。尽管存在挑战,但应重新努力在人道主义紧急情况下产生 IYCF 干预措施有效性的证据。