Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC.
Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC.
J Nutr. 2019 Jan 1;149(1):159-166. doi: 10.1093/jn/nxy249.
Antenatal care may be a means to reduce food insecurity in pregnancy and postpartum periods.
With the use of a cluster-randomized design, we tested whether participation in nutrition-focused antenatal care intending to improve household knowledge about the importance of nutrition for pregnant and lactating women and encourage allocation of household resources to ensure sufficient quality and quantity of foods, without providing food assistance, would reduce household food insecurity.
Alive & Thrive integrated nutrition interventions into an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. The nutrition-focused MNCH package was delivered in 10 subdistricts through antenatal care visits with the use of interpersonal communication, community mobilization, and monitoring of weight gain, aiming to improve maternal diet quality, quantity, and micronutrient intake during pregnancy and breastfeeding. The package included components that could reduce food insecurity, measured using the Household Food Insecurity Access Scale. To examine the impact of the nutrition-focused MNCH package compared with the standard MNCH package, we used linear and multinomial logit regression models, adjusted for subdistrict clustering, to test differences at endline in items, domains, and categories of food insecurity, after first confirming no differences at baseline.
At baseline, nearly half of households were food insecure. At endline, the groups differed in food insecurity, whether expressed as items, domains, or categories, with food insecurity in the nutrition-focused MNCH group 22 percentage points lower than in the standard MNCH group and 20 percentage points lower than at baseline.
Participation in nutrition-focused antenatal care reduced household food insecurity among recently delivered and pregnant women. Integration of social and behavioral nutrition interventions into antenatal care with components that promote food security provides a potentially effective means to reduce food insecurity, without incurring high costs of providing supplemental food, in populations where limited resources can be directed towards accessing adequate and appropriate foods. Registered at clinicaltrials.gov as NCT02745249.
产前护理可能是减少孕期和产后期间食物不安全的一种手段。
我们采用整群随机设计，检验参与以营养为重点的产前护理是否会减少家庭食物不安全，这种护理旨在提高家庭对孕妇和哺乳期妇女营养重要性的认识，并鼓励家庭资源分配，以确保食物的充足质量和数量，而不提供食物援助。
Alive & Thrive 将综合营养干预措施纳入孟加拉国现有的母婴和儿童健康（MNCH）项目中。通过使用人际沟通、社区动员和监测体重增加，营养为重点的 MNCH 一揽子计划在 10 个分区开展，旨在改善孕妇在怀孕和哺乳期的饮食质量、数量和微量营养素摄入。该计划包括可以减少食物不安全的组成部分，使用家庭食物不安全评估量表进行测量。为了检验与标准 MNCH 一揽子计划相比，营养为重点的 MNCH 一揽子计划的影响，我们使用线性和多项逻辑回归模型，根据分区聚类进行调整，以在基线时确认没有差异后，检验终线时在食物不安全项目、领域和类别方面的差异。
在基线时，近一半的家庭食物不安全。在终线时，营养为重点的 MNCH 组和标准 MNCH 组在食物不安全方面存在差异，无论是以项目、领域还是类别表示，营养为重点的 MNCH 组的食物不安全程度比标准 MNCH 组低 22 个百分点，比基线低 20 个百分点。
参与以营养为重点的产前护理降低了近期分娩和孕妇家庭的食物不安全程度。将社会和行为营养干预措施纳入产前护理，并纳入促进粮食安全的组成部分，为在资源有限的情况下，为获取充足和适当的食物提供了一种减少食物不安全的有效方法，而无需承担提供补充食物的高成本。在 clinicaltrials.gov 注册为 NCT02745249。
