USAID's Maternal and Child Survival Program (MCSP)/PATH Mozambique, Maputo, Mozambique.
UNICEF-Mozambique, Maputo, Mozambique.
Matern Child Nutr. 2019 Jan;15 Suppl 1(Suppl 1):e12721. doi: 10.1111/mcn.12721.
In Mozambique, about two thirds of children 6-59 months of age are affected by vitamin A deficiency and anaemia. The objective of this case study is to provide programme considerations for planning, implementing, monitoring, and evaluating vitamin A and iron deficiency interventions within the context of lessons learned to date for vitamin A supplementation, micronutrient powders (MNPs), and food-based strategies. For 15 years, the Mozambique Ministry of Health implemented twice-yearly vitamin A supplementation through both campaigns and routine health services. Yet coverage in 2017 (55%) was not much higher than in 2003 (44%). Reaching every district/reaching every child, a strategy adapted from the field of immunization, was used to achieve equitable coverage of vitamin A and for microplanning of outreach services in health facilities, with support from the Maternal and Child Survival Program. In Mozambique, a free or subsidized distribution model for MNPs has been rolled out, yet integration of MNPs into infant and young child feeding programming (i.e., cooking demonstrations) is needed to reinforce "the who, what, and why" of MNPs through culturally sensitive behaviour change communication. Food-based strategies to promote dietary diversity, such as through complementary feeding recipes, are also critical. To harmonize efforts, the Mozambique government should consider the development of a national strategy for the prevention and control of micronutrient malnutrition, with clear monitoring and evaluation targets. Ongoing monitoring of the prevalence of micronutrient deficiencies and coverage of implemented micronutrient interventions is needed to make evidence-based decisions to drive nutrition-health programming.
在莫桑比克，约三分之二的 6-59 个月大的儿童患有维生素 A 缺乏症和贫血。本案例研究的目的是提供在迄今有关维生素 A 补充、微量营养素粉（MNP）和基于食物的策略方面的经验教训的背景下，规划、实施、监测和评估维生素 A 和铁缺乏干预措施的方案考虑因素。15 年来，莫桑比克卫生部通过运动和常规卫生服务实施了每年两次的维生素 A 补充。然而，2017 年的覆盖率（55%）与 2003 年（44%）相比并没有高多少。“普及到每一个地区/普及到每一个儿童”，这一从免疫领域借鉴来的策略，被用于实现维生素 A 的公平覆盖，并通过母婴生存项目为卫生设施中的外展服务进行微规划。在莫桑比克，已经推出了 MNP 的免费或补贴分发模式，但需要将 MNP 纳入婴幼儿喂养方案（例如烹饪示范），以通过文化敏感的行为改变沟通来强化 MNP 的“何人、何事、为何”。促进饮食多样化的基于食物的策略，如补充喂养食谱，也是至关重要的。为了协调工作，莫桑比克政府应考虑制定一项预防和控制微量营养素营养不良的国家战略，明确监测和评估目标。需要持续监测微量营养素缺乏的流行情况和实施的微量营养素干预措施的覆盖情况，以便根据循证做出决策，推动营养-健康规划。
