Society for Nutrition, Education and Health Action, Mumbai, India.
Matern Child Nutr. 2019 Jan;15 Suppl 1(Suppl 1):e12706. doi: 10.1111/mcn.12706.
This study reviews the performance of a community-based nutrition programme in preventing and treating wasting without complications among children under age three in urban informal settlements of India. Implemented by a non-profit organization, with national (Integrated Child Development Services [ICDS]) and city-level (Municipal Corporation of Greater Mumbai [MCGM]) government partners, the programme screened 7,759 children between May 2014 and April 2015. During this period, the programme admitted 705 moderately wasted and 189 severely wasted children into the treatment group and 6,820 not wasted children into the prevention group. Both prevention and treatment groups received growth monitoring, referrals to public health facilities, and home-based counselling (if <6 months) by community health workers. Treatment groups received additional home-based counselling and access to medical screenings. Severely wasted children also received access to ready-to-use therapeutic food. The study assessed default rates, wasting status, and average weight gain 3 months after admission. Factors associated with growth faltering in the prevention group were explored using logistic regression. Default rates for the severely wasted, moderately wasted, and prevention group were 12.7%, 20.4%, and 22.1%, respectively. Recovery rate was 42.4% for the severely wasted and 61.3% for the moderately wasted. For the moderately wasted, mean weight gain was 2.1 g/kg/day, 95% confidence interval (CI) [1.6, 2.6], and 4.5 g/kg/day for the severely wasted, 95% CI [3.1, 5.9]. Among prevention group children, 3.6% faltered into wasting-3.2% into moderate and 0.4% into severe. The paper gives insights into ways in which ICDS and MCGM can successfully integrate large-scale community-based acute malnutrition programming.
本研究回顾了一个基于社区的营养项目在预防和治疗印度城市非正规住区三岁以下儿童无并发症消瘦方面的表现。该项目由一个非营利组织实施，得到了国家（综合儿童发展服务[ICDS]）和市级（孟买市政公司[MCGM]）政府合作伙伴的支持。该项目在 2014 年 5 月至 2015 年 4 月期间对 7759 名儿童进行了筛查。在此期间，该项目将 705 名中度消瘦和 189 名重度消瘦儿童纳入治疗组，将 6820 名不消瘦儿童纳入预防组。预防组和治疗组都接受了生长监测、转介到公共卫生机构以及社区卫生工作者提供的家庭咨询（<6 个月）。治疗组还接受了额外的家庭咨询和医疗筛查。严重消瘦的儿童还可以获得即食治疗食品。该研究评估了入院 3 个月后的失访率、消瘦状况和平均体重增加情况。使用逻辑回归探讨了预防组生长不良的相关因素。严重消瘦、中度消瘦和预防组的失访率分别为 12.7%、20.4%和 22.1%。严重消瘦组的康复率为 42.4%，中度消瘦组为 61.3%。对于中度消瘦的儿童，平均体重增加量为 2.1 克/公斤/天，95%置信区间（CI）[1.6, 2.6]，严重消瘦的儿童为 4.5 克/公斤/天，95%CI [3.1, 5.9]。在预防组儿童中，有 3.6%消瘦-3.2%中度和 0.4%重度。本文深入探讨了 ICDS 和 MCGM 成功整合大规模基于社区的急性营养不良规划的方法。
