School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
PLoS One. 2019 Mar 7;14(3):e0213136. doi: 10.1371/journal.pone.0213136. eCollection 2019.
Malnutrition is one of the main causes of death in children under 5 years of age and one of the most common factors threatening children's life and health. Nutrition policy analysis and solving existing problems in children can reduce the effects of malnutrition. This study aimed to analyze the current policies of malnutrition prevention in children under five years of age in Iran.
This study was conducted in 2017 to analyze policies using the "policy triangle framework". In order to examine the policy-making process, the Kingdon's multiple streams model was used. A combination of two sampling methods, including purposeful and snowball sampling, was applied to select the interviewees. In relation to the implemented documents and policies, the country's most important policies were selected based on the suggestions of policy makers as well as searching scientific databases and electronic portals. A data collection form was used to identify the current policies and documents and a semi-structured interview guide form was used for the interviews. The framework analysis and MaxQDA software were applied to analyze the data obtained from the interviews.
The key factors affecting policies in Iran included the status of indicators as well as economic, social, structural-legal, policy and international factors. Among the most important policies and implemented programs, the following can be mentioned: growth monitoring, oral rehydration, breastfeeding, immunization, female education, family spacing, food supplementation, nutrition for children under five years of age, and control of nutritional deficiencies. Currently there is a need for a nationwide program and comprehensive document in the field of the nutrition in children under 5 years of age, which requires strengthening of the political process. Participants and stakeholders in nutrition-related policies for children under the age of five were divided into four categories of governmental, semi-governmental, non-governmental, and international organizations.
More attention should be paid to the shortage of some micronutrients, accurate implementation of breastfeeding programs, supplementary nutrition, fortification and supplementation programs for children and mothers, utilization of the advantages of each region and its resources, and better coordination between organizations and their policies, and finally strong incentives are needed to promote macro nutritional goals for children under five years of age.
营养不良是 5 岁以下儿童死亡的主要原因之一，也是威胁儿童生命和健康的最常见因素之一。分析营养政策和解决儿童现存问题可以减少营养不良的影响。本研究旨在分析伊朗五岁以下儿童营养不良预防政策。
本研究于 2017 年采用“政策三角框架”分析政策。为了检查政策制定过程，采用了金登的多流模型。采用目的抽样和滚雪球抽样相结合的两种抽样方法选择受访者。关于已实施的文件和政策，根据政策制定者的建议以及搜索科学数据库和电子门户，选择了该国最重要的政策。使用数据收集表识别现行政策和文件，使用半结构化访谈指南表进行访谈。采用框架分析和 MaxQDA 软件对访谈中获得的数据进行分析。
影响伊朗政策的关键因素包括指标状况以及经济、社会、结构-法律、政策和国际因素。在最重要的政策和已实施的方案中，可以提到以下内容：生长监测、口服补液、母乳喂养、免疫接种、女性教育、计划生育、食物补充、五岁以下儿童营养以及营养缺乏控制。目前，需要在五岁以下儿童营养领域制定一项全国性方案和综合文件，这需要加强政治进程。五岁以下儿童营养相关政策的参与者和利益攸关方分为政府、半政府、非政府和国际组织四类。
应更加关注某些微量营养素的缺乏，准确实施母乳喂养方案、补充营养、为儿童和母亲进行强化和补充方案，利用每个地区及其资源的优势，以及更好地协调组织及其政策，最终需要强有力的激励措施来促进五岁以下儿童的宏观营养目标。
