Sethi Vani, Tiwari Khyati, Sareen Neha, Singh Suneeta, Mishra Chittaranjan, Jagadeeshwar M, Sunitha K, Kumar S Vijay, de Wagt Arjan, Sachdev H P S
Child Development and Nutrition Section, UNICEF India Country Office, New Delhi, India.
UNICEF Field Office for Andhra Pradesh and Karnataka, Hyderabad, India.
Food Nutr Bull. 2019 Sep;40(3):393-408. doi: 10.1177/0379572119844142. Epub 2019 Jun 16.
Maternal spot feeding programs operational in southern Indian States are providing a package of nutrition services (food, micronutrient supplementation, deworming, gestation weight gain monitoring, and fortnightly nutrition health education) to pregnant women. These remain to be evaluated.
We evaluated the maternal spot feeding programs in 2 Southern Indian states.
Study design was cross-sectional entailing primary data collection (July to November 2016) on 360 pregnant and lactating women (of infants aged 0-6 months) per state and a review of the scheme's management information system (MIS) beneficiaries' records for the time period April 2014 to August 2017. To gain program functioning insights, open-ended interviews (n = 252) with state, district, and block program managers a state-level open space technology workshop was conducted.
Average days of meal consumption ranged from 19 to 21 days per month; spot meal enhanced high dietary diversity (≥6 food groups; 57%-59%) and consumption of eggs and milk (74%-96%) among pregnant and lactating women. On-the-spot consumption of iron, folic acid, calcium, and deworming was 18%, 87%, and 56%, respectively; 94% attended at least 1 of the 2 nutrition monthly counseling sessions. Majority (68%) of the beneficiaries were motivated to enroll by self-help groups or family members, suggesting the crucial persuasive role of peers and family members.
Maternal spot feeding schemes can potentially deliver nutrition interventions outlined in the World Health Organization antenatal care guidelines 2016 for a positive pregnancy outcome. Research on schemes' impact on birth outcomes, maternal depression, social norms, and its cost-effectiveness is needed.
印度南部各邦实施的孕产妇即点即供项目为孕妇提供了一系列营养服务（食物、微量营养素补充、驱虫、孕期体重增加监测以及每两周一次的营养健康教育）。这些项目仍有待评估。
我们对印度南部两个邦的孕产妇即点即供项目进行了评估。
研究设计为横断面研究，需要收集每个邦360名怀孕和哺乳期妇女（婴儿年龄为0至6个月）的原始数据（2016年7月至11月），并查阅该计划管理信息系统（MIS）在2014年4月至2017年8月期间受益人的记录。为了深入了解项目运作情况，我们与邦、区和街区项目管理人员进行了252次开放式访谈，并举办了一次邦级开放空间技术研讨会。
每月平均用餐天数为19至21天；即点即供餐提高了怀孕和哺乳期妇女的饮食多样性（≥6种食物类别；57%-59%）以及鸡蛋和牛奶的摄入量（74%-96%）。铁、叶酸、钙的当场服用率和驱虫率分别为18%、87%和56%；94%的人至少参加了每月两次营养咨询中的一次。大多数（68%）受益人是由自助团体或家庭成员推动登记的，这表明同伴和家庭成员具有关键的说服作用。
孕产妇即点即供计划有可能提供世界卫生组织《2016年产前保健指南》中概述的营养干预措施，以实现积极的妊娠结局。需要对该计划对出生结局、产妇抑郁、社会规范及其成本效益的影响进行研究。
