Gillespie Stuart, Menon Purnima, Heidkamp Rebecca, Piwoz Ellen, Rawat Rahul, Munos Melinda, Black Robert, Hayashi Chika, Kumar Saha Kuntal, Requejo Jennifer
Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, District of Columbia, USA.
International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Glob Health. 2019 Jun 24;4(Suppl 4):e001290. doi: 10.1136/bmjgh-2018-001290. eCollection 2019.
The global community is committed to addressing malnutrition. And yet, coverage data for high-impact interventions along the continuum of care remain scarce due to several measurement and data collection challenges. In this analysis paper, we identify 24 nutrition interventions that should be tracked by all countries, and determine if their coverage is currently measured by major household nutrition and health surveys. We then present three case studies, using published literature and empirical data from large-scale initiatives, to illustrate the kind of data collection innovations that are feasible. We find that data are not routinely collected in a standardised way across countries for most of the core set of interventions. Case studies-of growth monitoring and screening for acute malnutrition, infant and young child feeding counselling, and nutrition monitoring in India-highlight both challenges and potential solutions. Advancing the nutrition intervention coverage measurement agenda is essential for sustained progress in driving down rates of malnutrition. It will require (1) global consensus on a core set of validated coverage indicators on proven, high-impact nutrition-specific interventions; (2) the inclusion of coverage measurement and indicator guidance in WHO intervention recommendations; (3) the incorporation of these indicators into data collection mechanisms and relevant intervention delivery platforms; and (4) an agenda for continuous measurement improvement.
全球社会致力于解决营养不良问题。然而，由于一些测量和数据收集方面的挑战，在整个照护连续体中，高影响力干预措施的覆盖数据仍然匮乏。在本分析论文中，我们确定了所有国家都应追踪的24项营养干预措施，并确定主要的家庭营养与健康调查目前是否对其覆盖情况进行了测量。然后，我们利用已发表的文献和大规模倡议的实证数据，展示了三个案例研究，以说明可行的数据收集创新类型。我们发现，对于大多数核心干预措施集，各国并未以标准化方式常规收集数据。对印度的生长监测与急性营养不良筛查、婴幼儿喂养咨询以及营养监测的案例研究，凸显了挑战与潜在的解决方案。推进营养干预覆盖情况测量议程对于持续降低营养不良发生率至关重要。这将需要：（1）就一套经过验证的、针对已证实的高影响力特定营养干预措施的核心覆盖指标达成全球共识；（2）在世卫组织的干预建议中纳入覆盖情况测量和指标指南；（3）将这些指标纳入数据收集机制和相关干预实施平台；以及（4）一个持续改进测量的议程。
