Yawson A E, Amoaful E O, Senaya L K, Yawson A O, Aboagye P K, Mahama A B, Selenje L, Ngongalah V
1Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Room 46, P. O. Box 4236, Accra, Ghana.
2Family Health Division, Ghana Health Service, Accra, Ghana.
BMC Nutr. 2017 Mar 15;3:27. doi: 10.1186/s40795-017-0147-1. eCollection 2017.
Malnutrition is a leading cause of mortality and morbidity among children in low- and middle-income countries. Ghana is one of 36 countries with the highest burden of stunting, globally. The aim of this work is to use data driven planning methods to conduct in-depth analysis on the Lancet series nutrition interventions in Ghana to inform nutritional strategic planning.
A mixed methods approach was employed for this national nutritional assessment conducted in May 2016. Quantitative data on nutritional interventions were generated by application of the Determinants Analysis Tool and phenomenological approach was employed to explain the causes of barriers identified. Outputs from the tool were analyzed by simple descriptive statistics and data from group discussions were assessed by thematic content analysis. The base line years for this assessment were 2014 and 2015.
Overall in Ghana, 21.0% of frontline health workers are trained on lactation management and breastfeeding counselling and support, 56.6% of mothers of children 0-2 years initiated breastfeeding within one hour of birth, and 59.4% of mothers with children 0-5 months took iron folate supplementation for 90 or more days during pregnancy. In addition, only 19.9% of children 12-59 months received two doses of vitamin A supplementation in a calendar year, and 32.5% of children 6-59 months with severe acute malnutrition were admitted for treatment at health facilities. In all, among infants 6-8 months old, 6.9% were fed with minimum dietary diversity, 50.6% received age appropriate meal frequency and 21.6% received iron rich diet. Inadequate pre-service and in-service training for staff, low prioritization and coordination (at higher levels) and weak integration of services (at lower levels) were key barriers to nutrition coverage in Ghana.
Data driven analysis and planning based on proven nutritional interventions in Ghana demonstrated gaps and barriers and garnered workable strategies to improve nutrition services.
营养不良是低收入和中等收入国家儿童死亡和发病的主要原因。加纳是全球36个发育迟缓负担最重的国家之一。本研究旨在运用数据驱动的规划方法，对《柳叶刀》系列中关于加纳营养干预措施进行深入分析，为营养战略规划提供参考。
2016年5月进行的这项全国营养评估采用了混合方法。通过应用决定因素分析工具生成营养干预措施的定量数据，并采用现象学方法解释所发现障碍的成因。工具的输出结果通过简单描述性统计进行分析，小组讨论的数据通过主题内容分析进行评估。本次评估的基线年份为2014年和2015年。
在加纳，总体而言，21.0%的一线卫生工作者接受了泌乳管理以及母乳喂养咨询和支持方面的培训，56.6%的0至2岁儿童的母亲在孩子出生后一小时内开始母乳喂养，59.4%的0至5个月孩子的母亲在孕期服用铁叶酸补充剂达90天或更长时间。此外，在一自然年内，只有19.9%的12至59个月大的儿童接受了两剂维生素A补充剂，32.5%患有重度急性营养不良的6至59个月大的儿童在医疗机构住院接受治疗。总体而言，在6至8个月大的婴儿中，6.9%的婴儿饮食多样性达到最低标准，50.6%的婴儿进餐频率适宜，21.6%的婴儿摄入了富含铁的食物。工作人员的职前和在职培训不足、（高层）优先级和协调度低以及（基层）服务整合薄弱是加纳营养覆盖的关键障碍。
基于加纳已证实的营养干预措施进行的数据驱动分析和规划揭示了差距和障碍，并获得了改善营养服务的可行策略。
