Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada.
Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Curr Opin Clin Nutr Metab Care. 2020 May;23(3):190-195. doi: 10.1097/MCO.0000000000000653.
Malnutrition is a pervasive problem that causes negative acute, long-term, and intergenerational consequences. As we have begun to move from efficacy to effectiveness trials of nutrition interventions, and further still to more holistic case study approaches to understanding how and why nutrition outcomes change over time, it has become clear that more emphasis on the 'nutrition-sensitive' interventions is required.
In this article, we propose recategorizing the nutrition-specific and sensitive terminology into a new framework that includes direct and indirect health sector actions and supportive strategies that exist outside the health sector; an adjustment that will improve sector-specific planning and accountability. We outline indirect health sector nutrition interventions, with a focus on family planning and the evidence to support its positive link with nutrition outcomes. In addition, we discuss supportive strategies for nutrition, with emphasis on agriculture and food security, water, sanitation, and hygiene, and poverty alleviation and highlight some of the recent evidence that has contributed to these fields.
Indirect health sector nutrition interventions and supportive strategies for nutrition will be critical, alongside direct health sector nutrition interventions, to reach global targets. Investments should be made both inside and outside the health sector.
营养不良是一个普遍存在的问题，会导致急性、长期和代际负面后果。随着我们开始从营养干预的疗效试验向效果试验，以及更进一步地采用更全面的案例研究方法来了解营养结果如何以及为何随时间发生变化，显然需要更加重视“营养敏感”干预措施。
本文提出将营养特定和敏感的术语重新分类到一个新框架中，包括直接和间接的卫生部门行动以及支持性策略，这些策略存在于卫生部门之外；这一调整将改善特定部门的规划和问责制。我们概述了间接的卫生部门营养干预措施，重点关注计划生育及其与营养结果之间的积极联系的证据。此外，我们讨论了支持性的营养策略，重点是农业和粮食安全、水、环境卫生和减贫，并强调了一些最近有助于这些领域的证据。
间接的卫生部门营养干预措施和支持性的营养策略将与直接的卫生部门营养干预措施一样，成为实现全球目标的关键。应在卫生部门内外进行投资。
