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巴基斯坦儿童营养不良和发育迟缓的现状:需要做些什么?

Current Status of Malnutrition and Stunting in Pakistani Children: What Needs to Be Done?

机构信息

School of Engineering, University of Guelph, Guelph, Ontario, Canada.

出版信息

J Am Coll Nutr. 2021 Feb;40(2):180-192. doi: 10.1080/07315724.2020.1750504. Epub 2020 Apr 10.

Abstract

Malnutrition is one of the greatest health challenges that affects about 2 billion people globally. Multiple factors including poverty, food insecurity, maternal health and nutritional status, mother's age at marriage and educational status, low birthweight or small for gestational age (SGA), premature births, suboptimal breastfeeding practices, unhealthy dietary and lifestyle patterns, health and immunization status of children, socioeconomic status of family, environmental and household conditions, together with cultural practices and myths, play vital role in affecting the growth of children at early age. Although child stunting has declined in Pakistan, the reduction rate is only 0.5%, which is very low. This may be due to ineffective or inappropriate intervention programs as they are mostly addressing only one issue at a time and don't use the multi-sector approach to address numerous determinants of stunting. It is therefore important to initiate cost-effective multi-tiered intervention approaches to be implemented at pre-conception, pregnancy and early postpartum stages to prevent the problems of malnutrition and stunting in Pakistani children. This review discusses the etiology of child malnutrition and stunting in Pakistan, role of various determinants of stunting and what type of intervention strategies and approaches should be developed and implemented to deal with these problems. Key teaching pointsMalnutrition is one of the greatest global health challenges.Poverty, food insecurity, socioeconomic status, unhealthy dietary patterns, maternal health and nutritional status, low birthweight, suboptimal breast feeding, environmental conditions, cultural practices and myths, are the main factors for child malnutrition and stunting in Pakistan.The slow reduction rate in child stunting may be due to inappropriate intervention programs.Cost-effective multi-tiered intervention approaches must be implemented at pre-conception, pregnancy and early postpartum stages to prevent child malnutrition and stunting in Pakistan.A holistic approach comprising nutrition and WASH interventions, together with strategies to improve the socioeconomic status be developed and implemented to resolve this dilemma.

摘要

营养不良是影响全球约 20 亿人健康的最大挑战之一。多种因素包括贫困、粮食不安全、孕产妇健康和营养状况、母亲结婚年龄和受教育程度、低出生体重或小于胎龄儿(SGA)、早产、母乳喂养实践不当、不健康的饮食和生活方式、儿童的健康和免疫状况、家庭的社会经济状况、环境和家庭条件,以及文化习俗和神话,都对儿童早期的生长发育起着至关重要的作用。尽管巴基斯坦儿童发育迟缓的情况有所下降,但下降速度仅为 0.5%,非常低。这可能是由于干预计划无效或不当,因为它们大多一次只解决一个问题,没有采用多部门办法解决发育迟缓的众多决定因素。因此,必须启动具有成本效益的多层次干预措施,在受孕前、怀孕和产后早期阶段实施,以防止巴基斯坦儿童出现营养不良和发育迟缓问题。这篇综述讨论了巴基斯坦儿童营养不良和发育迟缓的病因、发育迟缓的各种决定因素,以及应该制定和实施哪些类型的干预策略和方法来解决这些问题。关键教学要点营养不良是全球最大的健康挑战之一。贫困、粮食不安全、社会经济地位、不健康的饮食模式、孕产妇健康和营养状况、低出生体重、母乳喂养不足、环境条件、文化习俗和神话,是导致巴基斯坦儿童营养不良和发育迟缓的主要因素。儿童发育迟缓的缓慢下降速度可能是由于干预计划不当。必须在受孕前、怀孕和产后早期阶段实施具有成本效益的多层次干预措施,以防止巴基斯坦儿童出现营养不良和发育迟缓问题。必须制定和实施一项整体办法,包括营养和水环境卫生干预措施,以及改善社会经济地位的战略,以解决这一困境。

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