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东南亚地区关注孕产妇、婴幼儿营养的国家营养战略并不始终与区域及国际建议保持一致。

National nutrition strategies that focus on maternal, infant, and young child nutrition in Southeast Asia do not consistently align with regional and international recommendations.

作者信息

Nguyen Tuan T, Darnell Ashley, Weissman Amy, Cashin Jennifer, Withers Mellissa, Mathisen Roger, Lapping Karin, Mastro Timothy D, Frongillo Edward A

机构信息

Alive & Thrive Southeast Asia, FHI 360, Hanoi, Vietnam.

Asia Pacific Regional Office (APRO), FHI 360, Bangkok, Thailand.

出版信息

Matern Child Nutr. 2020 Oct;16 Suppl 2(Suppl 2):e12937. doi: 10.1111/mcn.12937. Epub 2020 Jun 30.

Abstract

We examined the consistency of national nutrition strategies and action plans (NNS) focusing on maternal, infant, and young child nutrition in Southeast Asia with regional and international recommendations. Between July and December 2017, we identified and extracted information on context, objectives, interventions, indicators, strategies, and coordination mechanisms from the most recent NNS in nine Southeast Asian countries. All NNS described context, objectives, and the following interventions: antenatal care, micronutrient supplementation during pregnancy, breastfeeding promotion, improved complementary feeding, nutrition in emergencies, and food fortification or dietary diversity. Micronutrient supplementation for young children was included in eight NNS; breastfeeding promotion during pregnancy and support at birth in seven; and school feeding, deworming, and treatment of severe acute malnutrition in six. All NNS contained programme monitoring and evaluation plans with measurable indicators and targets. Not all NNS covered wasting, exclusive breastfeeding, low birthweight, and childhood overweight. Strategies for achieving NNS goals and objectives were health system strengthening (nine), social and behaviour change communication (nine), targeting vulnerable groups (eight), and social or community mobilization (four). All addressed involvement, roles and responsibilities, and collaboration mechanisms among sectors and stakeholders. There was a delay in releasing NNS in Indonesia, Myanmar, and the Philippines. In conclusion, although Southeast Asian NNS have similarities in structure and contents, some interventions and indicators vary by country and do not consistently align with regional and international recommendations. A database with regularly updated information on NNS components would facilitate cross-checking completeness within a country, comparison across countries, and knowledge sharing and learning.

摘要

我们考察了东南亚地区关注孕产妇、婴幼儿营养的国家营养战略与行动计划(NNS)与区域及国际建议的一致性。2017年7月至12月期间,我们从9个东南亚国家最新的NNS中识别并提取了有关背景、目标、干预措施、指标、战略以及协调机制的信息。所有NNS均描述了背景、目标以及以下干预措施:产前护理、孕期微量营养素补充、促进母乳喂养、改善辅食喂养、紧急情况中的营养、食品强化或膳食多样化。8个NNS纳入了针对幼儿的微量营养素补充;7个纳入了孕期促进母乳喂养及出生时的支持;6个纳入了学校供餐、驱虫以及重度急性营养不良的治疗。所有NNS均包含带有可衡量指标和目标的项目监测与评估计划。并非所有NNS都涵盖消瘦、纯母乳喂养、低出生体重以及儿童超重问题。实现NNS目标的战略包括加强卫生系统(9个国家)、社会和行为改变沟通(9个)、针对弱势群体(8个)以及社会或社区动员(4个)。所有NNS均涉及各部门及利益相关者的参与、角色与责任以及协作机制。印度尼西亚、缅甸和菲律宾在发布NNS方面存在延迟。总之,尽管东南亚的NNS在结构和内容上有相似之处,但一些干预措施和指标因国家而异,且与区域及国际建议并不完全一致。一个定期更新NNS组成部分信息的数据库将有助于在一个国家内交叉核对完整性、进行跨国比较以及知识共享与学习。

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