Rochester Institute of Technology, College of Health Sciences and Technology, Wegmans School of Health and Nutrition, Rochester, New York.
Point Hope International, Ghana Program, Kasoa, Ghana.
Ann N Y Acad Sci. 2021 May;1492(1):27-41. doi: 10.1111/nyas.14538. Epub 2020 Dec 24.
In spite of multiple program efforts in Ghana, progress in reducing the burden of anemia is slow. The objective was to conduct multilevel assessments of existing childhood (<5 years) anemia prevention and treatment programs according to UNICEF's conceptual framework of malnutrition, and to elucidate implementation gaps in Ghana. Purposive and snowball sampling strategies recruited 25 program personnel from 20 organizations to participate in audiorecorded interviews conducted through in-person, telephone, or email correspondence in August 2018. Interview guides constructed around UNICEF's conceptual framework of malnutrition identified context-specific immediate, underlying, and basic causes of anemia, and corresponding programs. Interviews were transcribed, coded, and analyzed using the Dedoose software version 8.1.8. Few programs addressed identified basic causes of anemia, such as inadequate human resources, housing/water/toilet facilities, and poverty/poor access to financial resources. Organizations implemented programs addressing ≥1 underlying cause. Five organizations provided food rations and/or supplements to address immediate causes. A key food-based gap identified was minimal education on fruit intake or antinutritive factors in foods; however, no interventions included vitamin C supplements. Food manufacturers mainly used cereals and grains in commercial food products. Multiple organizations worked in the same region on anemia with instances of an overlapping program focus. Food sources of vitamin C or supplements could be promoted in food-based interventions to increase the absorption of nonheme iron consumed.
尽管加纳开展了多项计划，但在减少贫血负担方面进展缓慢。目的是根据儿童基金会营养不良概念框架，对现有的儿童（<5 岁）贫血预防和治疗方案进行多层次评估，并阐明加纳实施工作中的差距。采用有针对性和滚雪球抽样策略，从 20 个组织中招募了 25 名方案人员，于 2018 年 8 月通过面对面、电话或电子邮件联系，对其进行了录音采访。采访指南围绕儿童基金会营养不良概念框架构建，确定了贫血的特定背景下的即时、根本和基本原因，以及相应的方案。使用 Dedoose 软件版本 8.1.8 对采访进行了转录、编码和分析。很少有方案针对贫血的基本原因，如人力资源不足、住房/水/厕所设施以及贫困/获得财政资源的机会有限。组织实施了针对确定的根本原因的方案。五个组织提供食物配给和/或补充剂，以解决即时原因。确定的一个关键的基于食物的差距是，关于水果摄入或食物中的抗营养因素的教育很少，但没有干预措施包括维生素 C 补充剂。食品制造商主要在商业食品中使用谷物和粮食。多个组织在同一地区开展贫血工作，存在方案重点重叠的情况。可以在基于食物的干预措施中推广维生素 C 或补充剂的食物来源，以提高非血红素铁摄入的吸收。
