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基于社区的儿童健康咨询干预对中国农村 6-23 月龄儿童卫生保健行为、补充喂养和营养状况的影响:前后比较研究。

Effect of a community-based child health counselling intervention on health-seeking behaviours, complementary feeding and nutritional condition among children aged 6-23 months in rural China: A pre- and post-comparison study.

机构信息

Child Health Care Department, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.

Division of Program Management, Liangshan Yi Autonomous Prefecture Hospital for Women and Children's Health, Sichuan, China.

出版信息

Matern Child Nutr. 2022 Jan;18(1):e13289. doi: 10.1111/mcn.13289. Epub 2021 Nov 23.

Abstract

In China, the prevalence of undernutrition among children under 5 years of age has declined significantly during recent decades. However, noticeable gaps exist between rural and urban areas. Since 2012, a government-funded nutrition programme, Ying Yang Bao (YYB; soybean powder-based iron-rich supplement) programme, has been implemented in poor rural areas to decrease the risk of developing anaemia among children aged 6-23 months, but there are still inadequate health care awareness, feeding knowledge and skills among caregivers. From June 2018 to December 2020, a child health counselling intervention was delivered through a home visit based on the YYB programme in Liangshan. Child health messages were given by trained village child health assistants while distributing YYB. Surveys were conducted before and after the intervention to analyse changes in child health check-up frequency, complementary feeding practice and prevalence of undernutrition. After the intervention, the proportion of children who had regular health check-ups, who were vaccinated and who met the minimum YYB consumption significantly increased from 26.0%, 81.6%, and 67.8% to 59.7%, 95.0%, and 79.2%. Increased rates of IYCF indicators (introduction of solid, semisolid, or soft foods, minimum dietary diversity and consumption of iron-rich or iron-fortified foods) were observed after the intervention. The prevalence of stunting, underweight, wasting, and anaemia significantly decreased from 26.3% to 10.8%, 13.4% to 8.7%, 14.0% to 10.5%, and 52.1% to 43.9%. This intervention can be well integrated into the YYB programme with less additional resources. Children in resource-limited areas will benefit more from a comprehensive nutritional package, including food supplements and child health education.

摘要

在中国,近几十年来,5 岁以下儿童的营养不良患病率显著下降。然而,城乡之间仍存在明显差距。自 2012 年以来,政府资助的营养计划——“阴阳包”(富含大豆粉的铁补充剂)计划在贫困农村地区实施,以降低 6-23 个月儿童患贫血的风险,但照顾者的卫生保健意识、喂养知识和技能仍然不足。2018 年 6 月至 2020 年 12 月,在凉山通过家访基于“阴阳包”计划实施了儿童健康咨询干预。在分发“阴阳包”的同时,经过培训的乡村儿童健康助理会提供儿童健康信息。在干预前后进行调查,分析儿童健康检查频率、补充喂养实践和营养不良患病率的变化。干预后,定期健康检查、接种疫苗和满足最低“阴阳包”消费的儿童比例从 26.0%、81.6%和 67.8%显著增加到 59.7%、95.0%和 79.2%。干预后观察到 IYCF 指标(引入固体、半固体或软食、最低饮食多样性和食用富含铁或铁强化食品)的增加率。发育迟缓、消瘦、消瘦和贫血的患病率从 26.3%显著下降到 10.8%、13.4%下降到 8.7%、14.0%下降到 10.5%和 52.1%下降到 43.9%。这种干预措施可以很好地与“阴阳包”计划相结合,不需要额外的资源。资源有限地区的儿童将从包括食物补充剂和儿童健康教育在内的综合营养套餐中受益更多。

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