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东南亚提高孕产妇营养服务覆盖率和利用率的干预策略范围性综述

Scoping Review of Intervention Strategies for Improving Coverage and Uptake of Maternal Nutrition Services in Southeast Asia.

机构信息

MAMTA Health Institute for Mother and Child, Delhi 110048, India.

Department of Clinical Sciences, Lund University, Skåne University Hospital, S-20502 Malmo, Sweden.

出版信息

Int J Environ Res Public Health. 2021 Dec 16;18(24):13292. doi: 10.3390/ijerph182413292.

Abstract

Maternal undernutrition can lead to protein-energy malnutrition, micronutrient deficiencies, or anemia during pregnancy or after birth. It remains a major problem, despite evidence-based maternal-nutrition interventions happening on ground. We conducted a scoping review to understand different strategies and delivery mechanisms to improve maternal nutrition, as well as how interventions have improved coverage and uptake of services. An electronic search was conducted in PubMed and Google Scholar for published studies reporting on the effectiveness of maternal-nutrition interventions in terms of access or coverage, health outcomes, compliance, and barriers to intervention utilization. The search was limited to studies published within ten years before the initial search date, 8 November 2019; later, it was updated to 17 February 2021. Of 31 studies identified following screening and data extraction, 22 studies were included for narrative synthesis. Twelve studies were reported from India and eleven from Bangladesh, three from Nepal, two from both Pakistan and Thailand (Myanmar), and one from Indonesia. Nutrition education and counselling, home visits, directly observed supplement intake, community mobilization, food, and conditional cash transfer by community health workers were found to be effective. There is a need to incorporate diverse strategies, including various health education approaches, supplementation, as well as strengthening of community participation and the response of the health system in order to achieve impactful maternal nutrition programs.

摘要

母体营养不足可导致孕妇或产后出现蛋白质-能量营养不良、微量营养素缺乏或贫血。尽管已有基于证据的母体营养干预措施在实地实施,但这仍然是一个主要问题。我们进行了范围界定审查,以了解改善母体营养的不同策略和交付机制,以及干预措施如何提高服务的覆盖范围和利用率。在 PubMed 和 Google Scholar 上进行了电子检索,以查找报告母体营养干预措施在获取或覆盖、健康结果、依从性和干预措施利用障碍方面有效性的已发表研究。检索范围限于在最初检索日期 2019 年 11 月 8 日之前十年内发表的研究,之后更新至 2021 年 2 月 17 日。经过筛选和数据提取,共确定了 31 项研究,其中 22 项研究进行了叙述性综合。有 12 项研究来自印度,11 项来自孟加拉国,3 项来自尼泊尔,2 项来自巴基斯坦和泰国(缅甸),1 项来自印度尼西亚。营养教育和咨询、家访、直接观察补充剂摄入、社区动员、食物以及社区卫生工作者提供的有条件现金转移被认为是有效的。需要结合多种策略,包括各种健康教育方法、补充剂,以及加强社区参与和卫生系统的应对能力,以实现有影响力的母体营养计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8a8/8701361/8b97ccf96a60/ijerph-18-13292-g001.jpg

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