Poverty, Health and Nutrition Division, International Food Policy Research Institute, 1201 I Street, NW, Washington DC, 20005, United States of America (USA).
International Food Policy Research Institute, New Delhi, India.
Bull World Health Organ. 2022 Jan 1;100(1):20-29. doi: 10.2471/BLT.21.286650. Epub 2021 Oct 22.
To examine inequalities and opportunity gaps in co-coverage of health and nutrition interventions in seven countries.
We used data from the most recent (2015-2018) demographic and health surveys of mothers with children younger than 5 years in Afghanistan ( = 19 632), Bangladesh ( = 5051), India ( = 184 641), Maldives ( = 2368), Nepal ( 3998), Pakistan ( = 8285) and Sri Lanka ( = 7138). We estimated co-coverage for a set of eight health and eight nutrition interventions and assessed within-country inequalities in co-coverage by wealth and geography. We examined opportunity gaps by comparing coverage of nutrition interventions with coverage of their corresponding health delivery platforms.
Only 15% of 231 113 mother-child pairs received all eight health interventions (weighted percentage). The percentage of mother-child pairs who received no nutrition interventions was highest in Pakistan (25%). Wealth gaps (richest versus poorest) for co-coverage of health interventions were largest for Pakistan (slope index of inequality: 62 percentage points) and Afghanistan (38 percentage points). Wealth gaps for co-coverage of nutrition interventions were highest in India (32 percentage points) and Bangladesh (20 percentage points). Coverage of nutrition interventions was lower than for associated health interventions, with opportunity gaps ranging from 4 to 54 percentage points.
Co-coverage of health and nutrition interventions is far from optimal and disproportionately affects poor households in south Asia. Policy and programming efforts should pay attention to closing coverage, equity and opportunity gaps, and improving nutrition delivery through health-care and other delivery platforms.
考察七个国家中卫生和营养干预措施共同覆盖方面的不平等和机会差距。
我们使用了最近（2015-2018 年） 7 个国家有 5 岁以下儿童的母亲的人口和健康调查数据，包括阿富汗（ = 19 632）、孟加拉国（ = 5051）、印度（ = 184 641）、马尔代夫（ = 2368）、尼泊尔（ 3998）、巴基斯坦（ = 8285）和斯里兰卡（ = 7138）。我们估计了 8 项卫生干预措施和 8 项营养干预措施的共同覆盖率，并按财富和地理位置评估了国内共同覆盖方面的不平等情况。我们通过比较营养干预措施与相应卫生服务平台的覆盖情况，考察了机会差距。
在 231 113 对母婴中，只有 15%（加权百分比）接受了所有八项卫生干预措施。在巴基斯坦（25%），没有接受任何营养干预措施的母婴比例最高。在巴基斯坦（不平等斜率指数：62 个百分点）和阿富汗（38 个百分点），卫生干预措施共同覆盖方面的贫富差距最大。印度（32 个百分点）和孟加拉国（20 个百分点）的营养干预措施共同覆盖方面的贫富差距最大。营养干预措施的覆盖情况低于相关的卫生干预措施，机会差距范围为 4 到 54 个百分点。
卫生和营养干预措施的共同覆盖远非理想，在南亚特别影响贫困家庭。政策和规划工作应注意缩小覆盖范围、公平性和机会差距，并通过医疗保健和其他服务平台改善营养服务。
