Hromi-Fiedler Amber J, Pérez-Escamilla Rafael, Segura-Pérez Sofia, Garg Aashima, Bégin France
Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA.
Community Nutrition Unit, Hispanic Health Council, Hartford, CT, USA.
Curr Dev Nutr. 2022 Feb 8;6(3):nzac018. doi: 10.1093/cdn/nzac018. eCollection 2022 Mar.
The United Nations Children's Fund (UNICEF) Community Infant and Young Child Feeding Counselling Package (C-IYCF CP) is used globally for infant and young child feeding (IYCF) counseling. With the C-IYCF CP last updated 8 y ago, mapping existing nurturing care content, identifying gaps, and documenting current country-level changes offers a unique opportunity to guide recommendations to strengthen the nurturing care content of this package.
The primary study aims were to: ) identify and map existing nurturing care content within UNICEF's C-IYCF CP, ) identify gaps related to nurturing care or feeding elements within the C-IYCF CP, ) identify country-level nurturing care adaptations to the C-IYCF CP, and ) identify best practices and lessons learned from country adaptations that can be recommended for inclusion in the C-IYCF CP.
The assessment included 4 phases: ) conduct an iterative process to identify and map nurturing care elements within the C-IYCF CP using a codebook explicitly developed for this assessment; ) identify gaps in the C-IYCF CP; ) apply the codebook to IYCF packages from 11 countries, revise, then finalize the codebook; and ) identify and interview key informants from 4 countries whose IYCF packages had the most comprehensive nurturing care content plus 1 country where health care professionals make routine mother-child home visits.
The C-IYCF CP contained limited nurturing care content, especially around safety/security and early learning. All 5 countries interviewed had systematically identified and included priority nurturing care content in each package, yet content level varied. Two countries were also incorporating information technology into the training and delivery of the C-IYCF CP.
Existing country-level best practices can address nurturing care elements missing from UNICEF's C-IYCF CP. Sharing these practices can allow countries to make context-driven, evidence-informed decisions on the nurturing care content to prioritize.
联合国儿童基金会（UNICEF）的社区婴幼儿喂养咨询包（C-IYCF CP）在全球范围内用于婴幼儿喂养咨询。由于C-IYCF CP上次更新是在8年前，梳理现有的养育照护内容、找出差距并记录当前国家层面的变化，为指导加强该咨询包养育照护内容的建议提供了一个独特的机会。
主要研究目的是：（1）识别并梳理UNICEF的C-IYCF CP中现有的养育照护内容；（2）找出C-IYCF CP中与养育照护或喂养要素相关的差距；（3）识别各国对C-IYCF CP的养育照护调整；（4）识别各国调整过程中的最佳实践和经验教训，以便推荐纳入C-IYCF CP。
评估包括4个阶段：（1）使用专门为此评估制定的编码手册，进行迭代过程，以识别并梳理C-IYCF CP中的养育照护要素；（2）找出C-IYCF CP中的差距；（3）将编码手册应用于11个国家的婴幼儿喂养包，修订后最终确定编码手册；（4）从4个国家的婴幼儿喂养包养育照护内容最全面的国家以及1个医疗保健专业人员进行常规母婴家访的国家识别并访谈关键信息提供者。
C-IYCF CP包含的养育照护内容有限，尤其是在安全保障和早期学习方面。接受访谈的所有5个国家都系统地识别并在每个包中纳入了优先养育照护内容，但内容水平各不相同。两个国家还将信息技术纳入C-IYCF CP的培训和提供过程中。
现有的国家层面最佳实践可以解决UNICEF的C-IYCF CP中缺失的养育照护要素。分享这些实践可以让各国根据具体情况，基于证据对优先考虑的养育照护内容做出决策。
