1996 年至 2019 年巴西母乳喂养指标的变化趋势以及与实现世卫组织/儿基会 2030 年目标的差距。
Trends of breastfeeding indicators in Brazil from 1996 to 2019 and the gaps to achieve the WHO/UNICEF 2030 targets.
机构信息
Laboratório de Informática em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
Departamento de Nutrição e Dietética, Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
出版信息
BMJ Glob Health. 2023 Sep;8(9). doi: 10.1136/bmjgh-2023-012529.
BACKGROUND
The comprehension of breastfeeding patterns and trends through comparable indicators is essential to plan and implement public health policies.
OBJECTIVE
To evaluate the trends of breastfeeding indicators in Brazil from 1996 to 2019 and estimate the gap to achieve the WHO/UNICEF 2030 targets in children under 5 years.
METHODS
Microdata from two National Surveys on Demography and Health of Women and Children (PNDS-1996 and PNDS-2006) and the Brazilian National Survey on Child Nutrition-2019 were used. The indicators of early initiation of breastfeeding (EIBF), exclusive breastfeeding of infants 0-5 months of age (EBF<6 mo), continued breastfeeding at 1 year of age (CBF1yr) and CBF at 2 years of age (CBF2yr) were analysed using prevalence and 95% CI. The average annual variation and years to achieve the WHO/UNICEF 2030 targets were calculated for Brazil and the macroregions. Statistical analyses considered the survey's complex sample design for each database.
RESULTS
EIBF increased from 36.3% (95% CI 33.6% to 39.0%) in 1996 to 60.9% (95% CI 56.5% to 65.3%) in 2006 (statistically significant) and 62.5% (95% CI 58.3% to 66.6%) in 2019. EBF<6 mo increased from 26.9% (95% CI 21.3% to 31.9%) in 1996 to 39.0% (95% CI 31.0% to 47.1%) in 2006 and 45.8% (95% CI 40.9% to 50.7%) in 2019 (significant increases for 1996-2019 for Brazil, Northeast and Midwest regions). CBF1yr rose from 36.6% (95% CI 30.8% to 42.4%) in 1996 to 48.7% (95% CI 38.3% to 59.0%) in 2006, and 52.1% (95% CI 45.4% to 58.9%) in 2019. CBF2yr increased from 24.7% (95% CI 19.5% to 29.9%) in 1996 to 24.6% (95% CI 15.7% to 33.5%) in 2006 and 35.5% (95% CI 30.4% to 40.6%) in 2019 (significant increase for 1996-2019). The South and Southeast regions need to double the 2019 prevalence to reach the target for the CBF1yr and CBF2yr; the Northeast and North need to increase 60% the current prevalence for the indicator of EBF<6 mo.
CONCLUSION
A substantial improvement in breastfeeding indicators occurred in Brazil from 1996 to 2019, although at an insufficient rate to achieve the WHO/UNICEF 2030 targets.
背景
通过可比指标了解母乳喂养模式和趋势对于规划和实施公共卫生政策至关重要。
目的
评估 1996 年至 2019 年巴西母乳喂养指标的趋势，并估计在 5 岁以下儿童方面实现世卫组织/儿基会 2030 年目标的差距。
方法
使用两次全国妇女儿童人口与健康调查（1996 年和 2006 年的 PNDS 以及 2019 年的巴西儿童营养国家调查）和巴西儿童营养国家调查的微观数据。使用流行率和 95%置信区间分析早期母乳喂养开始（EIBF）、0-5 月龄婴儿纯母乳喂养（EBF<6 个月）、1 岁时继续母乳喂养（CBF1yr）和 2 岁时母乳喂养（CBF2yr）的指标。为巴西和各地区计算了实现世卫组织/儿基会 2030 年目标的平均年变化率和所需年份。统计分析考虑了每个数据库的调查复杂样本设计。
结果
EIBF 从 1996 年的 36.3%（95%置信区间 33.6%至 39.0%）增加到 2006 年的 60.9%（95%置信区间 56.5%至 65.3%）（具有统计学意义），并在 2019 年增加到 62.5%（95%置信区间 58.3%至 66.6%）。EBF<6 个月从 1996 年的 26.9%（95%置信区间 21.3%至 31.9%）增加到 2006 年的 39.0%（95%置信区间 31.0%至 47.1%），并在 2019 年增加到 45.8%（95%置信区间 40.9%至 50.7%）（巴西、东北部和中西部地区 1996-2019 年均显著增加）。CBF1yr 从 1996 年的 36.6%（95%置信区间 30.8%至 42.4%）增加到 2006 年的 48.7%（95%置信区间 38.3%至 59.0%），并在 2019 年增加到 52.1%（95%置信区间 45.4%至 58.9%）。CBF2yr 从 1996 年的 24.7%（95%置信区间 19.5%至 29.9%）增加到 2006 年的 24.6%（95%置信区间 15.7%至 33.5%），并在 2019 年增加到 35.5%（95%置信区间 30.4%至 40.6%）（1996-2019 年显著增加）。南部和东南部地区需要将 2019 年的流行率翻一番，才能达到 CBF1yr 和 CBF2yr 的目标；东北地区和北部需要将 EBF<6 个月的当前流行率提高 60%。
结论
1996 年至 2019 年期间，巴西母乳喂养指标有了显著改善，但速度不足以实现世卫组织/儿基会 2030 年的目标。
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