Johns Hopkins Bloomberg School of Public Health, International Health Department, Johns Hopkins University, Baltimore, Maryland, USA.
Centre for Evidence Based Health Care, Stellenbosch University, Cape Town, South Africa.
Matern Child Nutr. 2024 Jan;20(1):e13566. doi: 10.1111/mcn.13566. Epub 2023 Oct 4.
Niger is afflicted with high rates of poverty, high fertility rates, frequent environmental crises, and climate change. Recurrent droughts and floods have led to chronic food insecurity linked to poor maternal and neonatal nutrition outcomes in vulnerable regions. We analyzed maternal and neonatal nutrition trends and subnational variability between 2000 and 2021 with a focus on the implementation of policies and programs surrounding two acute climate shocks in 2005 and 2010. We used four sources of data: (a) national household surveys for maternal and newborn nutritional indicators allowing computation of trends and differences at national and regional levels; (b) document review of food security reports; (c) 30 key informant interviews and; (d) one focus group discussion. Many food security policies and nutrition programs were enacted from 2000 to 2020. Gains in maternal and neonatal nutrition indicators were more significant in targeted vulnerable regions of Maradi, Zinder, Tahoua and Tillabéri, from 2006 to 2021. However, poor access to financial resources for policy execution and suboptimal implementation of plans have hindered progress. In response to the chronic climate crisis over the last 20 years, the Nigerien government and program implementers have demonstrated their commitment to reducing food insecurity and enhancing resilience to climate shocks by adopting a deliberate multisectoral effort. However, there is more that can be achieved with a continued focus on vulnerable regions to build resilience, targeting high risk populations, and investing in infrastructure to improve health systems, food systems, agriculture systems, education systems, and social protection.
尼日尔深受贫困率高、生育率高、环境危机频繁和气候变化等问题的困扰。反复发生的干旱和洪水导致脆弱地区长期存在粮食不安全问题,这与孕产妇和新生儿营养状况不良有关。我们分析了 2000 年至 2021 年期间的孕产妇和新生儿营养趋势以及国家以下各级的差异,重点关注了 2005 年和 2010 年两次急性气候冲击事件前后政策和方案的执行情况。我们使用了四个数据源:(a) 国家家庭调查,获取孕产妇和新生儿营养指标数据,从而计算国家和地区各级别的趋势和差异;(b) 对粮食安全报告的文献回顾;(c) 30 次关键知情人访谈;以及(d) 一次焦点小组讨论。2000 年至 2020 年期间制定了许多粮食安全政策和营养方案。2006 年至 2021 年期间,马里迪、津德尔、塔瓦和蒂拉贝里等目标脆弱地区的孕产妇和新生儿营养指标取得了更为显著的进展。然而,政策执行缺乏财政资源以及计划执行情况欠佳,阻碍了进展。过去 20 年来,尼日尔政府和方案执行者面对长期的气候危机,承诺通过采取深思熟虑的多部门努力来减少粮食不安全并增强抵御气候冲击的能力。然而,如果继续关注脆弱地区,以建立抵御能力、针对高风险人群,并投资于基础设施以改善卫生系统、粮食系统、农业系统、教育系统和社会保护,那么还可以取得更大的成就。