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印度午餐计划对儿童到青少年阶段纵向身体发育的影响。

The effect of the Mid-Day Meal programme on the longitudinal physical growth from childhood to adolescence in India.

作者信息

Gharge Shivani, Vlachopoulos Dimitris, Skinner Annie M, Williams Craig A, Iniesta Raquel Revuelta, Unisa Sayeed

机构信息

Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, Maharashtra, India.

Children's Health and Exercise Research Centre, Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom.

出版信息

PLOS Glob Public Health. 2024 Jan 11;4(1):e0002742. doi: 10.1371/journal.pgph.0002742. eCollection 2024.

Abstract

The study aims to examine the effect of the world's largest school-feeding programme, the Mid-Day Meal (MDM) programme, on the changes in the underweight prevalence among school-children in India. Data from the Indian Human Development Survey (IHDS) Rounds 1 (2004-05) and 2 (2011-12) were utilized. The sample included individual-level information of children aged 6 to 9 years in IHDS-1 who then turned 13 to 16 years in IHDS-2. The sample was categorised into four groups based on their MDM consumption history (Group 1: no MDM support in IHDS-1 and IHDS-2, Group 2: MDM support in IHDS-1, Group 3: MDM support in IHDS-2, Group 4: persistent MDM support in IHDS-1 and IHDS-2). The dependent variable was underweight status as defined by the World Health Organisation Child Growth Standards Body Mass Index for age (BMI Z-score) < -2 SD of the median. Bivariate analysis was used to examine the prevalence of underweight and establish associations between underweight status and socio-demographic characteristics. Logistic regression was performed to assess the strength of the association of socio-demographic characteristics and MDM consumption patterns with underweight across poor and non-poor asset groups. The findings suggest that early and persistent MDM support among respondents reduced the likelihood of low BMI Z-scores compared to those without MDM support. Respondents from the poor asset group who received MDM support in at least one of the two survey rounds had higher odds of being underweight in comparison with those who did not receive MDM support at all. Girls and adolescents residing in the Eastern region of India were less likely to be underweight. The study shows that the MDM programme was effective in reducing the rate of underweight among school children. However, continuous programme upscaling with a special focus on children from poor households will significantly benefit India's school-aged children.

摘要

该研究旨在考察世界上最大的学校供餐计划——午餐计划(MDM)对印度学童体重不足患病率变化的影响。研究使用了印度人类发展调查(IHDS)第1轮(2004 - 2005年)和第2轮(2011 - 2012年)的数据。样本包括在IHDS - 1中年龄为6至9岁、在IHDS - 2中变为13至16岁儿童的个人层面信息。样本根据其MDM食用历史分为四组(第1组:在IHDS - 1和IHDS - 2中均无MDM支持;第2组:在IHDS - 1中有MDM支持;第3组:在IHDS - 2中有MDM支持;第4组:在IHDS - 1和IHDS - 2中均持续获得MDM支持)。因变量是根据世界卫生组织儿童生长标准年龄别体重指数(BMI Z评分)低于中位数 - 2个标准差定义的体重不足状况。采用双变量分析来考察体重不足的患病率,并确定体重不足状况与社会人口学特征之间的关联。进行逻辑回归以评估社会人口学特征和MDM消费模式与贫困和非贫困资产组体重不足之间关联的强度。研究结果表明,与没有MDM支持的受访者相比,受访者早期并持续获得MDM支持降低了低BMI Z评分的可能性。在两轮调查中至少有一轮获得MDM支持的贫困资产组受访者与完全没有获得MDM支持的受访者相比,体重不足的几率更高。居住在印度东部地区的女孩和青少年体重不足的可能性较小。该研究表明,MDM计划在降低学童体重不足率方面是有效的。然而,持续扩大该计划规模并特别关注贫困家庭儿童将使印度学龄儿童显著受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fe5/10783765/84134667e500/pgph.0002742.g001.jpg

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