护理小组参与对津巴布韦农村地区婴幼儿喂养、饮食多样性、水、环境卫生与个人卫生行为及营养状况的影响。
Influence of care group participation on infant and young child feeding, dietary diversity, WASH behaviours and nutrition outcomes in rural Zimbabwe.
作者信息
Matsungo Tonderayi Mathew, Kamazizwa Faith, Mavhudzi Tafadzwa, Makota Starlet, Kamunda Blessing, Matsinde Calvin, Chagwena Dexter, Mukudoka Kudzai, Chopera Prosper
机构信息
Department of Nutrition, Dietetics and Food Sciences, University of Zimbabwe, Harare, Zimbabwe.
Nutrition Action Zimbabwe (NAZ), Harare, Zimbabwe.
出版信息
BMJ Nutr Prev Health. 2023 Sep 14;6(2):164-172. doi: 10.1136/bmjnph-2023-000627. eCollection 2023.
BACKGROUND
The care group approach (CGA) is a community-based nutrition behaviour change strategy centred on 'peer-to-peer learning' through women support groups.
OBJECTIVE
To assess the impact of the CGA on the adoption of appropriate infant and young child feeding (IYCF), dietary diversity and water, sanitation and hygiene (WASH) practices, and associated nutrition-related outcomes.
METHODS
A retrospective cohort study used a mixed-method approach in selected rural districts in Zimbabwe in June 2022. A structured questionnaire was used to collect data on IYCF, diet quality, WASH and child morbidity. Binary logistic regression was used to evaluate the association between exposure and outcome. Significance was at p<0.05.
RESULTS
A total of 127 exposed and 234 controls were enrolled. There was no significant difference between exposed and controls on the prevalence of; diarrhoea (p0.659), cough (p=0.191) and fever (p=0.916). No significant difference was observed in the proportion ever breastfed (p=0.609), Children with Adequate Dietary Diversity Score (p=0.606) across the two groups. However, the proportion of families with adequate Household Dietary Diversity Score (HDDS) (p=0.005) and Minimum Dietary Diversity for Women (MDD-W) (p=0.009) were significantly higher in exposed than controls. Knowledge on all promoted behaviours was significantly higher in the exposed than in controls with the exception of exclusive breast feeding. While the practices were significantly higher in exposed compared with controls for: 'Appropriate complementary feeding for children aged 6-24 months' (p=0.001), 'good nutrition for women of reproductive age' (p=0.001), 'production and consumption of diverse nutritious food' (p=0.001) and 'production and consumption of biofortified crops' (p=0.001).
CONCLUSIONS
The results showed that CGA potential to increase knowledge and achieve nutrition and health-related behaviour change in low-income settings if integrated into existing community programmes. Interestingly, HDDS and MDD-W were significantly higher in exposed than controls. However, more research is required to obtain conclusive results.
背景
照护小组方法（CGA）是一种基于社区的营养行为改变策略，以通过妇女支持小组进行“ peer-to-peer学习”为核心。
目的
评估CGA对采用适当的婴幼儿喂养（IYCF）、饮食多样性以及水、环境卫生和个人卫生（WASH）做法以及相关营养相关结果的影响。
方法
2022年6月在津巴布韦选定的农村地区进行了一项回顾性队列研究，采用混合方法。使用结构化问卷收集有关IYCF、饮食质量、WASH和儿童发病率的数据。二元逻辑回归用于评估暴露与结果之间的关联。显著性水平为p<0.05。
结果
共纳入127名暴露组和234名对照组。暴露组和对照组在腹泻（p = 0.659）、咳嗽（p = 0.191）和发烧（p = 0.916）的患病率上没有显著差异。两组在曾经母乳喂养的比例（p = 0.609）、具有足够饮食多样性得分的儿童（p = 0.606）方面没有观察到显著差异。然而，暴露组中具有足够家庭饮食多样性得分（HDDS）（p = 0.005）和妇女最低饮食多样性（MDD-W）（p = 0.009）的家庭比例显著高于对照组。除纯母乳喂养外，暴露组对所有推广行为的知晓率显著高于对照组。在以下方面，暴露组的做法显著高于对照组：“对6至24个月儿童进行适当的辅食喂养”（p = 0.001）、“育龄妇女的良好营养”（p = 0.001）、“生产和消费多样化的营养食品”（p = 0.001）以及“生产和消费生物强化作物”（p = 0.001）。
结论
结果表明，如果将CGA纳入现有社区项目，其在低收入环境中增加知识并实现与营养和健康相关的行为改变方面具有潜力。有趣的是，暴露组的HDDS和MDD-W显著高于对照组。然而，需要更多研究以获得确凿结果。
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