International Food Policy Research Institute, Washington, D.C., USA.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Matern Child Nutr. 2024 Oct;20(4):e13661. doi: 10.1111/mcn.13661. Epub 2024 Jun 12.
Optimal child growth requires a combination of nutrition-specific and sensitive interventions in the first 1,000 days. There is limited guidance on how to measure the population-level coverage of nutrition-sensitive social protection (NSSP), which is designed with explicit nutrition goals and often provides food or cash transfers and co-coverage with nutrition and health intervention. In this study in India, we designed a questionnaire that captures seven core NSSP program elements (transfer type, size, modality, population, timing, provider, conditionalities), then used cognitive testing to refine the questionnaire, and then implemented the questions as part of a telephone survey. Cognitive testing indicated variability in understanding the terms used to specify NSSP programs, including the need to use regional program names. Respondents also had difficulty recalling the timing of the benefit receipt. We included the refined NSSP coverage questions in a phone-based survey with 6,627 mothers with children <2 years across six states. Coverage of subsidized food was 73% across all households. Women were more likely to report receiving food than cash transfers during pregnancy (89% vs. 60%) and during lactation (75% vs. 13%). Co-coverage of NSSP with nutrition and health interventions during pregnancy (16%) and early childhood (3%) was low. It was feasible to measure coverage of NSSP investments in these populations; however, further research is needed to comprehensively assess all the dimensions of the NSSP benefits, including benefit adequacy and the validity of these questions when administered in person and by phone.
儿童最佳生长需要在最初的 1000 天内将营养特定和敏感干预措施结合起来。对于如何衡量旨在明确营养目标且通常提供食物或现金转移以及与营养和健康干预措施共同覆盖的营养敏感型社会保护（NSSP）的人口水平覆盖率，目前指导有限。在印度的这项研究中，我们设计了一份问卷，其中包含七个核心 NSSP 计划要素（转移类型、规模、方式、人群、时间、提供者、条件），然后使用认知测试对问卷进行了完善，之后将这些问题作为电话调查的一部分实施。认知测试表明，理解指定 NSSP 计划的术语的能力存在差异，包括需要使用地区性计划名称。受访者还难以回忆起受益时间。我们在基于电话的调查中纳入了经过完善的 NSSP 覆盖问题，该调查涵盖了六个州的 6627 名 2 岁以下儿童的母亲。所有家庭的补贴食品覆盖率为 73%。在怀孕期间（89%比 60%）和哺乳期（75%比 13%），女性报告收到食物的可能性比收到现金转移的可能性更大。在怀孕期间（16%）和幼儿期（3%），NSSP 与营养和健康干预措施的共同覆盖范围较低。衡量这些人群的 NSSP 投资覆盖率是可行的；然而，需要进一步研究以全面评估 NSSP 福利的所有维度，包括福利充足性以及这些问题在面对面和电话调查中的有效性。
