Samnani Amir Ali, Nuruddin Rozina, Petrucka Pammla, Soofi Sajid B, Karmaliani Rozina
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan.
Front Nutr. 2024 Aug 1;11:1395883. doi: 10.3389/fnut.2024.1395883. eCollection 2024.
In 1995, the World Health Organization launched its Global School Health Initiative intending to expand this health promotion approach throughout schools globally. In this study, we aim to assess the preparedness of preschools in the adoption of intervention packages under the Nutrition Friendly School Initiative (NFSI) checklist.
From three campuses of the Aga Khan School located in the Thatta and Sujawal districts of the Sindh province, Pakistan, all eligible preschool children were selected for this study. Using a pre-and post-intervention design, we assessed preschool preparedness using the NFSI checklist, knowledge of parents/caregivers regarding health and nutrition promoting behaviors, and anthropometric measurements (i.e., mid-upper arm circumference (MUAC), weight, and height) for preschool children. The NFSI checklist was analyzed with differential scores, while descriptive statistics were used for anthropometric and knowledge data. Continuous variables (i.e., height, weight, MUAC) were presented as means, while categorical variables (knowledge) were expressed as numbers and percentages. Paired t-tests for dependent samples were used to statistically assess mean differences in MUAC, height, weight, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score, and changes in parental knowledge of preschool children.
Data from 164 preschool children (ages 24-84 months, mean age 56.7 months) were analyzed over 3 months. School preparedness scores improved from 10 to 22 points (out of 26). Parental knowledge on nutrition and health increased by 7.2 points (out of 25). Children showed mean increases in MUAC (0.27 cm), weight (0.36 kg), and height (0.62 cm) ( < 0.001). Stunting and overweight/obesity rates remained the same (7.3 and 4.3%), while underweight and wasting rates dropped from 10.4 to 7.3% and 7.9 to 6.1%, respectively. The initiative effectively reduced underweight and wasting but did not impact stunting and overweight.
The NFSI has greatly enhanced preschool readiness for nutrition-friendly schools. Engaging the private sector in addressing nutritional challenges has paved the way for future public-private partnerships to tackle malnutrition. The nutrition policy formulated through this initiative could serve as a blueprint for a National School Nutrition Policy.
1995年，世界卫生组织发起了全球学校健康倡议，旨在将这种健康促进方法推广到全球各地的学校。在本研究中，我们旨在评估幼儿园在采用营养友好型学校倡议（NFSI）清单中的干预措施方面的准备情况。
从位于巴基斯坦信德省塔塔和苏贾瓦尔区的阿迦汗学校的三个校区中，选取所有符合条件的学龄前儿童参与本研究。采用干预前后设计，我们使用NFSI清单评估幼儿园的准备情况、家长/照顾者对促进健康和营养行为的了解，以及学龄前儿童的人体测量指标（即上臂中部周长（MUAC）、体重和身高）。对NFSI清单进行差异评分分析，而对人体测量和知识数据采用描述性统计。连续变量（即身高、体重、MUAC）以均值表示，分类变量（知识）以数字和百分比表示。使用配对t检验对相关样本进行统计分析，以评估MUAC、身高、体重、年龄别身高Z评分、年龄别体重Z评分、身高别体重Z评分的平均差异，以及学龄前儿童家长知识的变化。
在3个月内对164名学龄前儿童（年龄24 - 84个月，平均年龄56.7个月）的数据进行了分析。学校准备情况得分从10分提高到了22分（满分26分）。家长对营养和健康的知识增加了7.2分（满分25分）。儿童的MUAC（0.27厘米）、体重（0.36千克）和身高（0.62厘米）均有平均增加（<0.001）。发育迟缓以及超重/肥胖率保持不变（分别为7.3%和4.3%），而体重不足和消瘦率分别从10.4%降至7.3%，以及从7.9%降至6.1%。该倡议有效降低了体重不足和消瘦情况，但对发育迟缓和超重没有影响。
NFSI极大地提高了幼儿园对营养友好型学校的准备程度。让私营部门参与应对营养挑战为未来公私合作解决营养不良问题铺平了道路。通过该倡议制定的营养政策可作为国家学校营养政策的蓝图。
