改善母婴营养的基于证据的干预措施:可以做些什么,有什么代价?
Zulfiqar A Bhutta1, Jai K Das1, Arjumand Rizvi1
1Aga Khan University, Karachi, Pakistan.
Lancet (London, England)
|June 11, 2013
概括
改善母婴营养干预措施可以预防15%的5岁以下儿童死亡. 扩大十项以证据为基础的营养干预措施和盐的获取,对于避免发育迟缓和改善全球儿童健康结果至关重要.
科学领域:
- 公共卫生 公共卫生
- 营养科学 营养科学
- 全球健康 全球健康
背景情况:
- 孕产妇营养不良是新生儿死亡的一个重要原因,每年导致80万例死亡.
- 发育迟缓,衰减和微量营养素缺乏与每年大约310万儿童死亡有关.
- 以前的研究,包括2008年"柳叶刀"杂志系列,已经确定了营养干预措施的有效性.
研究的目的:
- 综合更新关于对母亲和儿童营养不良和微量营养素缺乏的干预措施的证据.
- 建模基于证据的营养干预措施对高负担国家的挽救生命和成本的影响.
- 评估包括社区卫生工作者在内的交付平台在改善获取和吸收方面的作用.
主要方法:
- 对解决营养不良和微量营养素缺乏问题的干预措施进行了全面的更新.
- 利用标准方法评估交付平台和战略的新证据.
- 模拟了干预措施对34个儿童衰退负担最高的国家的挽救生命和成本的影响.
主要成果:
- 获得10种基于证据的营养干预措施,达到90%的覆盖率,可以将5岁以下儿童的死亡率降低15%.
- 改善对盐的获取可以有效地缓解缺乏症并改善健康结果.
- 目前约有五分之一的发育迟缓负担可以通过改善干预获取来避免.
结论:
- 在34个重点国家扩大10项直接营养干预措施需要每年额外估计96亿美元.
- 持续投资于特定营养干预措施,利用社区参与和有效的交付策略,至关重要.
- 将营养特异性方法与营养敏感策略 (例如,妇女赋权,粮食系统) 联系起来,可以加速高负担国家的进展.
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