儿童早期发展的家庭访问是否可以在规模上以足够的覆盖和质量实施? 来自印度和巴基斯坦SPRING计划的证据
Zelee Hill1, Shamsa Zafar2, Seyi Soremekun3
1Institute for Global Health, University College London, London, United Kingdom.
Frontiers in nutrition
|July 5, 2023
概括
在低收入国家实施早期儿童发展 (ECD) 家庭访问计划面临挑战. 巴基斯坦和印度的低于最佳的实施强调了需要可行的策略来改善有效的ECD干预措施的覆盖范围和质量.
科学领域:
- 全球健康 全球健康
- 发展心理学 发展心理学
- 公共卫生干预 公共卫生干预
背景情况:
- 关于在低收入和中等收入国家大规模早期儿童发展 (ECD) 干预措施的有效性的证据有限.
- 为了解决这一知识差距,在巴基斯坦和印度实施了SPRING家庭访问计划.
研究的目的:
- 进行SPRING家庭访问计划的过程评估,以了解实施挑战和促进者.
- 确定在不同环境中扩大ECD干预措施的障碍和推动因素.
主要方法:
- 通过24次与母亲的深入采访,20次与母亲,祖母和父亲的焦点小组讨论进行定性数据收集.
- 17次采访和聚焦小组与巴基斯坦和印度的社区代理人和监督员.
主要成果:
- 巴基斯坦和印度的实施情况都不理想,包括监督低,访问质量差和覆盖率低等问题.
- 护理人员的时间压力和对干预内容的看法 (以游戏为重点而不是以互动为重点) 是吸收和有效性的关键障碍.
- 在这两种情况下,对响应式交互的辅导都是次于最佳的.
结论:
- 有效实施需要可行的质量,覆盖和监督战略,利用监测和反循环.
- 当现有社区工作人员过度劳累时,可能需要使用组交付等替代策略.
- 优先考虑指导等核心组成部分,并专注于日常活动中的互动,可以提高EDD干预措施的可行性和影响.
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