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将幼儿发展纳入现有的健康和营养计划:来自集群随机对照试验的证据
Caitlin Hemlock1,2, Emanuela Galasso3, Ann M Weber4
1School of Public Health, University of California Berkeley, Berkeley, CA, USA. chemlock@uw.edu.
BMC public health
|September 28, 2024
概括
将早期儿童发展 (ECD) 计划引入社区卫生服务是可行的,并且不会减少现有计划的出席率. 需要新的策略来让弱势儿童参与卫生服务.
科学领域:
- 全球健康 全球健康
- 公共卫生 公共卫生
- 儿童发展 儿童发展
背景情况:
- 引入新的儿童健康计划可能会在资源有限的环境中耗费护理人员的时间.
- 社区卫生工作者 (CHW) 计划,如马达加斯加的改善营养结果计划 (PARN),对于儿童健康和营养至关重要.
- 评估早期儿童发展 (ECD) 服务与现有卫生框架的整合对于优化资源配置和护理人员参与至关重要.
研究的目的:
- 分析一项新的ECD计划对马达加斯加农村现有卫生服务的出席率的影响.
- 评估提供家庭游戏材料对ECD课程出席率的影响.
- 确定与护理人员注册和参与ECD计划相关的因素.
主要方法:
- 一项随机对照试验在马达加斯加农村的75个社区进行.
- 提供了两个为期6个月的ECD课程周期,在第二个周期中增加了带回家的游戏材料.
- 差异分析和随机拦截模型被用于评估程序影响和注册特征.
主要成果:
- 然而,ECD计划的整合并没有减少现有的PARN健康计划的出席率.
- 添加游戏材料并没有增加EDD会议出席率.
- 来自富裕家庭的孩子和已经参加PARN的孩子更有可能注册;来自人口较多地区的孩子参与的可能性较低.
结论:
- 将ECD服务整合到现有卫生系统中是可行的,而不会影响参与其他服务.
- 在人口密集地区增加对医疗服务的投资是公平覆盖的必要条件.
- 需要有针对性的战略来改善弱势儿童参与新的和现有的卫生计划.
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