Maternal and Child Nutrition最新文献

{"title":"Integration of a WASH Component in the Standard National Protocol for Treatment of Severe Acute Malnutrition in Children Aged 6–59 Months in Northern Senegal—A Costing Study","authors":"Bibata Wassonguema,&nbsp;Maily Lê-Lacanette,&nbsp;Laura Braun,&nbsp;Matar Ba,&nbsp;Françoise Siroma,&nbsp;Albert Emile Cabo,&nbsp;Antonio Vargas Brizuela,&nbsp;Moustapha Seye,&nbsp;Jean Lapègue,&nbsp;Alexandre Devort,&nbsp;Oliver Cumming,&nbsp;Dieynaba S. N'Diaye","doi":"10.1111/mcn.70100","DOIUrl":"10.1111/mcn.70100","url":null,"abstract":"<p>Severe acute malnutrition (SAM) affects 12.2 million children globally. Integrating a water, sanitation and hygiene (WASH) kit in outpatient SAM treatment can improve recovery rates by preventing WASH-related diseases and complications, but its cost at scale remains unknown. This study estimates the cost of integrating a WASH kit, composed of chlorine-based water treatment, safe water storage with a lid, soap, and a hygiene promotion component into Senegal's national protocol for treating uncomplicated SAM. This costing study was nested within the TISA randomised controlled trial, which evaluated the addition of a WASH component to standard SAM treatment for children aged 6–59 months. Cost data were collected from 660 participants enroled between December 2020 and December 2021. We took a societal perspective and used a micro-costing approach to estimate direct medical, non-medical and indirect costs. The WASH component led to a 2021 international $105.32 additional cost per child treated, with the WASH kit, transportation and management representing $33.03. Sensitisation to hygiene and water treatment cost $13.46 at health posts and $29.63 for two at-home visits. No additional out-of-pocket expenses were incurred by households, but $1.58 in opportunity costs (income loss) was observed. Human resources were the main cost driver for the WASH component, exceeding the human resources for standard SAM treatment. The total societal cost per child treated was $338.77, ranging from $238.09 to $517.29 in sensitivity analysis, with the SAM treatment representing 69% ($233.40) of this total cost. The main expense for this component was Ready-to-Use-Therapeutic Food (RUTF) ($154.39). The absence of additional costs for households induced by the WASH component is encouraging, as it suggests that it would not represent an obstacle to integration into the national protocol. We produced a robust and comprehensive cost estimate for integrating a WASH kit and hygiene promotion into Senegal's SAM treatment protocol. This increased the treatment cost by 45% which was lower than estimates from a previous study. Results inform budget planning and support future cost-effectiveness analyses of integrating WASH interventions into SAM protocols.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"22 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70100","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lunch Provision, Consumption and Plate Waste in Early Years Settings in Sheffield","authors":"Claire J. Wall,&nbsp;Jo Pearce","doi":"10.1111/mcn.70132","DOIUrl":"10.1111/mcn.70132","url":null,"abstract":"<p>Food provision in early years settings (EYS) presents an opportunity to support healthy eating amongst young children. This study aimed to record and nutritionally analyse setting lunches provided for, consumed and wasted by 3- to 4-year-old children attending EYS in Sheffield, England, including a comparison to packed lunches. Lunch choices were recorded for participating children, along with weights of foods served and any leftovers. A total of 142 setting lunches were recorded, eaten by 46 children attending four of eight recruited EYS. Lunches included vegetables (83.8%) more often than fruit (59.2%), and on average provided sufficient energy, carbohydrate, fibre, protein, vitamins A and C, calcium, iodine and zinc, but insufficient iron. Free sugars and saturated fat, but not sodium, were higher than recommended. Children left 22% of food served on their plate, and consumption of energy, carbohydrate, fibre, vitamin A, iron, iodine and zinc was lower than recommended. Food and nutrient contents were also compared to 185 packed lunches eaten by 67 children from eight settings. Setting lunches contained less food (median 288 g) than packed lunches (median 321 g, <i>p</i> &lt; 0.001) and were more likely to meet guidelines for free sugars (<i>p</i> &lt; 0.001), saturated fat (<i>p</i> &lt; 0.001), vitamin A (<i>p</i> = 0.034), vitamin C (<i>p</i> &lt; 0.001) and sodium (<i>p</i> &lt; 0.001) but less frequently provided sufficient fibre (<i>p</i> = 0.025), calcium (<i>p</i> &lt; 0.001), iron (<i>p</i> &lt; 0.001) and zinc (<i>p</i> &lt; 0.001). Setting lunches were more nutritionally balanced than packed lunches. However, to maximise EYS potential contribution to children's diets, settings must have access to support to both provide sufficiently nutrient-dense meals and encourage children to eat them.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"22 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PS-SAM: A Mixed Methods Study to Understand Current Practice and the Facilitators and Barriers to the Utilisation of Psycho-Social Stimulation Interventions in Severe Acute Malnutrition","authors":"Mike Kalmus Eliasz,&nbsp;Dolce Advani,&nbsp;Melissa Gladstone","doi":"10.1111/mcn.70135","DOIUrl":"https://doi.org/10.1111/mcn.70135","url":null,"abstract":"<p>Psycho-social stimulation interventions, recommended in the WHO guidelines for severe acute malnutrition (SAM), have been demonstrated to improve neurodevelopment and growth. However, interventions which have proven effective in clinical trials are resource-intensive and may be challenging in many contexts. This study aimed to explore facilitators, barriers and the existing provision of psycho-social stimulation interventions. We undertook a survey targeting practitioners across the globe who are involved in SAM care and/or programme management. We then undertook 12 semi-structured key informant interviews with practitioners from diverse professional contexts. We transcribed and coded interviews using a deductive approach based on the Consolidated Framework for Implementation Science Research (CFIR). We gained 42 responses from 18 countries for our survey with 29 respondents including psycho-social stimulation interventions in their SAM programmes. Our 12 key informant interviews described several barriers (financial, physical, and human resource limitations, prioritisation of life-saving care, and staff beliefs) as well as some potential facilitators (inclusion in guidelines, enjoyment for staff and parents, and emerging evidence of benefits in terms of short and long-term outcomes). This multi-country mixed methods study revealed that there are very heterogeneous patterns around the implementation of psycho-social interventions in children with SAM. Our study has demonstrated the perceived challenges by professionals involved in SAM care of the feasibility of implementing interventions from research trials. Pragmatic studies are needed which also include an assessment of implementation to enhance an understanding of what might drive uptake. Limitations of our study include a potential respondent bias and small sample size.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"22 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145436140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conflicts of Interest in Infant and Young Child Feeding: A Review of Australian Health Professional Associations' Guidance to Members on the International Code of Marketing of Breast-Milk Substitutes.","authors":"Naomi Hull, Alessandro Iellamo, Julie P Smith","doi":"10.1111/mcn.70137","DOIUrl":"https://doi.org/10.1111/mcn.70137","url":null,"abstract":"<p><p>There is growing attention to the influence of commercial milk formula (CMF) marketing on health professionals and their professional associations, with ongoing controversies about the conflicts of interest created by the CMF industry and how health professionals and their associations can avoid them. Australian guidelines state that health workers should implement the International Code of Marketing of Breast-milk Substitutes (the Code), and a recent regulatory review considered whether health professional association (HPA) ethical codes and standards require compliance with the Code. However, evidence was lacking. This study aimed to assess the extent to which Australian HPAs' codes and standards require compliance with the Code. Sampled were national associations of regulated health professionals likely to provide health care to mothers and infants. Online searches of websites of these Australian HPAs were conducted in 2021 and repeated in 2024, to identify documents on professional ethics on the Code and breastfeeding. To assess the documents, we developed a simple scoring system and tool using the eight critical elements of the Code and World Health Organisation guidance for health workers. Searches identified 19 within-scope associations. Most (15/19) had no provisions relating to the Code or Guidance in their ethics or standards documents in 2024. Only one comprehensively covered the Code components and just five scored above 50 per cent. Professional association codes of ethics and standards in Australia do not prevent health professionals being influenced by CMF company marketing or ensure breastfeeding is protected, promoted and supported in line with health worker responsibilities under Australian guidelines and the Code. Future research could apply this scoring system in other country settings, and for other HPAs.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70137"},"PeriodicalIF":2.6,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gaza's Infant Malnutrition Crisis Needs More Than Just Infant Formula","authors":"Karleen Gribble,&nbsp;Bindi Borg,&nbsp;Nerfana Mowadad,&nbsp;Reem Al Soufi,&nbsp;Mija Ververs","doi":"10.1111/mcn.70131","DOIUrl":"10.1111/mcn.70131","url":null,"abstract":"&lt;p&gt;In recent months, media reports have highlighted the crisis of malnourished infants in Gaza with an infant formula shortage commonly presented as causal. Infant formula has become a symbol of the blockade, the war, and the need to end both. As practitioners in infant and young child feeding in emergencies, including with first-hand experience in Gaza (Qudieh et al. &lt;span&gt;2025&lt;/span&gt;), we find this messaging concerning. It risks promoting donations and untargeted distribution of infant formula that will harm, rather than assist, infants.&lt;/p&gt;&lt;p&gt;In situations of war, maximising infant survival relies upon as many women as possible being supported to exclusively breastfeed. Breastfeeding provides infants with safe food and liquid and protection from infectious disease (Victora et al. &lt;span&gt;2016&lt;/span&gt;). Malnourished mothers can and do breastfeed (Prentice et al. &lt;span&gt;1994&lt;/span&gt;; Rahman et al. &lt;span&gt;2022&lt;/span&gt;). Relactation is possible for women who have stopped breastfeeding (World Health Organization&lt;span&gt;1998&lt;/span&gt;) and wet nursing provides safe alternative feeding for infants whose mothers are absent or deceased (UNICEF &amp; Infant and Young Child Feeding in Emergencies Core Group &lt;span&gt;2025&lt;/span&gt;). Breastfeeding counselling, provided in-person or remotely, assists women to breastfeed, including in Gaza (Qudieh et al. &lt;span&gt;2025&lt;/span&gt;).&lt;/p&gt;&lt;p&gt;It is well established that not being breastfed is dangerous for infants in resource-poor settings. Sankar et al. (&lt;span&gt;2015&lt;/span&gt;) calculated an infection-related mortality relative risk of 8.66 for non-breastfed infants in low- and middle-income countries as compared to exclusively breastfed infants. To survive in emergencies, infants who cannot be breastfed require a continuous package of support be provided to caregivers (IFE Core Group &lt;span&gt;2017&lt;/span&gt;). This support includes not just infant formula but water as well as fuel to heat water for washing feeding implements and to make water safe for reconstitution (where powdered formula is used) (Gribble and Fernandes &lt;span&gt;2018&lt;/span&gt;). A pot for boiling water, feeding cups and health care are also needed. Providing this support is extremely difficult in emergencies. In Gaza, it has sometimes been impossible. We acknowledge that infant formula may be required in specific situations in Gaza and every effort should be made to provide proper support to infants who cannot be breastfed. However, it is also necessary that nothing is done to undermine breastfeeding, otherwise the result is the imperilment of more infants.&lt;/p&gt;&lt;p&gt;At the beginning of the conflict, anticipating challenges related to infant feeding, the Global Nutrition Cluster (GNC) reminded humanitarian actors of the importance of ensuring breastfeeding women were supported and of avoiding infant formula donations and improper distributions (Global Nutrition Cluster &lt;span&gt;2023&lt;/span&gt;). This guidance has often not been followed.&lt;/p&gt;&lt;p&gt;The famine in Gaza is a moral failure (Osendarp et al","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"22 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Evidence Gaps: Diets and Fruit and Vegetable Intake Across Five Diverse Low- and Middle-Income Countries.","authors":"Manisha Tharaney, Sonja Y Hess, Lilia Bliznashka, Dorcas A Amunga, Fusta Azupogo, Nadia Koyratty, Taryn J Smith, Imelda Angeles-Agdeppa, Eva A Goyena, Frederick Grant, Joyce Kinabo, Irene Medeme Mitchodigni, Anasaini Moala Silatolu, Renuka Silva, Mutinta Hambayi, Thushanthi Perera, Deanna K Olney","doi":"10.1111/mcn.70117","DOIUrl":"https://doi.org/10.1111/mcn.70117","url":null,"abstract":"<p><p>Poor dietary quality, particularly inadequate fruit and vegetable (F&V) intake, remains a significant public health challenge globally. This article synthesizes findings from scoping reviews examining diet and F&V intake, and interventions to increase F&V consumption among population groups in five countries: Benin, Fiji, the Philippines, Sri Lanka and Tanzania. Our analysis confirms previous findings of inadequate F&V intake across all five countries, with most adults consuming well below the WHO recommendations of 400 g per day. Across the five countries, the identified scientific evidence is limited due to heterogeneous dietary assessment methods, limited coverage of population groups in national surveys and smaller studies, and limited data from rigorous evaluations of interventions aiming to increase F&V intake. Although all five countries have developed food-based dietary guidelines promoting F&V intake, research on their implementation and effectiveness remains limited. To build evidence for effective programmes and policies to improve both quantity and diversity of F&V intake, we identify three priority areas for future research: standardizing dietary assessment methods for use in surveys and evaluations, understanding context-specific drivers and determinants of F&V intake and strengthening intervention research in low-resource settings.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70117"},"PeriodicalIF":2.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Complementary Feeding of Preterm Infants: Kangaroo Care Method Versus Conventional Care","authors":"Rejane Sousa Romão,&nbsp;Vivian Mara Gonçalves de Oliveira Azevedo,&nbsp;Rayany Cristina Souza,&nbsp;Eliziane Santos Medeiros,&nbsp;Priscilla Larissa Silva Pires,&nbsp;Leandro Alves Pereira,&nbsp;Ana Elisa Madalena Rinaldi","doi":"10.1111/mcn.13788","DOIUrl":"10.1111/mcn.13788","url":null,"abstract":"<p>In Brazil, the Kangaroo Care Method (KCM) is a public policy that proposes systematic and humanized care for preterm low birth weight infants (LBWI), and one of its pillars is breastfeeding promotion. Therefore, this study aims to compare complementary feeding of LBWI in terms of age of introduction and the type of food offered according to the type of care received—KCM or Conventional Care (CC). A prospective cohort study was conducted from September 2019 to August 2021 at a Brazilian university hospital. A total of 65 LBWI born at the institution weighing 1800 g or less were included. Data were collected during the first week of hospitalization and at 4 and 6 months of corrected age. The median age at food introduction was estimated by survival analysis using the Kaplan–Meier method. The log-rank test was used to compare the median age at the time of food introduction according to the type of care. Longer exclusive breastfeeding (KCM = 30 days; CC = 0.001, <i>p</i> = 0.002) and continued breastfeeding were observed in KCM preterm infants (KCM = 172 days; CC = 0.001, <i>p</i> = 0.002). The median age at introduction of infant formula (KCM = 38 days; CC = 35 days), water (KCM = 65 days; CC = 46 days), salted porridge (KCM = 139 days; CC = 136 days) and fruits (KCM = 134 days; CC = 136 days) was similar between both types of care received. No ultra-processed foods were consumed. In conclusion, despite encouraging exclusive and continuous breastfeeding, there was no significant difference in the time of introduction of foods according to the type of care received.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"22 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145304338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Perspectives and Experiences of Donor and Recipient Mothers Regarding Human Milk Bank Services in Iran","authors":"Zahra Mahdikhani,&nbsp;Shahideh Jahanian Sadatmahalleh,&nbsp;Zainab Alimoradi,&nbsp;Abbas Habibelahi","doi":"10.1111/mcn.70084","DOIUrl":"10.1111/mcn.70084","url":null,"abstract":"<p>Human milk provides essential nutrition for infants, particularly vulnerable preterm and low-birth-weight neonates. This qualitative study explored Iranian mothers' perspectives on human milk bank (HMB) services through semi-structured interviews with 16 participants (9 donors, 7 recipients) across four HMBs. Using inductive content analysis, we identified five key themes: (1) Expanding opportunities for HMB utilization requires integrating milk donation education into prenatal programs and addressing awareness gaps; (2) Familiarizing parents with HMB services through healthcare providers and social media is crucial for engagement; (3) Infrastructure limitations including equipment shortages and insufficient HMB locations hinder service delivery; (4) Donated human milk (DHM) represents both hope for recipients and fulfillment for donors; and (5) Religious beliefs about milk kinship and family support significantly influence participation. Findings reveal that while Iran has developed the Middle East's most extensive HMB network, cultural and religious considerations around milk kinship require sensitive approaches. Donors reported altruistic motivations and emotional rewards, whereas recipients described DHM as critical for infant survival. Key barriers included limited public awareness, equipment deficiencies, and concerns about milk safety. The study highlights the need for culturally adapted education campaigns, standardized equipment, and policy support to expand services. These results provide valuable insights for improving HMB implementation in Muslim-majority contexts while addressing unique regional challenges in neonatal nutrition. The research underscores DHM's potential to reduce infant mortality when combined with appropriate infrastructure and community engagement strategies.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":"22 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12893511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's Dietary Diversity and Child Feeding Practices Amidst COVID19 in India: Findings From National Family Health Surveys, 2016-2021.","authors":"Anjali Pant, Suman Chakrabarti, Derek Headey, Nishmeet Singh, Phuong Hong Nguyen","doi":"10.1111/mcn.70104","DOIUrl":"https://doi.org/10.1111/mcn.70104","url":null,"abstract":"<p><p>The COVID-19 pandemic caused a crisis that jeopardized food consumption and dietary diversity. This study aimed to: (1) investigate relationship between COVID-19 and women's and children's diets in India; (2) examine how this varies by socioeconomic status and mothers' vegetarianism; and (3) assess whether mobility restrictions during India's national lockdown influenced these dietary changes. The analysis drew on data from India's National Family Health Survey 2015-16 and 2019-21, focusing on 11 states surveyed before and during COVID-19 (N = 567,727 women, 141,905 children). COVID-19 exposure was defined as interviews after 24 March 2020 (national lockdown). Outcomes included child feeding practices and women's food consumption and dietary diversity. The impact of COVID-19 on diets was estimated using a difference-in-difference model; effect of mobility reduction on diets was examined using linear regression. All analyses were adjusted for confounders, interview month, state fixed effects, and sampling weights. Results showed that COVID-19 exposure was linked to significant declines in child feeding practices (-6.9 percentage points [pp] for minimum dietary diversity, -5.0 pp for minimum acceptable diet, and -6.1 pp for fruit consumption) and women's diet (-5.7 pp for dietary diversity and green vegetable consumption). While magnitude of impact varied across socioeconomic sub-strata and mothers' vegetarianism status, the differences were not statistically significant. The diets of women and children were greatly impacted by mobility reduction. COVID-19 has worsened the diets of women and children in India. More research is needed on the impact of relief measures to strengthen food safety nets nationwide.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70104"},"PeriodicalIF":2.6,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Growth Monitoring and Promotion in the Era of Universal Health Coverage: Qualitative Assessment of Programme Delivery Challenges in Ethiopia.","authors":"Bereket Gebremichael, Kaleab Baye, Yetayesh Maru, Ramadanhi Noor, Firehiwot Mengistu, Hiwot Darsene, Yilkal Simachew, Tegene L Dadi, Rahel Dereje, Stanley Chitekwe","doi":"10.1111/mcn.70118","DOIUrl":"https://doi.org/10.1111/mcn.70118","url":null,"abstract":"<p><p>Growth monitoring and promotion (GMP) programmes have been implemented for decades in almost all countries. Despite this long history of implementation, GMP has been criticised for being ineffective, calling for a rethink of the programme. With a view of contributing evidence towards the redesign of GMP, we conducted a qualitative evaluation of the programme in various contexts of Ethiopia. We conducted focus-group discussions (FGDs; n = 28) and key informant interviews (KIIs; n = 193) with programme managers, service providers and caregivers beneficiaries. Supply-side, service delivery, and barriers hindering effective coverage were identified. Lack of functional weighing scales, budget constraints, limited transportation facilities, overlap of interventions, and the low motivation and performance of health workers were identified as main barriers affecting the quality-of-service delivery. The benefits of participating in GMP were not always clear to beneficiaries. Competing priorities like household chores, long travel distances to health centres, and in some contexts culturally insensitive practices deterred participation. Although GMP can serve as an entry point for mainstreaming nutrition into universal health coverage (UHC), the programme would need to be redesigned and supported by adequate supply, resources (financial and human), planning, and quality service delivery that is contextual and culturally sensitive.</p>","PeriodicalId":51112,"journal":{"name":"Maternal and Child Nutrition","volume":" ","pages":"e70118"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}