{"title":"在三个中低收入国家，孕妇在接受孕产妇营养干预措施后，叶酸铁的摄入量和膳食多样性不平等。","authors":"Deepali Godha, Sandra Remancus, Tina Sanghvi","doi":"10.1017/S1368980024001150","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Research is available on improved coverage and practices from several large-scale maternal nutrition programmes, but not much is known on change in inequalities. This study analyses wealth and education inequality using Erreygers and Concentration indices for four indicators: adequate iron and folic acid (IFA) consumption, women's dietary diversity, and counselling on IFA and dietary diversity.</p><p><strong>Design: </strong>A pre-test-post-test, control group design.</p><p><strong>Setting: </strong>Maternal nutrition intervention programmes conducted in Bangladesh, Burkina Faso and Ethiopia during 2015-2022.</p><p><strong>Participants: </strong>Recently delivered women (RDW) and pregnant women (PW).</p><p><strong>Results: </strong>Statistically significant reductions in education inequality were observed for adequate IFA consumption, counselling on IFA and dietary diversity in intervention areas of Bangladesh and for adequate IFA consumption in intervention areas of Burkina Faso.A significant decrease in wealth inequality was observed for adequate IFA consumption in the intervention areas of Bangladesh, whereas a significant increase was observed in the non-intervention areas for counselling on IFA in Ethiopia and for dietary diversity in Burkina Faso.</p><p><strong>Conclusion: </strong>The results can be attributed to the extensive delivery system at community level in Bangladesh and being predominantly facility-based in Burkina Faso and Ethiopia. COVID-19 disruptions (in Burkina Faso and Ethiopia) and indicator choice also had a role in the results.The main takeaways for nutrition programmes are as follows: (a) assessing inequality issues through formative studies during designing, (b) monitoring inequality indicators during implementation, (c) diligently addressing inequality through targeted interventions, setting aside resources and motivating frontline workers to reduce disparities and (d) making inequality analysis a routine part of impact evaluations.</p>","PeriodicalId":20951,"journal":{"name":"Public Health Nutrition","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Inequality in iron and folic acid consumption and dietary diversity in pregnant women following exposure to maternal nutrition interventions in three low- and middle-income countries.\",\"authors\":\"Deepali Godha, Sandra Remancus, Tina Sanghvi\",\"doi\":\"10.1017/S1368980024001150\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Research is available on improved coverage and practices from several large-scale maternal nutrition programmes, but not much is known on change in inequalities. This study analyses wealth and education inequality using Erreygers and Concentration indices for four indicators: adequate iron and folic acid (IFA) consumption, women's dietary diversity, and counselling on IFA and dietary diversity.</p><p><strong>Design: </strong>A pre-test-post-test, control group design.</p><p><strong>Setting: </strong>Maternal nutrition intervention programmes conducted in Bangladesh, Burkina Faso and Ethiopia during 2015-2022.</p><p><strong>Participants: </strong>Recently delivered women (RDW) and pregnant women (PW).</p><p><strong>Results: </strong>Statistically significant reductions in education inequality were observed for adequate IFA consumption, counselling on IFA and dietary diversity in intervention areas of Bangladesh and for adequate IFA consumption in intervention areas of Burkina Faso.A significant decrease in wealth inequality was observed for adequate IFA consumption in the intervention areas of Bangladesh, whereas a significant increase was observed in the non-intervention areas for counselling on IFA in Ethiopia and for dietary diversity in Burkina Faso.</p><p><strong>Conclusion: </strong>The results can be attributed to the extensive delivery system at community level in Bangladesh and being predominantly facility-based in Burkina Faso and Ethiopia. COVID-19 disruptions (in Burkina Faso and Ethiopia) and indicator choice also had a role in the results.The main takeaways for nutrition programmes are as follows: (a) assessing inequality issues through formative studies during designing, (b) monitoring inequality indicators during implementation, (c) diligently addressing inequality through targeted interventions, setting aside resources and motivating frontline workers to reduce disparities and (d) making inequality analysis a routine part of impact evaluations.</p>\",\"PeriodicalId\":20951,\"journal\":{\"name\":\"Public Health Nutrition\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-05-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Nutrition\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/S1368980024001150\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NUTRITION & DIETETICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Nutrition","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/S1368980024001150","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NUTRITION & DIETETICS","Score":null,"Total":0}
引用次数: 0
摘要
目标：有研究表明，几项大规模孕产妇营养计划的覆盖率和实践都有所提高，但对不平等现象的变化却知之甚少。本研究使用 Erreygers 指数和集中指数分析了财富和教育不平等的四个指标：充足的 IFA 摄入量、妇女的膳食多样性以及关于 IFA 和膳食多样性的咨询：设计：前测-后测对照组设计：2015-2022年期间在孟加拉国、布基纳法索和埃塞俄比亚开展的孕产妇营养干预项目：最近分娩的妇女（RDW）和孕妇（PW）：在孟加拉国的干预地区，充足的反式脂肪酸消费、反式脂肪酸咨询和膳食多样性方面的教育不平等现象出现了统计学意义上的明显减少；在布基纳法索的干预地区，充足的反式脂肪酸消费方面的教育不平等现象出现了统计学意义上的明显减少：结论：这些结果可归因于孟加拉国社区一级广泛的提供系统，而布基纳法索和埃塞俄 比亚则主要以设施为基础。对营养计划的主要启示是：a) 在设计过程中通过形成性研究评估平等问题；b) 在实施过程中监测不平等指标；c) 通过有针对性的干预措施、预留资源和激励一线工作人员减少差异，努力解决不平等问题；d) 将平等分析作为影响评估的常规部分。
Inequality in iron and folic acid consumption and dietary diversity in pregnant women following exposure to maternal nutrition interventions in three low- and middle-income countries.
Objective: Research is available on improved coverage and practices from several large-scale maternal nutrition programmes, but not much is known on change in inequalities. This study analyses wealth and education inequality using Erreygers and Concentration indices for four indicators: adequate iron and folic acid (IFA) consumption, women's dietary diversity, and counselling on IFA and dietary diversity.
Design: A pre-test-post-test, control group design.
Setting: Maternal nutrition intervention programmes conducted in Bangladesh, Burkina Faso and Ethiopia during 2015-2022.
Participants: Recently delivered women (RDW) and pregnant women (PW).
Results: Statistically significant reductions in education inequality were observed for adequate IFA consumption, counselling on IFA and dietary diversity in intervention areas of Bangladesh and for adequate IFA consumption in intervention areas of Burkina Faso.A significant decrease in wealth inequality was observed for adequate IFA consumption in the intervention areas of Bangladesh, whereas a significant increase was observed in the non-intervention areas for counselling on IFA in Ethiopia and for dietary diversity in Burkina Faso.
Conclusion: The results can be attributed to the extensive delivery system at community level in Bangladesh and being predominantly facility-based in Burkina Faso and Ethiopia. COVID-19 disruptions (in Burkina Faso and Ethiopia) and indicator choice also had a role in the results.The main takeaways for nutrition programmes are as follows: (a) assessing inequality issues through formative studies during designing, (b) monitoring inequality indicators during implementation, (c) diligently addressing inequality through targeted interventions, setting aside resources and motivating frontline workers to reduce disparities and (d) making inequality analysis a routine part of impact evaluations.
期刊介绍：
Public Health Nutrition provides an international peer-reviewed forum for the publication and dissemination of research and scholarship aimed at understanding the causes of, and approaches and solutions to nutrition-related public health achievements, situations and problems around the world. The journal publishes original and commissioned articles, commentaries and discussion papers for debate. The journal is of interest to epidemiologists and health promotion specialists interested in the role of nutrition in disease prevention; academics and those involved in fieldwork and the application of research to identify practical solutions to important public health problems.
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