对儿童营养不良的潜在因素和后果的认识以及5岁以下急性营养不良儿童的求医行为:孟加拉国农村的一项定性研究。

IF 2.8 2区 医学 Q3 NUTRITION & DIETETICS
Md. Abdul Alim, Bibi Marium, Benjamin Guesdon, M. Munirul Islam, Caroline Antoine, Mehedi Hasan Anik, Stefaan De Henauw, Tahmeed Ahmed, Souheila Abbeddou
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引用次数: 0

摘要

急性营养不良影响着全球4500万5岁以下儿童,其中孟加拉国占170多万例。虽然孟加拉国存在以社区为基础的急性营养不良管理指南,但它们主要强调营养咨询,并在覆盖和实施方面面临挑战。了解cmm吸收和实施的障碍是很重要的。本研究旨在探讨父母、医疗保健提供者和政策制定者对急性营养不良的潜在因素和后果的看法,以及父母对五岁以下急性营养不良儿童的求医行为。该研究在有和没有CMAM项目的地区进行,采用现象学设计,对焦点小组讨论(fgd)和关键信息提供者访谈(KIIs)进行专题分析。与父母进行了30次fgd,与卫生保健提供者进行了28次kii,与政策制定者进行了16次kii。已查明的急性营养不良的原因包括感染、疾病、对营养食品缺乏认识、迷信超自然现象、贫穷以及护理和喂养方法不当。其后果包括发育迟缓、智力发育受损和患病风险增加。尽管家长们承认治疗急性营养不良的紧迫性,但他们无论患病与否都到医疗机构寻求治疗。影响求医行为的因素包括无法确定问题的优先顺序、交通成本和可用性、医疗保健获取、工资损失和自付费用。尽管人们意识到急性营养不良的潜在因素和后果,但寻求父母照顾的人数仍然有限。该研究建议将急性营养不良指南与传染病项目结合起来,实施有针对性的社会和行为改变项目,消除迷信,促进与传统治疗师的合作,加强社会安全网,并赋予妇女在医疗保健决策中的权力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Perceptions of Underlying Factors and Consequences of Childhood Malnutrition and Care-Seeking Behaviour for Children Under 5 Years With Acute Malnutrition: A Qualitative Study in Rural Bangladesh

Perceptions of Underlying Factors and Consequences of Childhood Malnutrition and Care-Seeking Behaviour for Children Under 5 Years With Acute Malnutrition: A Qualitative Study in Rural Bangladesh

Acute Malnutrition affects 45 million children under five globally, with Bangladesh contributing more than 1.7 million cases. While community-based management of acute malnutrition (CMAM) guidelines in Bangladesh exist, they primarily emphasise nutritional counselling and face challenges in coverage and implementations. It is important to understand barriers to CMAM uptake and implementation. This study aims to explore the perceptions of acute malnutrition's underlying factors and consequences among parents, healthcare providers, and policymakers, alongside parents' care-seeking behaviours for under-five children with acute malnutrition. Conducted in areas with and without CMAM programs, the research follows a phenomenological design with thematic analysis of focus group discussions (FGDs) and key informant interviews (KIIs). Thirty FGDs with parents, 28 KIIs with healthcare providers, and 16 KIIs with policymakers were conducted. Identified causes of acute malnutrition included infections, diseases, lack of awareness about nutritious foods, supernatural beliefs, poverty, and inadequate care and feeding practices. Consequences included stunted growth, impaired mental development, and increased illness risk. Although parents acknowledged the urgency of treating acute malnutrition, they sought care at healthcare facilities regardless of illness. Factors influencing care-seeking behaviour were inability in problem prioritisation, transportation cost and availability, healthcare access, wage loss, and out-of-pocket expenses. Despite awareness of acute malnutrition's underlying factors and consequences, parental care-seeking remains limited. The study recommends integrating acute malnutrition guidelines with communicable disease programs, implementing targeted social and behavioural change programs, addressing superstitions, fostering collaboration with traditional healers strengthening social safety nets, and empowering women in healthcare decision-making.

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来源期刊
Maternal and Child Nutrition
Maternal and Child Nutrition 医学-小儿科
CiteScore
7.70
自引率
8.80%
发文量
144
审稿时长
6-12 weeks
期刊介绍: Maternal & Child Nutrition addresses fundamental aspects of nutrition and its outcomes in women and their children, both in early and later life, and keeps its audience fully informed about new initiatives, the latest research findings and innovative ways of responding to changes in public attitudes and policy. Drawing from global sources, the Journal provides an invaluable source of up to date information for health professionals, academics and service users with interests in maternal and child nutrition. Its scope includes pre-conception, antenatal and postnatal maternal nutrition, women''s nutrition throughout their reproductive years, and fetal, neonatal, infant, child and adolescent nutrition and their effects throughout life.
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