儿童长期营养不良仍然是全球公共卫生问题。埃塞俄比亚记录了儿童发育迟缓的患病率显著下降,一种慢性营养不良的衡量标准,
这项研究的目的是对2000年至2016年导致埃塞俄比亚儿童发育迟缓减少的决定因素进行系统评估,重点是国家,社区,家庭,和个人水平。
本研究采用了定量和定性两种方法。具体来说,系统的文献综述,使用2000-2016年人口与健康调查进行回顾性定量数据分析,定性数据收集和分析,并对关键的营养特异性和敏感性政策和计划进行了分析。
全国发育迟缓患病率从2000年的51%提高到2016年的32%。存在区域差异,就像亲富人一样,亲城市,和受教育的不平等。儿童身高年龄z评分(HAZ)分解解释了2000年至2016年间平均HAZ的预测变化>100%,关键因素包括消耗性作物总产量的增加(变化的32%)。卫生工作者人数增加(28%),露天排便减少(13%),父母教育(10%),产妇营养(5%),经济改善(4%),和减少腹泻发生率(4%)。阻碍衰退的关键政策和方案侧重于促进农村农业,以改善粮食安全;卫生系统的权力下放,纳入卫生推广工作者,以改善农村获得卫生服务的机会并减少露天排便;多部门减贫战略;并致力于改善女童教育。与国家和区域利益攸关方以及社区母亲的访谈表明,在获得保健服务方面有所改善,妇女和女孩的教育,改善农业生产,改善卫生和儿童保育做法,作为减少发育迟缓的驱动因素。
埃塞俄比亚的缓慢衰退是由营养特异性和敏感性部门驱动的,特别关注农业部门,医疗保健服务,卫生,和教育。
Chronic undernutrition in children continues to be a global public health concern. Ethiopia has documented a significant decline in the prevalence of childhood stunting, a measure of chronic undernutrition, over the last 20 y.
The aim of this research was to conduct a systematic assessment of the determinants that have driven child stunting reduction in Ethiopia from 2000 to 2016, focused on the national, community, household, and individual level.
This study employed both quantitative and qualitative methods. Specifically, a systematic literature review, retrospective quantitative data analysis using Demographic and Health Surveys from 2000-2016, qualitative data collection and analysis, and analyses of key nutrition-specific and -sensitive policies and programs were undertaken.
National stunting prevalence improved from 51% in 2000 to 32% in 2016. Regional variations exist, as do pro-rich, pro-urban, and pro-educated inequalities. Child height-for-age z score (HAZ) decomposition explained >100% of predicted change in mean HAZ between 2000 and 2016, with key factors including increases in total consumable crop yield (32% of change), increased number of health workers (28%), reduction in open defecation (13%), parental education (10%), maternal nutrition (5%), economic improvement (4%), and reduced diarrhea incidence (4%). Policies and programs that were key to stunting decline focused on promoting rural agriculture to improve food security; decentralization of the health system, incorporating health extension workers to improve rural access to health services and reduce open defecation; multisectoral poverty reduction strategies; and a commitment to improving girls\' education. Interviews with national and regional stakeholders and mothers in communities presented improvements in health service access, women and girls\' education, improved agricultural production, and improved sanitation and child care practices as drivers of stunting reduction.
Ethiopia\'s stunting decline was driven by both nutrition-specific and -sensitive sectors, with particular focus on the agriculture sector, health care access, sanitation, and education.