背景:营养不良仍然是南非母亲和儿童紧迫的公共卫生问题。尽管政府的多部门反应,未解决的社会需求阻碍了一些母亲从干预措施中充分受益,跨越财务规划,收入稳定,住房,获得政府服务,社会支持,提供负担得起的,营养食品。如果我们希望克服阻碍妇女受益于政府营养干预措施的障碍,与母亲接触并优先考虑她们的关切是重要的。这项研究旨在确定在南非一个资源有限的城市城镇中,妇女在满足幼儿母亲和孕妇的社会需求以增强营养方面被视为优先事项的方案。
方法:一项横断面研究采用了定量偏好启发调查,对索韦托五个初级医疗机构的210名母亲和孕妇进行了管理。该调查工具是与社区一起开发的,旨在确定未满足的社会需求和潜在解决方案,这些都是用文献中的发现综合起来的。调查描述了15个节目,分为三个交付级别:诊所,社区,和政府。参与者被要求分两个阶段对方案选择进行排名。首先,他们在每个交付级别选择了前两个方案。随后,他们分配了贴纸,以表明他们在各级顶级节目中的偏好程度。使用描述性统计分析排名。
结果:最优先考虑的是五个方案。在社区一级提供了两项服务:妇女经济赋权小组和求职援助,两个在诊所层面:社会需求评估和转诊,和基于处方的食物,在政府层面:免费优质托儿服务。排名最低的方案是两个以诊所为基础的方案,特别是产妇营养组和夫妇产前教育。
结论:妇女对哪些方案应优先支持母亲和孕妇满足其社会需求和改善营养表达了强烈的看法。关键领域包括为求职和创业提供支持,获得儿童保育和诊所推荐的健康食品,以及查找有关可用社区和政府服务的信息。利用多部门合作,一致的政策目标,高效的公共融资,加强执行能力对于实施这些方案至关重要。
BACKGROUND: Malnutrition remains a pressing public health concern for mothers and children in South Africa. Despite the government\'s multisectoral response, unaddressed social needs prevent some mothers getting full benefit from interventions, spanning financial planning, income stability, housing, access to government services, social support, and provision of affordable, nutritious foods. Engaging with mothers and prioritising their concerns is important if we wish to overcome obstacles to women benefiting from government nutrition interventions. This study aimed to identify the programmes that women perceived as a priority in addressing the social needs of mothers of young infants and pregnant women to enhance nutrition in a resource-constrained urban township in South Africa.
METHODS: A cross-sectional study employed a quantitative preference elicitation survey, administered to 210 mothers and pregnant women from five primary healthcare facilities in Soweto. The survey tool was developed with the community to identify unmet social needs and potential solutions, which were synthesised with findings from the literature. The survey described 15 programmes, grouped into three delivery levels: clinics, community, and government. Participants were required to rank programme options in two stages. First, they selected their top two programmes within each delivery level. Subsequently, they allocated stickers to indicate the strength of their preference among the top programmes across the levels. Rankings were analysed using descriptive statistics.
RESULTS: The highest priority was given to five programmes. Two delivered at the community level: Women\'s economic empowerment groups and Job search assistance, two at the clinic level: Social needs assessment and referral, and Prescription-based food, and one at the government level: Free quality childcare. The lowest-ranked programmes were two clinic-based programmes, specifically Maternal nutrition groups and Couple antenatal education.
CONCLUSIONS: Women expressed strong views about which programmes should be prioritised to support mothers and pregnant women in addressing their social needs and improving nutrition. Key areas included providing support with job searching and entrepreneurship, accessing childcare and the healthy foods recommended at clinics, as well as finding information on available community and government services. Leveraging multisectoral collaboration, aligned policy objectives, efficient public financing, and strengthened implementation capacity will be pivotal in delivering these programmes.