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矿业社区五岁以下儿童营养不良的背景决定因素:对营养干预措施以实现最佳影响的批判性综述

Contextual determinates of under-five malnutrition in mining communities: a critical review of nutrition interventions for optimal impact.

作者信息

Nyirenda Herbert Tato, Mulenga David, Nyambe-Silavwe Hilda

机构信息

Department of Public Health, School of Medicine, The Copperbelt University, Ndola, Zambia.

出版信息

Front Public Health. 2025 Feb 12;13:1482200. doi: 10.3389/fpubh.2025.1482200. eCollection 2025.

Abstract

PURPOSE

Malnutrition continues to be a widespread and critical public health issue, yet there is a lack of comprehensive evidence synthesizing empirical findings and assessing the practicality of nutrition interventions in diverse contexts. This paper analyzes contextual data to establish a benchmark for selecting effective nutrition strategies, thereby maximizing their impact and ensuring targeted, sustainable outcomes.

METHODS

This study employed a cross-sectional design to examine the key drivers of nutrition in mining communities, focusing on children under five and their caregivers. A sample of 711 participants was selected using a systematic random sampling technique. Data collection involved structured questionnaires, direct measurements of children, and interviews with caregivers. Anthropometric measurements were conducted according to WHO standards to assess underweight status. Statistical analysis included descriptive statistics and chi-square tests to evaluate the effectiveness and feasibility of context-specific nutrition interventions.

RESULTS

Chi-square analysis highlights a complex interplay of factors influencing underweight in children under 5 years of age, including expenditure priorities ( = 0.002), access to resources such as primary grocery stores ( = 0.001) and farmers' markets ( < 0.001), food preparation practices ( = 0.006), agricultural empowerment ( < 0.001), and feeding styles/strategies ( = 0.004). Multivariate logistic regression further reveals that key determinants of child underweight include age (aOR = 15.24,  < 0.001), caregiver disability or chronic illness status (aOR = 0.14,  < 0.001), inadequate food production (aOR = 1.94,  = 0.009), and expenditure priorities (aOR = 2.46,  = 0.007). These factors collectively highlight the multifaceted nature of child undernutrition.

CONCLUSION

The findings highlight the critical importance of considering contextual factors when developing nutrition interventions. Key elements such as expenditure priorities, access to food resources, food preparation practices, agricultural empowerment, and feeding strategies play a significant role in shaping child nutrition outcomes. Understanding these factors is essential for designing interventions that are not only effective but also sustainable and culturally appropriate.

摘要

目的

营养不良仍然是一个广泛且严重的公共卫生问题,但缺乏综合证据来汇总实证研究结果并评估不同背景下营养干预措施的实用性。本文分析背景数据,以建立一个选择有效营养策略的基准,从而最大限度地扩大其影响并确保有针对性的可持续成果。

方法

本研究采用横断面设计,以五岁以下儿童及其照料者为重点,考察矿区营养的关键驱动因素。使用系统随机抽样技术选取了711名参与者作为样本。数据收集包括结构化问卷、儿童直接测量以及与照料者的访谈。根据世界卫生组织标准进行人体测量,以评估体重不足状况。统计分析包括描述性统计和卡方检验,以评估针对具体背景的营养干预措施的有效性和可行性。

结果

卡方分析突出了影响五岁以下儿童体重不足的因素之间的复杂相互作用,包括支出优先级(P = 0.002)、获得诸如主要杂货店(P = 0.001)和农贸市场(P < 0.001)等资源的机会、食物制备习惯(P = 0.006)、农业赋权(P < 0.001)以及喂养方式/策略(P = 0.004)。多变量逻辑回归进一步显示,儿童体重不足的关键决定因素包括年龄(调整后比值比[aOR] = 15.24,P < 0.001)、照料者残疾或慢性病状况(aOR = 0.14,P < 0.001)、粮食产量不足(aOR = 1.94,P = 0.009)以及支出优先级(aOR = 2.46,P = 0.007)。这些因素共同凸显了儿童营养不良的多面性。

结论

研究结果突出了在制定营养干预措施时考虑背景因素的至关重要性。支出优先级、获得食物资源的机会、食物制备习惯、农业赋权和喂养策略等关键要素在塑造儿童营养结果方面发挥着重要作用。了解这些因素对于设计不仅有效而且可持续且符合文化背景的干预措施至关重要。

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Contextual determinates of under-five malnutrition in mining communities: a critical review of nutrition interventions for optimal impact.
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