Rov saib dua Tus Stunting Metric Rau Kev Saib Xyuas Thiab Kev Ntsuas Cov Cai Noj Zaub Mov
Mar 28, 2022
Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791
Thoob plaws ntiaj teb, nrog rau hauv Is Nrias teb, feem ntau ntawm stunting yog ib qho kev siv metric los ntsuaskev noj zaub mov tsis zoo ntawm menyuam. Stunting prevalence yog qhov feem pua ntawm cov menyuam yaus hnub nyoog qis dua 5 xyoos uas luv dhau rau lawv lub hnub nyoog, raws li 2006 WHO tus qauv kev loj hlob, tsim los ntawm Multi Growth Reference Study (MGRS).1 Siv tus qauv MGRS, nyob ib ncig ntawm 38 feem pua ntawm cov menyuam yaus hauv Is Nrias teb yog stunted.2 Qhov kev ntsuas no kuj tau siv los ntawm cov teb chaws los saib xyuas kev ua tau zoo ntawm cov cai tam sim no uas muaj nyob rau hauv qhov chaw kom txo tus menyuam.kev noj zaub mov tsis zoolub nra. Hauv Is Nrias teb tus flagshipkev pab cuam khoom noj khoom haus, POSHAN Abhiyaan, launched nyob rau hauv 2017, stunting yog ib qho ntawm cov kev soj ntsuam thiab ntsuam xyuas metrics, raws li yog cov underweight, tsis muaj hnub yug, thiab anemia. Raws li Is Nrias teb tsim POSHAN Abhiyaan 2.0, kev siv cov kev ntsuas stunting los ntsuas qhov ua tau zoo ntawm cov kev cuam tshuam tam sim no yuav tsum tau rov xav dua.
suab puam ginseng cistancheraukev pab cuam khoom noj khoom haus
Kev loj hlob ntawm cov me nyuam nyob rau hauv MGRS qhia txog cov qauv uas yuav tsum tau nyob rau hauv lub zoo tagnrho ib puag ncig. Los ntawm txhais tau tias, qhov feem ntau stunting ntawm cov menyuam yaus nyob hauv qhov chaw zoo tshaj plaws yuav tsum nyob ib puag ncig 2·3 feem pua. Yog li, muaj tus qauv muab kev nkag siab dav dav ntawm cov tebchaws nyob deb li cas xws li Is Nrias teb, nrog 38 feem pua stunting, yog los ntawm qhov zoo tagnrho.
Tus me nyuam qhov siab muaj qhov sib txuam sib xyaw ua ke: cov menyuam yug los rau cov niam luv, qhov nruab nrab, luv dua. Ntawm ob lub kaum ob sib txheeb uas tau pom tias muaj feem cuam tshuam nrog kev pheej hmoo ntawm stunting thaum yau, niam qhov siab yog qhov muaj zog tshaj plaws.4 Qhov siab ntawm leej niam, txiav txim siab los ntawm nws tus kheej caj ces thiab yav dhau los.khoom noj khoom haus-sensitive insultstej zaum nws yuav tau nyiaj dhau lawm, ces muab tso rau nws cov me nyuam.5
Raws li qhov tseem ceeb raws li kev nthuav tawm kev sib raug zoo yog rau kev nkag siab txog kev loj hlob ntawm tus me nyuam, cov cai tam sim no tsis tuaj yeem ua ib yam dab tsi los hloov pauv tus poj niam cev xeeb tub lossis yav dhau los kev tsis txaus siab los ntawm leej niam. Vim hais tias cov stunting metric tau suav nrog qee qhov ntawm qhov kev sib txuam no, nws tsis tsim nyog raws li kev ntsuas kom nkag siab txog kev cuam tshuam tam sim no thiab kev nce qib. Cov ntsiab lus no tau pom zoo nyob rau hauv ntau lub teb chaws txoj kev tshawb fawb uas piv cov crude stunting prevalence nrog prevalence standardized rau leej niam qhov siab. Rau Is Nrias teb, qhov muaj feem ntau ntawm leej niam-qhov siab-tus qauv stunting yog 25 feem pua piv nrog MGRS-raws li crude prevalence ntawm 38 feem pua .6 Nyob rau hauv ib tug striking coincidence, txo mus rau 25 feem pua prevalence yog raws nraim lub hom phiaj txo nyob rau hauv stunting teem los ntawm POSHAN Abhiyaan yuav tsum ua kom tiav los ntawm 2022.
Muaj ib qho teeb meem loj ntawm kev siv MGRS tus qauv rau kev ntsuas cov menyuam yausnoj zaub mov tsis zoouas tsis tau txais txiaj ntsig zoo. Nyob rau hauv cov ntaub ntawv ntawm Is Nrias teb, cov niam nyob rau hauv lub MGRS, nyob rau hauv nruab nrab, muaj ntau ntau siab dua li nruab nrab Indian niam. Yog li ntawd, qhov tshwm sim hauv MGRS tus qauv tsis yog tsuas yog kev cia siab ntawm cov menyuam yaus loj hlob hauv ib puag ncig zoo xwb tab sis kuj yog qhov xav tias muaj niam siab dua.
Ua kom ntseeg tau tias cov xwm txheej zoo tshaj plaws thaum tsim cov qauv yog nkag siab. Txawm li cas los xij, suav nrog cov niam uas siab dua li cov niam Indian nyob rau hauv tus qauv nyuaj rau kev siv stunting rau kev ntsuam xyuas Is Nrias teb tam sim no.noj zaub movinsults raws li cov ntaub ntawv yuav inevitably muaj kev cuam tshuam lub teb chaws lub luv luv maternal stature. Yog li ntawd, stunting prevalence raws li tus qauv MGRS yuav, rau qee qhov, overestimate tus menyuamkev noj zaub mov tsis zoonyob rau hauv luv luv cov pej xeem xws li nyob rau hauv Is Nrias teb.7 Hauv luv luv, MGRS cov qauv yog unattainable, vim hais tias qhov siab ntawm cov niam yug los nyob rau hauv lub neej yav tom ntej yuav tsis hloov.
Txhawm rau muab qhov no tso rau hauv cov ntsiab lus, nyob rau hauv pooled-MGRS (muaj cov qauv los ntawm rau lub teb chaws, suav nrog Is Nrias teb) qhov siab ntawm niam txiv yog 161·6 cm (thiab 157·6 cm hauv MGRS India).1 Txawm li cas los xij, qhov siab ntawm cov niam. Hauv Is Nrias teb yog 151·7 cm, 6 uas yog 9·3 cm luv dua li MGRS (thiab 5·9 cm luv dua MGRS-India). Qhov tseem ceeb, tsis muaj ib lub xeev lossis ib cheeb tsam hauv Is Nrias teb sib tw MGRS Is Nrias teb qhov siab ntawm niam txiv, cia nyob ib leeg ntawm qhov siab-MGRS leej niam qhov siab uas tus menyuam loj hlob raws li tus qauv. Qhov no piav qhia yog vim li cas, thaum leej niam qhov siab suav nrog, Is Nrias teb feem ntau ntawm stunting pom qhov kev hloov kho qis dua ntawm 13 feem pua ntawm cov ntsiab lus, txhais tau hais txog 15 lab tus menyuam tsawg dua.6
Qhov kev hloov kho qis qis tau pom nyob thoob plaws txhua lub xeev thiab thaj chaw koom siab hauv Is Nrias teb mus rau qhov sib txawv (cov ntawv ntxiv 1). Hauv Uttar Pradesh, Bihar, Madhya Pradesh, thiab Rajasthan - tag nrho cov xeev uas muaj kev sib tw loj heev - muaj kev hloov kho qis dua 10 feem pua los yog ntau dua. Kerala thiab Goa tsuas muaj kev hloov kho qis qis. Tsis tas li ntawd, 603 ntawm 640 koog tsev kawm ntawv tau rov qab kho dua ntawm qhov muaj feem ntau ntawm stunting tom qab standardizing rau leej niam qhov siab (appendix 2). Cov cheeb tsam nrog cov niam luv luv ntawm qhov nruab nrab thiab muaj zog sib raug zoo ntawm leej niam qhov siab thiab stunting yuav muaj kev hloov kho qis dua piv nrog cov cheeb tsam uas qhov nruab nrab ntawm niam qhov siab tau ze rau MGRS tus qauv thiab qhov sib txheeb ntawm leej niam qhov siab thiab stunting tsis muaj zog. Ob txoj hauv kev ntawm kev suav nyiaj rau leej niam qhov siab thaum kwv yees qhov feem ntau ntawm stunting (piv txwv li, siv cov qauv ncaj qha [tus qauv kev nthuav dav ntawm stunting] thiab kev kwv yees raws li kev rov ua dua [qhov kev kwv yees prevalence ntawm stunting]) feem ntau ua rau cov kwv yees zoo sib xws (appendix 1, 2) .6
Cov kev hloov kho qis qis no tsis tas txhais tau tias stunting thiab undernutrition tsis muaj teeb meem hauv Is Nrias teb. Tseeb tiag, nrog rau qhov tsis txaus ntseeg ntawm 25 feem pua (txawm tias tom qab niam-qhov siab standardization) nws yog qhov tseeb tias Is Nrias teb nyob deb ntawm qhov kev cia siab zoo tshaj plaws stunting prevalence ntawm 2·3 feem pua. Qhov tseeb tiag, nws zoo li qhov teeb meem hauv qab ntawm cov menyuam yaus tsis muaj zaub mov zoo tsuas yog ua rau muaj kev cuam tshuam los ntawm COVID-19 cuam tshuam.8
Nyob rau hauv cov ntsiab lus, lub stunting metric, vim nws rhiab heev rau leej niam qhov siab, tsis tuaj yeem txheeb xyuas qhov twg ntawm lub nra hnyav tam sim no. Ntawm cov phiaj xwm ntsuas tau txheeb xyuas hauv POSHAN Abhiyaan, stunting tsawg kawg yog qhov qhia txog kev noj zaub mov tshwj xeeb tam sim no thiab cov khoom noj muaj txiaj ntsig zoo. Anthropometric-raws li kev ntsuas kev noj zaub mov tsis zoo, feem ntau, yog qhov nyuaj thiab tsis muaj qhov tseeb txhawm rau txheeb xyuas qhov tsis txaus noj zaub mov ntawm cov menyuam yaus.9,10 Raws li POSHAN Abhiyaan 2.0 yog tsim los, kev xav txog kev xav txog kev xaiv ntawm kev soj ntsuam cov ntsuas uas meej. thiab raug ntes Is Nrias teb cov teeb meem kev noj haus tam sim no tau raug ceeb toom sai.
*SV Subramanian, Omar Karlsson, Rockli Kim
Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA (SVS); Department of Social and Behavioral Sciences (SVS) thiab Takemi Program in International Health (OK), Harvard University TH Chan School of Public Health, Boston, MA, USA; Division of Health Policy and Management, College of Health Science, Kauslim University, Seoul, Kauslim Teb (RK); Interdisciplinary Program nyob rau hauv Precision Public Health, Department of Public Health Sciences, Graduate School of Kauslim University, Seoul, Kauslim Teb (RK)
Kev siv
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