中国农村重点人群营养改善措施的系统评价

Nutrition Improvement Measures for Vulnerable Populations in Rural Areas of China: A Systematic Review

目的系统评价我国农村重点人群营养改善措施的实施情况、实施效果以及存在的问题。方法计算机检索VIP、CNKI、Wan Fang Data和CBM数据库,纳入所有关于我国农村重点人群营养改善措施的实施情况、实施效果以及存在问题的研究,检索时限截至2014年1月1日。由2位研究者按照纳入与排除标准筛选文献、提取资料和评价纳入研究的方法学质量后,对纳入研究从营养改善措施实施情况和实施效果等方面进行定性分析。结果共纳入79个研究。定性分析结果显示:纳入研究最早发表于1990年,38.0%的研究实施地区在我国西北和西南地区,31.6%的研究有基金资助,主要是国际基金;90.0%的研究以婴幼儿及10岁以下儿童作为营养改善对象;营养改善措施多样,55.7%的研究以容易实施的营养宣教作为营养改善手段,38.0%的研究干预时间不超过半年;32.9%的研究以血液指标作为结局评价指标;所有研究均表明各种营养改善措施均能提升农村重点人群的营养水平。结论我国农村重点人群的营养改善研究实施较早且以西部不发达地区为重点,但对重点人群的关注不平衡,尤其是对老年人的关注不够。面对面营养宣教是开展最多的营养改善措施,但它不能直观反映出营养状况的改变情况。另外,一些营养改善研究干预的时间较短,提示需要更多的政府或机构的经费资助。

Objective To systematically review the implementation status, effectiveness and existing problems of nutrition improvement measures for x-alnerable populations in rural areas of China. Methods All studies about the implementation status, effectiveness and existing problems of nutrition improvement measures for vulnerable populations in rural areas of China were electronically searched in VIP, CNKI, WanFang Data and CBM from inception to January ist, 2014. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies, and then performed qualitative analysis in terms of implementation effectiveness and situation. Results A total of 79 studies were finally induded. The results of qualitative analysis showed that： the earliest study was published in 1990; 38.0% of these studies were carried out in the southwest and northwest areas of China; 31.6% of these studies were financially supported, and most funds were provided by some international institutions; 90.0% of these research subjects focused on infants and children （under the age of 10）; a variety of nutrition improvement measures had been taken, and 55.7% of these interventions measures were nutrition education which could be implemented easily; the implementation duration of 38.0% of these measures lasted less than halfa year; 32.9% of these studies adopted the blood test to evaluate the outcomes of nutrition measures; all of the studies showed that nutrition levels of vulnerable populations in rural areas of China had been obviously improved by these measures. Conclusion The nutrition improvement measures for vul- nerable populations in rural areas of China have been implemented relatively earlier focusing on populations in West China where was less developed. However, an imbalance exists in the attention to target populations, especially to the elderly. Face to face nutrition education is most frequently taken; however, it could not directly reflect the changing of nutritional status. In addition, implementation duration is fairly short which indicates that more fund supports are needed from the government or institutions.