Objective To explore the situation of nutrition services in maternal and child health institutions and their association with the nutrition and health status of mothers and children. Methods In 2020, we used an online information retrieval method to investigate the nutrition services of 441 maternal and child health institutions in provincial cities, municipal districts, and prefectural cities in China. Based on data from China Nutrition and Health Surveillance on Children and Adolescents Aged 0-17 Years and Postpartum Mothers (2016-2017), we compared the nutrition and health status of mothers and children among regions with and without nutrition services. Results There were 246 maternal and child health institutions having official websites, and the proportions of providing nutrition services accounted for 49.6% and 53.3% for women and children, respectively. Only 3.3% of the institutions hired full-time nutrition service staff. The proportions of nutrition services for women affiliated with health departments, obstetrics and gynecology, and nutrition departments accounted for 45.9%, 39.3%, and 14.8%, respectively. Nutrition services for children were mainly affiliated with child health departments, accounting for 93.9%. Compared with regions where there was no nutrition service for women and children, women in regions where there were nutrition services for women and children had a lower risk of excessive gestational weight gain, dyslipidemia, vitamin D deficiency, low serum albumin, and low serum total protein at postpartum (P<0.05); meanwhile, children in these regions had a lower risk of overweight (P<0.05), and children under six months of age were more likely to be predominantly breastfed (P<0.05). Conclusion The coverage of nutrition services is relatively low in Chinese maternal and child health institutions, which is not conducive to maternal and child health. We suggest implementing relevant national policies, improving department settings and staffing, establishing standards related to nutrition services and covering service costs in the health insurance payment system, and stabilizing, deepening, and expanding the content of nutrition services to promote maternal and child health.
Key words
nutrition service /
child malnutrition /
maternal health /
nutrition survey
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] 中国妇幼健康事业发展报告(2019)(一)[J]. 中国妇幼卫生杂志, 2019, 10: 1–8.
[2] 中国妇幼健康事业发展报告(2019)(二)[J]. 中国妇幼卫生杂志, 2019, 10: 1–7.
[3] 王杰, 段一凡, 庞学红, 等. 2013年中国足月单胎产妇孕期增重情况及适宜范围探讨[J]. 中华预防医学杂志, 2018, 52: 313–317.
[4] 国家卫生健康委员会. WS/T 801-2002妊娠期妇女体重增长推荐值标准 [S/OL]. (2022-07-28)[2022-08-19]. http://www.nhc.gov.cn/wjw/fyjk/202208/864ddc16511148819168305d3e576de9.shtml.
[5] 王杰. 中国居民营养与健康状况监测报告之十:2010-2013年中国孕妇乳母营养与健康状况 [M]. 北京: 人民卫生出版社, 2020:9-11.
[6] 杨振宇. 中国居民营养与健康状况监测报告之九:2010-2013年中国0-5岁儿童营养与健康状况 [M]. 北京: 人民卫生出版社, 2020:13–15.
[7] 全国人民代表大会常务委员会. 中华人民共和国母婴保健法[J]. 中华人民共和国全国人民代表大会常务委员会公报, 2017(6): 888–891.
[8] 国家卫生计生委办公厅. 关于印发各级妇幼健康服务机构业务部门设置指南的通知[J]. 中华人民共和国国家卫生和计划生育委员会公报, 2015(12): 37–59.
[9] 国家卫生计生委办公厅. 关于印发《国家基本公共卫生服务规范(第三版)》的通知[J]. 中华人民共和国国家卫生和计划生育委员会公报, 2017(3): 21.
[10] 冯莹, 饶燕珍, 吴金来, 等. 三甲医院产科营养门诊实践模式的实施与效果评价[J]. 世界最新医学信息文摘, 2018, 18: 132–133,135.
[11] 李沙沙, 郎芳, 孙洁, 等. 营养门诊个体化医学营养干预对妊娠期糖尿病患者治疗效果的影响[J]. 卫生研究, 2020, 49: 667–669.
[12] 苏海兰, 罗丽琼. 糖尿病一日门诊营养干预对孕妇血糖控制、母婴结局及新生儿免疫功能的作用[J]. 中国计划生育学杂志, 2020, 28: 690–692.
[13] Ge J, Wang D, Fan L.Effect of personalized nutrition guidance on the birth rate of fetal macrosomia in Chinese population: a meta-analysis of nine randomized control-led trials[J]. Cell Biochem Biophys, 2015, 72: 669–674.
[14] Gresham E, Byles JE, Bisquera A, et al. Effects of dietary interventions on neonatal and infant outcomes: a systematic review and meta-analysis[J]. Am J Clin Nutr, 2014, 100: 1298–1321.
[15] Amorim AR, Linne YM. Diet or exercise, or both, for weight reduction in women after childbirth [J]. Cochrane Database Syst Rev, 2013(7): CD005627.
[16] Mead E, Brown T, Rees K, ,et al. Diet. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years [J]. Cochrane Database Syst Rev, 2017, 6: CD012651.
[17] Colquitt JL, Loveman E, O'malley C, ,et al. Diet. Diet, physical activity,behavioural interventions for the treatment of overweight or obesity in preschool children up to the age of 6 years [J]. Cochrane Database Syst Rev, 2016, 3: CD012105.
[18] 丁强, 冯小梅. 儿童保健门诊中婴幼儿营养性贫血治疗方法及效果[J]. 中西医结合心血管病电子杂志, 2020, 8: 39.
[19] Moorthy D, Merrill R, Namaste S, et al. The impact of nutrition-specific and nutrition-sensitive intervene-tions on hemoglobin concentrations and anemia: a meta-review of systematic reviews[J]. Adv Nutr, 2020, 11: 1631–1645.
[20] 国务院办公厅. 国民营养计划(2017—2030年) [EB/OL]. (2017-07-13) [2017-07 -15].https://www.gov.cn/zhengce/content/2017-07/13/content_5210134.htm.
[21] 国家卫生健康委办公厅. 临床营养科建设与管理指南(试行) [EB/OL]. (2022-03-18)[2022-05-20].http://www.nhc.gov.cn/yzygj/s7659/202203/106295a75d5e426991616dc0f201b847.shtml.
[22] 国家卫生健康委办公厅. 超声诊断等5个专业医疗质量控制指标(2022年版) [EB/OL]. (2022-05-27)[2022-08-10].http://www.nhc.gov.cn/yzygj/s7657/202205/56765f0f512f4f058efc4169a0e1c639.shtml.