危机中的危机:新冠肺炎大流行在巴基斯坦五岁以下儿童严重急性营养不良社区管理中的作用

IF 4.1 Q1 HEALTH POLICY & SERVICES Avicenna Pub Date : 2023-01-05 DOI:10.5339/avi.2023.2
Munnaza Batool, Javeria Hassan, Ruhma Shahzad, S. Iqbal, Muhammad Salman Butt, S. Haider
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Methodology This study used a multicenter cross-sectional design in District Dera Ghazi Khan's rural areas located in the Southern Province of Punjab. Data were collected from the parents/guardians of SAM children through the researcher-administrated questionnaire. The sample size was 196, and data were analyzed through SPSS version 25. Results The majority of the children enrolled were males (52.5%), had fathers aged between 41 and 50 years (52.0%), mothers aged between 21 and 30 years (52.5%), had illiterate fathers (40.1%), illiterate mothers (73.8%) and had a monthly household income of PKR <15,000 (91.1%). All of the respondents mentioned that COVID-19 affected them in one way or the other (100.0%), with a majority of them did not visit the hospital during COVID-19 for their SAM child (52.5%) as they were afraid of COVID-19 (63.2%) and/or they lacked access to transport for visiting a hospital (93.4%). 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引用次数: 4

摘要

引言为了实现到2030年消除儿童营养不良的可持续发展目标2,巴基斯坦启动了一项基于社区的严重急性营养不良管理计划。该计划是在公共层面建立的,旨在早期发现和治疗无并发症的严重急性营养不良(SAM)儿童。然而,在新冠肺炎爆发期间,观察到对CMAM计划的遵守非常差。因此,儿童饮食的营养质量恶化,营养不良率预计还会上升。因此,本研究旨在评估新冠肺炎封锁对SAM儿童健康和遵守CMAM计划的影响。方法本研究采用多中心横断面设计,对位于旁遮普省南部的德拉加齐汗地区的农村地区进行研究。数据是通过研究人员管理的问卷从SAM儿童的父母/监护人那里收集的。样本量为196,数据通过SPSS 25版进行分析。结果被调查的儿童中,大多数为男性(52.5%),父亲年龄在41岁至50岁之间(52.0%),母亲年龄在21岁至30岁之间(5.25%),有不识字的父亲(40.1%),不识字的母亲(73.8%),家庭月收入低于15000 PKR(91.1%),他们中的大多数人在新冠肺炎期间没有为他们的SAM孩子去医院(52.5%),因为他们害怕新冠肺炎(63.2%)和/或他们缺乏去医院的交通工具(93.4%)。双变量分析显示,父亲的年龄(P=0.02)和收入(P=0.00)与新冠肺炎对收入的影响有关。相反,只有孩子的性别(P=0.00)与去医院就诊有关,孩子的性别和母亲的识字率(P=0.000)与从任何其他机构(包括Hakeem和Peer)选择治疗有关。结论本研究得出结论,新冠肺炎大流行等卫生紧急情况对获得医疗服务构成了重大障碍,并使SAM儿童等本已脆弱的群体处于更脆弱的状态。为了减少他们的脆弱性,应该引入移动医疗服务等举措,特别是定期为社会弱势社区、地方和群体提供服务,并应对未来的紧急情况。
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A crisis within a crisis: Role of COVID-19 pandemic in poor compliance of Community-based Management of Severe Acute Malnutrition among children younger than five years in Pakistan
Introduction In order to attain Sustainable Development Goal 2 (SDG-II) of eradicating malnutrition among children by 2030, Pakistan has initiated a Community-based Management of Severely Acute Malnutrition (CMAM) program. This program has been established at the public level to detect and treat uncomplicated Severely Acute Malnourished (SAM) children at an early stage. However, during the outbreak of COVID-19, very poor compliance with the CMAM program was observed. Consequently, the nutritional quality of children's diets has deteriorated, with malnutrition rates expected to rise. Therefore, this study has been set up to evaluate the effect of the COVID-19 lockdown on the health of SAM children and compliance with the CMAM program. Methodology This study used a multicenter cross-sectional design in District Dera Ghazi Khan's rural areas located in the Southern Province of Punjab. Data were collected from the parents/guardians of SAM children through the researcher-administrated questionnaire. The sample size was 196, and data were analyzed through SPSS version 25. Results The majority of the children enrolled were males (52.5%), had fathers aged between 41 and 50 years (52.0%), mothers aged between 21 and 30 years (52.5%), had illiterate fathers (40.1%), illiterate mothers (73.8%) and had a monthly household income of PKR <15,000 (91.1%). All of the respondents mentioned that COVID-19 affected them in one way or the other (100.0%), with a majority of them did not visit the hospital during COVID-19 for their SAM child (52.5%) as they were afraid of COVID-19 (63.2%) and/or they lacked access to transport for visiting a hospital (93.4%). Bivariate analysis revealed that the father's age (P = 0.02) and income (P = 0.00) is associated with the perceived effect of COVID-19 on income. In contrast, only the gender of the child (P = 0.00) is related to the visit to the hospital, and the gender of the child (P = 0.01) and mother's literacy (P = 0.00) is associated with the choice of treatment from any other setup, including Hakeem and Peer. Conclusion This study concludes that health emergencies like the COVID-19 pandemic pose a significant barrier to access to healthcare services and subject a more vulnerable state to already vulnerable groups like SAM children. To lessen their vulnerability, initiatives like mobile health care services should be introduced, especially for socially disadvantaged communities, localities, and groups on regular basis and for future emergencies.
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