Capacity of Frontline ICDS Functionaries to Support Caregivers on Infant and Young Child Feeding (IYCF) Practices in Gujarat, India

印度Gujarat第一線整合兒童發展服務（ICDS）公務員支持嬰幼兒照護者從事餵食的能力

Anuraag Chaturvedi ； N Nakkeeran ； Minal Doshi ； Ruchi Patel ； Sadhana Bhagwat

《Asia Pacific Journal of Clinical Nutrition》 23卷S1期 (2014/11) Pp. s29-s37

https://doi.org/10.6133/apjcn.2014.23.s1.04

摘要

改善嬰幼兒餵食方式，具有改善印度兒童的成長及發育成果的潛力。印度Anganwadi工作人員為國家營養補充計畫的第一線公務人員，在社區中扮演推動嬰幼兒餵食方式的重要角色。本研究評估Anganwadi工作人員對於從事嬰幼兒餵食的知識，以及針對嬰幼兒餵食與照護者的諮商及影響的能力。80名來自Gujarat四個區的Anganwadi工作人員參與評估，評估他們在一系列與嬰幼兒餵食施行成功必要的競爭力。評估結果顯示，比起那些直接與餵食直接相關的壓力，Anganwadi工作人員具備較多與嬰幼兒餵食的知識，例如開始母乳哺育、哺乳前餵食及初乳、副食品的介入年齡、份數及餵食頻率。不過，Anganwadi工作人員的知識，與他們將知識應用於正式諮詢時傳授給照護者的能力，有極大的差異。在諮商時，普遍存在缺乏吸引照護者情感的能力、忽視孩童的哺餵歷史、主動聆聽技巧不足，以及沒有足夠能力提供照護者需求的建議。總而言之，需確保加強Anganwadi工作人員及照護者在嬰幼兒餵食方式的互動，改變訓練模式是必要的。應該以溝通過程及諮商為訓練的核心。

關鍵字

嬰幼兒餵食施行 ； 知識 ； 技巧 ； 整合兒童發展服務 ； Anganwadi工作人員 ； 印度

並列摘要

Improved infant and young child feeding practices have the potential to improve child growth and development outcomes in India. Anganwadi Workers, the frontline government functionaries of the national nutrition supplementation programme in India, play a vital role in promoting infant and young child feeding practices in the community. The present study assessed the Anganwadi Workers' knowledge of infant and young child feeding practices, and their ability to counsel and influence caregivers regarding these practices. Eighty Anganwadi Workers from four districts of Gujarat participated in assessment centres designed to evaluate a range of competencies considered necessary for the successful promotion of infant and young child feeding practices. The results of the evaluation showed the Anganwadi Workers possessing more knowledge about infant and young child feeding practices like initiation of breastfeeding, pre-lacteal feeding and colostrum, age of introduction of complementary foods, portion size and feeding frequency than about domains which appear to have a direct bearing on practices. A huge contrast existed between the Anganwadi Workers’ knowledge and their ability to apply this in formal counselling sessions with caregivers. Inability to empathetically engage with caregivers, disregard for taking the feeding history of children, poor active listening skills and inability to provide need-based advice were pervasive during counselling. In conclusion, to ensure enhanced interaction between the Anganwadi Workers and caregivers on infant and young child feeding practices, a paradigm shift in training is required, making communication processes and counselling skills central to the training.

並列關鍵字

infant and young child feeding practices ； knowledge ； skills ； ICDS ； Anganwadi Workers ； India