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Thailand Nutrition in Transition: Situation and Challenges of Maternal and Child Nutrition

轉型中的泰國營養狀況:婦幼營養的現況及挑戰

摘要


營養不良的雙重負擔(DBMN),係指營養不足及營養過剩同時存在相同的族群,在發展中國家包含泰國,這是一個新近浮現的公共衛生問題。本篇文章使用大規模的國家性調查資料,回顧從低收入轉變為中等收入國家的過程中,婦幼營養的情況及趨勢。1980年代之前,蛋白質熱量營養不良及微量營養素缺乏顯著地影響媽媽及幼兒。這個情況在1980-1990年代,因多部門政策及計劃致力於執行扶貧及初級健康照護而大幅的改善。經濟的發展,改善健康服務的可近性及有效率的社區基礎營養計畫造就這些正向趨勢。然而,1990年代低出生體重的盛行率保持在8-10%,生長遲緩及體重過輕下降至約10%,爾後小幅度改變。懷孕婦女及兒童的貧血盛行率減少一半,而維生素A缺乏不再是公共衛生問題。碘缺乏,特別是懷孕期間,仍然是重要的關注點。當國家朝經濟及社會方面的發展前進,各個社經層面的婦女及兒童都受營養過剩的影響。在市鎮及鄉村地區都觀察到生活型態、食物可近性及飲食模式的改變。儘管已做出努力因應這些挑戰,針對複雜的社經環境中的DBMN問題,仍迫切需要一致性的政策及計畫。解決兒童肥胖及慢性疾病議題的同時,應考量幼兒期的營養不足。

關鍵字

母親 兒童 幼兒期 營養轉型期 泰國

並列摘要


Double burden of malnutrition (DBMN), the coexistence of under-and overnutrition in the same population, is an emerging public health concern in developing countries, including Thailand. This paper aims to review the maternal and child nutrition situation and trends as the country moved from a low-income to a middle-income country, using data from large scale national surveys. Protein-energy malnutrition and micronutrient deficiencies predominantly affected mothers and children prior to the 1980s. The situation greatly improved during the 1980s-1990s, with the implementation of multi-sectoral policies and programs focusing on poverty alleviation and primary health care. Economic development, improved access to health services and effective community-based nutrition programs contributed to these positive trends. However, the prevalence of low birth weight remained at 8-10%, while stunting and underweight declined to about 10% by the 1990s, with small change thereafter. The prevalence of anemia among pregnant women and children decreased by half and vitamin A deficiency is no longer a public health problem. Iodine deficiency, especially during pregnancy is still a major concern. As the country progressed in terms of economic and social development, overnutrition among women and children affected all socio-economic levels. Changes in lifestyles, food access and eating patterns are observed both in urban and rural areas. Although efforts have been made to address these challenges, harmonized policy and strategic programs that address DBMN in the complex social and economic environment are urgently needed. Early life undernutrition should be considered along with measures to address obesity and chronic diseases in children.

並列關鍵字

mothers children early life nutrition transition Thailand

參考文獻


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