四川省城乡医疗机构婴幼儿营养服务能力现况研究

丁彦曦; 张诗雨; 杨梦彤; 陈思佳; 张琚; 张飘; 李鸣; 苏丹萍; 董洪利; 郭怡杉; 阴文娅; 曾果

doi:10.12182/20240760503

四川省城乡医疗机构婴幼儿营养服务能力现况研究

Cross-Sectional Study of Nutritional Service Capacity for Infants and Toddlers in Urban and Rural Medical Facilities in Sichuan Province

摘要

摘要:
目的调查分析四川省城乡医疗机构婴幼儿营养服务能力现状及问题。
方法于2022年通过问卷调查收集四川省医疗机构婴幼儿营养服务内容（喂养指导、体格生长评价、微量营养素缺乏风险筛查）、人员及工具等信息，分析其营养服务现状及城乡差异。
结果共调查了2206所医疗机构（城市29.1%、农村70.9%）。3类营养服务均开展的医疗机构占比35.8%。营养服务总开展率分别为喂养指导94.6%、体格生长评价85.0%和微量营养素缺乏风险筛查37.4%，农村体格生长评价和微量营养素缺乏风险筛查总开展率均低于城市（P<0.05）。各喂养指导内容开展率为70.6%～93.2%，回应性喂养指导开展率最低（70.6%）且农村低于城市（P<0.05）；各体格生长评价和各微量营养素缺乏风险筛查内容开展率分别为75.3%～81.8%、23.6%～35.7%，且均农村低于城市（P<0.05）。营养服务人员主要为护士（52.3%）和临床执业医师（43.4%）。膳食评估工具配备率为7.7%～15.9%且农村低于城市（P<0.001），体格测量工具配备率为94.6%～98.5%。
结论目前四川省医疗机构婴幼儿营养服务内容不完善，喂养指导和体格生长评价开展不充分，微量营养素缺乏风险筛查开展不足，缺乏专业人员及工具，农村尤为突出。建议整体提高四川省婴幼儿营养服务能力，且需重点提高农村地区。

Abstract:
Objective To investigate and analyze the current status and challenges of infant and toddler nutritional services in urban and rural medical facilities in Sichuan Province.
Methods In 2022, a questionnaire survey was conducted to collect data on infant and toddler nutritional services, including feeding guidance, physical growth assessment, and micronutrient deficiency screening, as well as information on personnel and tools in medical facilities throughout Sichuan Province. The provision of nutritional services was analyzed and the urban-rural disparities were assessed.
Results A total of 2206 medical facilities (29.1% from urban areas and 70.9% from rural areas) were investigated. Only 35.8% of medical facilities provided all three types of nutritional services. Specifically, the overall service provision rates were high for feeding guidance (94.6%) and physical growth assessment (85.0%), but lower for micronutrient deficiency screening (37.4%). Rural facilities exhibited significantly lower rates than their urban counterparts for both physical growth assessment and micronutrient deficiency screening (P<0.05). The provision rates of feeding guidance ranged from 70.6% to 93.2%, with responsive feeding guidance being the least implemented (70.6%), particularly in rural areas compared to urban areas (P<0.05). Rates for physical growth assessment and micronutrient deficiency screening ranged from 75.3% to 81.8% and 23.6% to 30.8%, respectively, both showing lower rates in rural settings compared to urban ones (P<0.05). Nutrition service providers were predominantly nurses (52.3%) and clinical practitioners (43.4%). The availability of dietary assessment tools ranged from 7.7% to 15.9%, significantly lower in rural areas compared to urban areas (P<0.001), while physical measurement tools were widely available at rates of 94.6% to 98.5%.
Conclusion At present, the infant and toddler nutritional service provisions of medical facilities in Sichuan Province are incomplete, particularly so in the implementation of feeding guidance, physical growth assessment, and micronutrient deficiency screening. There is a notable shortage of personnel and necessary tools, with rural areas facing more significant challenges. Enhancing the overall capacity of infant and toddler nutritional services in Sichuan Province is essential, with specific attention needed for rural healthcare settings.

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