2015年-世界发展银行全球_The_Gambia_Impact_Evaluation_Baseline_Report___Child_Health_and_Nutrition_4页_444kb

报告摘要

Technical Brief Summary: The Gambia (December 2015)

Core Content

This technical brief summarizes the baseline findings of the Maternal and Child Nutrition and Health Results Project (MCNHRP) impact evaluation survey conducted in The Gambia between November 2014 and February 2015. The survey focused on child health and nutrition, with data collected from three regions: Central River Region (CRR), North Bank Region West (NBR-W), and Upper River Region (URR). The goal was to establish a baseline for assessing future project performance.

Key Findings

Child Malnutrition

Stunting: 25% of children under 5 were stunted, with the highest rate in CRR (28%) and lowest in URR (23%).
Wasting: 10% of children under 5 were wasted.
Underweight: 20% of children under 5 were underweight.
Wealth Gradient: Malnutrition rates decreased with increasing wealth.
Dietary Diversity: Only 11% of mothers of children under 24 months could describe the minimum dietary variety, and 4% in CRR could describe both variety and feeding frequency.

Nutrition Services Uptake

Growth Monitoring: Less than half of children under 5 had received growth monitoring in the previous six months.
Malnutrition Referrals: Only 34% of children identified as malnourished were referred for additional support, and even fewer received rehabilitation services.
Referral Rates: Referrals were particularly low in NBR-W and URR.

Breastfeeding

Exclusive Breastfeeding: 92% of mothers had heard about exclusive breastfeeding until 6 months, but only 49% practiced it.
Knowledge Gaps: Only 20% of women could list at least three benefits of breastfeeding.
Water Addition: 45% of mothers believed infants should receive water in addition to breast milk.

Childhood Illness

Malaria Prevalence: Reported prevalence of malaria among children under 5 was 0.5%, lower than the national estimate of 0.2% in 2014.
Illness Duration: Illness lasted an average of 2 days, with higher duration in lower wealth quintiles (2.6 days) compared to higher ones (1.6 days).

Care-Seeking and Health Services

Care-Seeking Behavior: Low care-seeking for childhood illnesses, especially malnutrition and diarrhea.
Health Facility Use: 31% used minor health centers, 11% used major health centers, 10% used pharmacies, and 8% used private clinics.
Vaccination Coverage: Overall coverage was high, but specific vaccines like Mebendazole and vitamin A were underutilized, especially in URR and CRR.

Vaccine Availability

BCG Vaccine: Only 23% of health workers knew when to administer the BCG vaccine.
Vaccine Stockouts: Essential vaccines and drugs were frequently unavailable. For example, only 33% of health facilities had folic acid, and 8% had ORS in stock.

Sanitation and Hygiene

Toilet Facilities: 35% of households had improved toilets, 61% had unimproved ones, and 4% had none.
Handwashing Stations: 37% of households had handwashing stations, with significant variation across regions (66% in URR, 18% in CRR).
Socioeconomic Gradient: Improved sanitation and hygiene facilities were more common in wealthier and more educated households.

Key Messages

Child malnutrition remains a significant issue, with high rates of stunting, wasting, and underweight.
There is a gap between knowledge and practice regarding exclusive breastfeeding.
Care-seeking for childhood illnesses, particularly for malnutrition and diarrhea, is low.
Vaccination coverage is high on average but varies by vaccine type, with some regions and vaccines showing low availability.
Essential drugs and vaccines are frequently in stockout, especially in NBR-W and URR.
Sanitation and hygiene practices vary widely, with a clear socioeconomic gradient.

Recommendations

Strengthen community-based nutrition and health services to improve malnutrition outcomes.
Enhance awareness and education on exclusive breastfeeding and its benefits.
Improve access to and availability of essential health services and vaccines.
Address the lack of knowledge among health workers regarding vaccine schedules.
Promote improved sanitation and hygiene practices, particularly in lower-income and less-educated communities.

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