Community-based care structures to promote nutritional health in the first 1000 days-Analysis of the status quo

Aim Nutrition in the first 1000 days of life is a relevant influencing factor for healthy (weight) development of children. Community- and population-based preventive approaches seem to be the most promising way in counteracting overweight (in childhood) and noncommunicable diseases. The aim of this study was to analyze the health care situation in terms of promoting nutritional health in the first 1000 days. Methods Based on an internet-based search of possible community-based practice projects, standardized, guideline-based interviews with experts from science and practice were conducted. The focus was on the general assessment of the health care situation or a possible need for action, as well as concrete recommendations, with special consideration of vulnerable groups. In all, 14 of 40 persons selected in a snowball procedure took part. Results All experts rated the current health care situation in terms of nutrition as insufficient. They were critical of the lack of a structural and political framework, in particular the frequent time limits of a program. As a result, measures to promote nutritional health or comparable interventions could not be successfully established. Therefore, clearer support by political and other relevant stakeholders, e.g., health insurances, and networking with or embedding of this topic area in public health services was demanded. Conclusion From the experts' point of view, our results confirm that the promotion of nutritional health in the first 1000 days is meaningful and important. However, there is a clear need to optimize care structures and the concrete, sustainable implementation of primary prevention services as well as low-threshold access for pregnant women and families in precarious living situations.