Improving Maternal and Infant Nutrition: A Framework for Action

5.18 The outcomes identified in the logic model need to be considered alongsidethose in The Early Years National Logic Model and the 4 Equally Well Logic Models,along with the Health Promoting Health Service “Every Healthcare contact is aHealth Improvement Opportunity” 785.19 Addressing inequality is a key aim of Scottish Government policy. It isproposed that there are three ways of tackling health inequalities. 791. Improving the health of the poor2. Narrowing health gaps3. Reducing health gradients5.20 The logic model attempts to target the most disadvantaged by being specificabout the population group whom activities are intended to reach, for examplespecific groups of women who are at risk of poor nutrition during pregnancy andthose least likely to breastfeed. As far as possible the outcomes in the logic modelare inequalities sensitive to attempt to reduce the gaps between groups. Forexample, if an outcome is to improve breastfeeding rates, it is focused on improvingbreastfeeding rates in all population groups. However if at the same time asimproving rates overall, the gap in breastfeeding rates between groups is to bereduced, then as well as rates in the whole population improving, they need toimprove faster in deprived communities. Since breastfeeding rates tend to be lowerin deprived communities, investment will need to be heavily weighted towardsinterventions here.5.21 Clearly, the achievement of the long term outcomes is dependent on otherwork and will not be achieved solely by the delivery of the Framework to improvematernal and infant nutrition, for example work underway to tackle overweight andobesity and work to improve the availability and affordability of healthy food and drinkwill have a significant impact on these outcomes.Mapping of Evidence to the Identified Outcomes5.22 While the refinement of the outcomes took place over several monthlymeetings, a small group comprising each sub-group Chair, the Infant Nutrition Coordinator,plus others, considered the implications of NICE Public Health Guidance11 75 for the Framework. This small group mapped the recommendations from NICEGuidance/Scottish Perspective to the short, medium and long term outcomes. Therationale for this process was that each recommendation made by NICE wasunderpinned by a robust and acceptable evidence base. Therefore, it wasconcluded, if the recommendations from NICE Guidance/Scottish Perspective wereimplemented in Scotland, progress towards the outcomes identified in the logicmodel could be achieved.Generation of Activities to Achieve Outcomes5.23 The Education, Training and Practice Development sub-group and theCommunication and Engagement sub-group were asked to identify what activitieswould be required to achieve the short and medium term outcomes relevant to theirsub-group theme.