Weak delivery systems reduce the potential of evidence-supported interventions to improve nutrition. We synthesized the evidence for the effectiveness of nutrition-specific intervention delivery platforms for improving nutrition outcomes in low and middle-income countries (LMIC). A systematic literature search for studies published from 1997 to June 2018 resulted in the inclusion of 83 randomized controlled trials (RCTs), quasi-randomized, and controlled before-after studies across a variety of delivery platforms. In this paper, we report on meta-analysed outcomes for community health worker (CHW) home visits and mother/peer group delivery platforms. Compared to care as usual, CHW home visits increased early initiation of breastfeeding (EIBF) (OR: 1.50; 95% CI: 1.12, 1.99; n = 10 RCTs) and exclusive breastfeeding (EBF) (OR: 4.42; 95% CI: 2.28, 8.56; n = 9 RCTs) and mother/peer groups were effective for improving children's minimum dietary diversity (OR: 2.34; 95% CI: 1.17, 4.70; n = 4) and minimum meal frequency (OR: 2.31; 95% CI: 1.61, 3.31; n = 3). Pooled estimates from studies using both home visit and group platforms showed positive results for EIBF (OR: 2.13; 95% CI: 1.12, 4.05; n = 9), EBF (OR: 2.43; 95% CI: 1.70, 3.46; n = 12), and < 5 wasting (OR: 0.77; 95% CI: 0.67, 0.89; n = 4). Our findings underscore the importance of interpersonal community platforms for improving infant and young child feeding practices and children's nutritional status in LMICs.Nutrients 2020, 12, 440 2 of 16 due to limited knowledge surrounding how best to integrate nutrition-focused interventions into these routine activities at the country level [13].Emerging evidence indicates that advancements in nutrition require nutrition-sensitive programmes that enhance the coverage and effectiveness of direct nutrition interventions [14]. Cash transfers requiring compliance with specific health/nutrition behaviours are commonly used in social protection/safety net programmes in LMICs [15,16]. Though evidence suggests they are effective for poverty reduction [14,17,18], there is limited high-quality evidence on the effectiveness of conditional cash transfers (CCTs) for improving nutrition-specific outcomes among women and children [19]. Mobile health (mHealth) technologies (e.g., SMS messaging) are increasingly being used in global nutrition programming, yielding potentially cross-cutting benefits through linkages with community and financial platforms [20]. However, knowledge gaps remain surrounding the effectiveness of mHealth platforms for delivering nutrition-specific interventions [21,22].We reviewed the available evidence to assess the effects of community-, financial-and technology-based nutrition intervention delivery platforms for improving nutrition outcomes in LMICs. In this paper, we report on meta-analysed outcomes for community health worker (CHW)/lay counselor home visits and mother/peer groups, which emerged as the most widely used community-based platforms for delivering nutrition-specific interventions in our review. Whil...

BACKGROUND About half of global under-5 child mortality, or about 3 million deaths, are linked to poor nutrition (UN Inter-agency Group for Child Mortality, 2017; UNICEF, 2018). The effects of compromised nutrition at an early age are evident throughout the life course, with physical and cognitive impairments affecting health, learning, and economic potential (Martins, Toledo Florêncio, & Grillo, 2011). Good nutrition is also important beyond the childhood years, with adolescent girls being especially vulnerable to undernutrition because of their higher nutritional requirements, particularly those who might become pregnant. Therefore, a focus on adolescent girls' nutrition is important to ensure adequate prepregnancy nutrition for maternal, fetal, and infant health. Evidence suggests under-5 child mortality can be reduced by 15% with 90% coverage of 10 evidence-based nutrition interventions (Bhutta, Das, & Rizvi, 2013). However, despite evidence of efficacy generated from controlled settings, the potential impacts of what are considered "proven" nutrition interventions are often not realized in real-world environments due to ineffective delivery channels for achieving high and equitable coverage. A review by Ramakrishnan et al. (2014) noted that while prenatal proteinenergy and iron folic acid supplementation have been shown to reduce low birth weight by 20-30% in trial settings, variable implementation has led to uncertain effectiveness. Menon et al. (2014) also acknowledge evidence supporting effective delivery platforms for nutrition-specific interventions remains limited. Of particular concern are gaps in how to successfully reach adolescents with evidence-based nutrition interventions in low-and middle-income countries (LMIC) (Bhutta, Lassi, & Bergeron, 2017; Salam, Hooda and Das, 2016). Our review considers delivery platforms that can improve coverage of nutrition-specific interventions at all stages of the life course from preconception to pregnancy, infancy, childhood, and adolescence. The review is part of a series of concurrent reviews to produce up-to-date evidence on preventive and curative nutrition interventions across the lifecycle. 1.1 | Description of the condition The review will consider platforms for interventions to address a variety of nutrition-specific conditions. We will examine the effects of using community, financial, and technology platforms for delivering evidence-based nutrition-specific interventions to improve nutrition behaviors and outcomes for women, children, and adolescents in LMICs. For the purpose of our review, a "platform" is defined as a modality through which a service is made available to target beneficiaries.