Effectiveness of nutrition training of health workers toward improving caregivers’ feeding practices for children aged six months to two years: a systematic review

Abstract

BackgroundNutrition training of health workers can help to reduce child undernutrition. Specifically, trained health workers might contribute to this end through frequent nutrition counseling of caregivers. This may improve child-feeding practices and thus reduce the risk of undernutrition among children of counseled caregivers. Although studies have shown varied impacts of health workers’ nutrition training on child feeding practices, no systematic review of the effectiveness of such intervention has yet been reported. Therefore, we conducted this study to examine the effectiveness of nutrition training for health workers on child feeding practices including feeding frequency, energy intake, and dietary diversity among children aged six months to two years.MethodsWe searched the literature for published randomized controlled trials (RCTs) and cluster RCTs using medical databases including PubMed/MEDLINE, CINAHL, EMBASE, and ISI Web of Knowledge, and through WHO regional databases. Our intervention of interest was nutrition training of health workers. We pooled the results of the selected trials, evaluated them using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) criteria, and calculated the overall effect size of the intervention in meta-analyses.ResultsTen RCTs and cluster RCTs out of 4757 retrieved articles were eligible for final analyses. Overall, health workers’ nutrition training improved daily energy intake of children between six months and two years of age. The pooled evidence from the three studies reporting mean energy intake per day revealed a standardized mean difference (SMD) of 0.76, 95% CI (0.63-0.88). For the two studies with median energy intake SMD was 1.06 (95% CI 0.87-1.24). Health workers’ nutrition training also improved feeding frequency among children aged six months to two years. The pooled evidence from the three studies reporting mean feeding frequency showed an SMD of 0.48 (95% CI 0.38-0.58). Regarding dietary diversity, children in intervention groups were more likely to consume more diverse diets compared to their counterparts.Conclusion and recommendationsNutrition training for health workers can improve feeding frequency, energy intake, and dietary diversity of children aged six months to two years. Scaling up of nutrition training for health workers presents a potential entry point to improve nutrition status among children.

Efetividade da Estratégia Nacional para Alimentação Complementar Saudável na melhoria da alimentação complementar de lactentes em um município do Sul do Brasil

“…Outros trabalhos têm demonstrado a influência dos profissionais de saúde na melhoria da alimentação infantil 27,28,29,30,31,32,33,34 . Destacamos a metanálise realizada por Sunguya et al 35 , que comprovou que a capacitação em nutrição dos profissionais de saúde melhorou a ingestão de energia, a frequência alimentar e a diversidade da dieta de crianças de 6 a 24 meses. Os autores concluíram que profissionais de saúde capacitados em nutrição infantil oferecem 36,37 .…”

Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training

“…Such practices include low feeding frequency, low dietary diversity, inadequate quantity, and diets with poor quality [1], [3]. Efforts to improve feeding practices can also improve undernutrition among children in developing countries [4]–[7].…”

The experiences of mothers and caregivers on feeding practices of children under the age of five years with undernutrition in Oshikoto region, Namibia

“…[3] It was indicated by other researchers that children under the age of five years are not fed with adequate variety of food as caregivers lack information related to nutrition. [4] Mothers and caregivers lack information related to nutrition, because they were not provided with such information by the health workers. [5] As a result, mothers/caregivers felt that whatever they feed their children contains sufficient nutrients.…”