Multisector nutrition gains amidst evidence scarcity: scoping review of policies, data and interventions to reduce child stunting in Afghanistan

Abstract

Background: Child health indicators have substantially improved across the last decade, yet Afghanistan has among the highest child stunting and malnutrition rates in Asia. Multisectoral approaches were recently introduced but evidence for this approach to improve support for and implementation of child nutrition programmes is limited compared to other countries. Methods: We reviewed policy and programme data to identify best practices and gaps surrounding child malnutrition in Afghanistan. We conducted a scoping review using broad search categories and approaches, including database and website searches, reference hand-searches, purposive policy and programme document request, and key informant interviews. Inclusion and exclusion criteria were developed iteratively, with abstracts and documents assessed against the final criteria. We abstracted documents systematically and summarised and synthesised content to generate the main findings. Results: We included 18 policies and strategies, 45 data sources and reports, and 20 intervention evaluations. Movement towards multisectoral efforts to address malnutrition at the policy level has started; however, integrated nutrition-specific and nutrition-sensitive interventions are not yet uniformly delivered at the community level. Many data sources capturing nutrition, food security and WASH (water, sanitation and hygiene) indicators are available but indicator definitions are not standardised and there are few longitudinal nutrition surveys. Political will to improve household nutrition status has shown increased government and donor investments in nutrition-sensitive and nutrition-specific programmes through combined small-and large-scale interventions between 2004 and 2013; however, evidence for interventions that effectively decrease stunting prevalence is limited.

Implementation Outcomes of National Convergence Action Policy to Accelerate Stunting Prevention and Reduction at the Local Level in Indonesia: A Qualitative Study

“…Learning from other countries, almost all of them have taken a long time to see the impact of implemented convergence policies on stunting reduction, such as Peru, Thailand, Vietnam, Brazil, and PNG [ 37 , 38 ]. This also occurred in Afghanistan—at the beginning of the implementation of the convergence, there was no uniformity for nutrition-specific and -sensitive intervention activities in the community, although the government’s political commitment began to increase [ 39 ]. Another obstacle in implementing the convergence policy at the sub-district level is that they do not manage finances.…”

Peran Ayah terhadap Kejadian Stunting pada Balita di Perdesaan

“…Research in Banyumas 60 and Aceh 40 , as well as other countries in Ethiopia 24,61 , also found similar things. Several other studies also found higher stunting in fathers with low education 27,32,[62][63][64][65] and no education 21,22,26 . Father's education was related to stunting in this study (Table 1).…”

“…Most of the stunted toddlers were found in fathers with a height < 162 cm (Table 1). Previous research showed fathers with heights < 160 cm 62 and < 165 cm 60 were more likely to have stunted toddlers. Research in the Philippines found that fathers under 5 feet tall were 4.7 times more likely to have stunted children than their counterparts over 5 feet tall 34 .…”

Literature Review: Daun Kelor (Moringa oleifera) sebagai Makanan Sehat Pelengkap Nutrisi 1000 Hari Pertama Kehidupan

“…Sepuluh intervensi telah diterapkan di Afghanistan sampai tingkat tertentu dan termasuk suplementasi asam folat perikonseptual, suplementasi protein energi seimbang ibu, suplementasi kalsium ibu, suplementasi multi mikronutrien pada kehamilan, promosi menyusui, makanan pendamping yang tepat, pemberian vitamin A dan suplementasi zinc preventif dalam anak usia 6-59 bulan, dan skrining dan pengelolaan malnutrisi akut dan kronis. Penargetan sangat penting untuk implementasi intervensi nutrisi berdampak tinggi pada skala besar (Kim, et al, 2020).…”