Review of policies, data, and interventions to improve maternal nutrition in Afghanistan

Abstract

Malnutrition contributes to direct and indirect causes of maternal mortality, which is particularly high in Afghanistan. Women's nutritional status before, during, and after pregnancy affects their own well‐being and mortality risk and their children's health outcomes. Though maternal nutrition interventions have documented positive impact on select child health outcomes, there are limited data regarding the effects of maternal nutrition interventions on maternal health outcomes globally. This scoping review maps policies, data, and interventions aiming to address poor maternal nutrition outcomes in Afghanistan. We used broad search categories and approaches including database and website searches, hand searches of reference lists from relevant articles, policy and programme document requests, and key informant interviews. Inclusion and exclusion criteria were developed by type of source document, such as studies with measures related to maternal nutrition, relevant policies and strategies, and programmatic research or evaluation by a third party with explicit interventions targeting maternal nutrition. We abstracted documents systematically, summarized content, and synthesized data. We included 20 policies and strategies, 29 data reports, and nine intervention evaluations. The availability of maternal nutrition intervention data and the inclusion of nutrition indicators, such as minimum dietary diversity, have increased substantially since 2013, yet few nutrition evaluations and population surveys include maternal outcomes as primary or even secondary outcomes. There is little evidence on the effectiveness of interventions that target maternal nutrition in Afghanistan. Policies and strategies more recently have shifted towards multisectoral efforts and specifically target nutrition needs of adolescent girls and women of reproductive age. This scoping review presents evidence from more than 10 years of efforts to improve the maternal nutrition status of Afghan women. We recommend a combination of investments in measuring maternal nutrition indicators and improving maternal nutrition knowledge and behaviours.

Nutritional and health status of Afghan refugee women living in Punjab: A cross‐sectional study

“…Proper nutrition and healthy eating habits are essential for survival, physical development, mental health, performance, and overall health (Khan, Khanlou, et al, 2018 ), whereas household food insecurity leads to poor physical and mental health, frequent hospitalizations, and premature deaths of infants (Hutchinson & Tarasuk, 2022 ). Maternal nutrition involves nutrition during antenatal or postnatal stages and also the time before conception and even starting from adolescence when early childbearing is normal (Kim et al, 2020 ). Adolescent population mostly experiences nutritional challenges, which strongly impacts their growth and development (Kumar, 2015 ).…”

“…Refugees face a high risk of malnutrition due to poor socioeconomic status, food insecurity, and insufficient health‐care facility (Saeedullah et al, 2021 ). Malnutrition is directly or indirectly responsible for maternal mortality and is particularly high in Afghanistan (Kim et al, 2020 ). Afghans are staunch Muslims (Malik et al, 2019 ), and Afghan women are less educated than men, marry at a young age, and have many babies until a boy is born (Smith, 2009 ).…”

Effect of nutrition assessment, counselling and support integration on mother- infant nutritional status, practices and health in Tororo and Butaleja districts, Uganda: A comparative non equivalent quasi experimental study

“…Future nutrition interventions should therefore be tailored to the specific needs and context of the target population. Furthermore, the study re-enforces, existing body of evidence indicating that maternal focused interventions particularly those with a multi-sectoral nature contribute to improved maternal diet diversity, micronutrient intake and overall nutritional status [29][30][31].…”

Maternal anaemia prevention and control in China: A policy review

“…In 2018, Lesotho had made substantial progress in the maternal and child nutrition surveillance policy, but it needed to increase investment in capacity strengthening of national food and nutrition offices, and enhanced collaboration with the agricultural department (Mugomeri, 2018 ). In 2020, a review reported that maternal anaemia interventions were incorporated in Afghanistan's health and nutrition‐related policies, however, the government did not develop specific goals to measure effectiveness (Kim, 2020 ).…”