Unequal coverage of nutrition and health interventions for women and children in seven countries

Nguyen, Phuong Hong; Singh, Nishmeet; Scott, Samuel; Neupane, Sumanta; Jangid, Manita; Walia, Monika; Murira, Zivai; Bhutta, Zulfiqar Ahmed; Torlesse, Harriet; Piwoz, Ellen; Heidkamp, Rebecca; Menon, Purnima

doi:10.2471/blt.21.286650

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…This included a strong policy focus on nutrition intervention delivery through health system service delivery platforms such as well‐care contacts during and after pregnancy (i.e., antenatal care visits, skilled birth attendants, IFA supplementation, deworming, breastfeeding, and IYCF counselling), and child growth and development (i.e., management of diarrhoea, growth monitoring, immunisation, and identification and management of SAM and MAM). With regard to data gaps for the recommended nutrition interventions, we observed that India and Nepal had the most available coverage data, reported earlier (Nguyen et al, 2022 ), while Bhutan had the least. Data gaps were most common in counselling during pregnancy, interventions targeted at newborns, IYCF counselling, and identification and treatment of SAM and MAM.…”

Section: Discussionsupporting

confidence: 51%

Availability of national policies, programmes, and survey‐based coverage data to track nutrition interventions in South Asia

Neupane,

Jangid,

Scott

et al. 2023

Maternal & Child Nutrition

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Progress to improve nutrition among women, infants and children in South Asia has fallen behind the pace needed to meet established global targets. Renewed political commitment and monitoring of nutrition interventions are required to improve coverage and quality of care. Our study aimed to assess the availability of national nutrition policies, programmes, and coverage data of nutrition interventions for women, children, and adolescents in eight countries in South Asia. We reviewed relevant policy and programme documents, examined questionnaires used in the most recent rounds of 20 nationally representative surveys, and generated an evidence gap map on the availability of policies, programmes, and survey data to track progress on coverage of globally recommended nutrition interventions. Current policies and programmes in South Asian countries addressed almost all the recommended nutrition interventions targeted at women, children, and adolescents. There was a strong policy focus in all countries, except Maldives, on health system platforms such as antenatal and postnatal care and child growth and development. Survey data on nutrition intervention coverage was most available in India and Nepal, while Bangladesh and Bhutan had the least. Though countries in South Asia have committed to national nutrition policies and strategies, national surveys had substantial data gaps, precluding progress tracking of nutrition intervention coverage. Greater attention and effort are needed for multisectoral collaboration to promote and strengthen nutrition data systems.

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Section: Discussionsupporting

confidence: 51%

Availability of national policies, programmes, and survey‐based coverage data to track nutrition interventions in South Asia

Neupane,

Jangid,

Scott

et al. 2023

Maternal & Child Nutrition

Self Cite

View full text Add to dashboard Cite

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Effects of nutritional interventions on the physical development of preschool children: a systematic review and meta-analysis

Shi¹,

Ren²,

Jia³

2023

Transl Pediatr

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Background There is a significant correlation between diet and delayed growth and development in children. However, the evidence for the crucial role of dietary interventions in children’s growth and development health remains inconclusive. This meta-analysis sought to comprehensively evaluate the effects of nutritional interventions on children’s physical development. Methods Articles published from January 2007 to December 2022 were retrieved from the PubMed, Embase, Cochrane Library, Wanfang, and China National Knowledge Infrastructure (CNKI) databases. Statistical analysis was conducted using Stata/SE 16.0 software, as well as Review Manager 5.4 software. Results The meta-analysis included a total of 8 original studies. The total sample comprised 6,645 children aged <8 years. The results of meta-analysis were as follows: (I) there was no significant difference in the body mass index (BMI)-for-age z scores between the nutritional intervention group and the control group [mean difference (MD) =0.12, 95% confidence interval (CI): –0.07, 0.30]. Thus, the nutritional interventions did not significantly improve the BMI-for-age z scores; (II) when the nutritional intervention period was <6 months, there was no significant difference in the weight-for-height z scores between the nutritional intervention group and the control group (MD =0.47, 95% CI: –0.07, 1.00), but when the nutritional intervention period was ≥6 months, the nutritional interventions significantly improved the weight-for-height z scores (MD =0.36, 95% CI: 0.00, 0.72); (III) a nutritional intervention period ≥6 months cannot significantly improved children’s height-for-age z scores; (4) When the nutritional intervention period was <6 months, there was no statistically significant difference in the weight-for-age z scores between the nutritional intervention group and the control group (MD =–0.20, 95% CI: –0.60, 0.20), but when the nutritional intervention period was ≥6 months, the nutritional interventions significantly increased children’s weight-for-age (mean difference =2.23, 95% CI: 0.01, 4.44). Conclusions Different nutritional interventions had a slight improvement effect on children’s physical growth and development. However, the effect of the short-term nutritional interventions (<6 months) was not obvious. In clinical practice, it is recommended that nutritional intervention programs be formulated that can be implemented for longer periods. However, due to the limited literature included, further research is needed.

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Optimal Allocation of Antenatal and Young Child Nutrition Interventions: An Individual-Based GBD-Calibrated Microsimulation

Bowman,

Lutze,

Albright

et al. 2024

Preprint

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Background: Undernutrition remains a global crisis and is a focus of Sustain Development Goals. While there are multiple known, effective interventions, complex interactions between prevention and treatment and resource constraints can lead to difficulties in allocating funding. Simulation studies that use in silico computer simulation can help illuminate the interactions between interventions and provide insight into the cost-effectiveness of alternative packages of options. Methods: We developed an individual-based microsimulation model to test a range of antenatal and child nutrition interventions (iron and folic acid, multiple micronutrients, balanced energy protein supplementation, treatment for severe acute malnutrition, treatment for moderate acute malnutrition, and wasting prevention with small-quantity lipid-based nutrient supplements) and an analytic approach to processes the results of the microsimulation and provide the optimal intervention funding allocation for a given budget size. Results: The reallocation of the baseline budget to minimize DALYs resulted in first funding multiple micronutrients to their maximum coverage, and then funding treatment for severe acute malnutrition. Relative to the baseline allocation, the reallocation optimized to minimizing DALYs resulted in 592,000 fewer annual DALYs. For budgets larger than the baseline, our model recommended funding first targeted moderate acute malnutrition treatment, second universal moderate acute malnutrition treatment, third wasting prevention with small-quantity lipid-based nutrient supplements, and fourth balanced energy protein supplementation. Conclusions: Our simulation is a novel model for estimating optimal allocation of spending on antenatal and child health nutrition interventions. We utilized a detailed health model that accounts for the interaction between preventive and therapeutic approaches. Our results show that an optimized reallocation of current spending on multiple micronutrients and treatment for severe acute malnutrition can substantially improve pregnancy-related and child health without additional funding. Additionally, we provide direction for how to best allocate expanded budgets to maximize impact.

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Unequal coverage of nutrition and health interventions for women and children in seven countries

Cited by 4 publications

References 30 publications

Availability of national policies, programmes, and survey‐based coverage data to track nutrition interventions in South Asia

Availability of national policies, programmes, and survey‐based coverage data to track nutrition interventions in South Asia

Effects of nutritional interventions on the physical development of preschool children: a systematic review and meta-analysis

Optimal Allocation of Antenatal and Young Child Nutrition Interventions: An Individual-Based GBD-Calibrated Microsimulation

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