Delivering nutrition interventions to women and children in conflict settings: a systematic review
Background Low/middle-income countries (LMICs) face triple burden of malnutrition associated with infectious diseases, and non-communicable diseases. This review aims to synthesise the available data on the delivery, coverage, and effectiveness of the nutrition programmes for conflict affected women...
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BMJ Publishing Group
2021-04-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/6/4/e004897.full |
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| author | Zulfiqar A Bhutta Michelle F Gaffey Jai K Das Mariella Munyuzangabo Fahad J Siddiqui Sarah Meteke Daina Als Reena P Jain Amruta Radhakrishnan Shailja Shah Anushka Ataullahjan Zahra Ali Padhani Wardah Ahmed |
| author_facet | Zulfiqar A Bhutta Michelle F Gaffey Jai K Das Mariella Munyuzangabo Fahad J Siddiqui Sarah Meteke Daina Als Reena P Jain Amruta Radhakrishnan Shailja Shah Anushka Ataullahjan Zahra Ali Padhani Wardah Ahmed |
| author_sort | Zulfiqar A Bhutta |
| collection | DOAJ |
| description | Background Low/middle-income countries (LMICs) face triple burden of malnutrition associated with infectious diseases, and non-communicable diseases. This review aims to synthesise the available data on the delivery, coverage, and effectiveness of the nutrition programmes for conflict affected women and children living in LMICs.Methods We searched MEDLINE, Embase, CINAHL, and PsycINFO databases and grey literature using terms related to conflict, population, and nutrition. We searched studies on women and children receiving nutrition-specific interventions during or within five years of a conflict in LMICs. We extracted information on population, intervention, and delivery characteristics, as well as delivery barriers and facilitators. Data on intervention coverage and effectiveness were tabulated, but no meta-analysis was conducted.Results Ninety-one pubblications met our inclusion criteria. Nearly half of the publications (n=43) included population of sub-Saharan Africa (n=31) followed by Middle East and North African region. Most publications (n=58) reported on interventions targeting children under 5 years of age, and pregnant and lactating women (n=27). General food distribution (n=34), micronutrient supplementation (n=27) and nutrition assessment (n=26) were the most frequently reported interventions, with most reporting on intervention delivery to refugee populations in camp settings (n=63) and using community-based approaches. Only eight studies reported on coverage and effectiveness of intervention. Key delivery facilitators included community advocacy and social mobilisation, effective monitoring and the integration of nutrition, and other sectoral interventions and services, and barriers included insufficient resources, nutritional commodity shortages, security concerns, poor reporting, limited cooperation, and difficulty accessing and following-up of beneficiaries.Discussion Despite the focus on nutrition in conflict settings, our review highlights important information gaps. Moreover, there is very little information on coverage or effectiveness of nutrition interventions; more rigorous evaluation of effectiveness and delivery approaches is needed, including outside of camps and for preventive as well as curative nutrition interventions.PROSPERO registration number CRD42019125221. |
| format | Article |
| id | doaj-art-c746de71cd82435ebe4f1fc2f2fb1441 |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-c746de71cd82435ebe4f1fc2f2fb14412025-08-20T01:59:26ZengBMJ Publishing GroupBMJ Global Health2059-79082021-04-016410.1136/bmjgh-2020-004897Delivering nutrition interventions to women and children in conflict settings: a systematic reviewZulfiqar A Bhutta0Michelle F Gaffey1Jai K Das2Mariella Munyuzangabo3Fahad J Siddiqui4Sarah Meteke5Daina Als6Reena P Jain7Amruta Radhakrishnan8Shailja Shah9Anushka Ataullahjan10Zahra Ali Padhani11Wardah Ahmed12Institute for Global Health and Development, Aga Khan University, South Central Asia and East AfricaCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada3 Institute for Global Health and Development, The Aga Khan University, Karachi, Sindh, PakistanCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaHealth Services and Systems Research, Duke-NUS Graduate Medical School, Singapore, SingaporeCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, CanadaCentre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada1 School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, AustraliaDivision of Women and Child Health, Aga Khan University, Karachi, PakistanBackground Low/middle-income countries (LMICs) face triple burden of malnutrition associated with infectious diseases, and non-communicable diseases. This review aims to synthesise the available data on the delivery, coverage, and effectiveness of the nutrition programmes for conflict affected women and children living in LMICs.Methods We searched MEDLINE, Embase, CINAHL, and PsycINFO databases and grey literature using terms related to conflict, population, and nutrition. We searched studies on women and children receiving nutrition-specific interventions during or within five years of a conflict in LMICs. We extracted information on population, intervention, and delivery characteristics, as well as delivery barriers and facilitators. Data on intervention coverage and effectiveness were tabulated, but no meta-analysis was conducted.Results Ninety-one pubblications met our inclusion criteria. Nearly half of the publications (n=43) included population of sub-Saharan Africa (n=31) followed by Middle East and North African region. Most publications (n=58) reported on interventions targeting children under 5 years of age, and pregnant and lactating women (n=27). General food distribution (n=34), micronutrient supplementation (n=27) and nutrition assessment (n=26) were the most frequently reported interventions, with most reporting on intervention delivery to refugee populations in camp settings (n=63) and using community-based approaches. Only eight studies reported on coverage and effectiveness of intervention. Key delivery facilitators included community advocacy and social mobilisation, effective monitoring and the integration of nutrition, and other sectoral interventions and services, and barriers included insufficient resources, nutritional commodity shortages, security concerns, poor reporting, limited cooperation, and difficulty accessing and following-up of beneficiaries.Discussion Despite the focus on nutrition in conflict settings, our review highlights important information gaps. Moreover, there is very little information on coverage or effectiveness of nutrition interventions; more rigorous evaluation of effectiveness and delivery approaches is needed, including outside of camps and for preventive as well as curative nutrition interventions.PROSPERO registration number CRD42019125221.https://gh.bmj.com/content/6/4/e004897.full |
| spellingShingle | Zulfiqar A Bhutta Michelle F Gaffey Jai K Das Mariella Munyuzangabo Fahad J Siddiqui Sarah Meteke Daina Als Reena P Jain Amruta Radhakrishnan Shailja Shah Anushka Ataullahjan Zahra Ali Padhani Wardah Ahmed Delivering nutrition interventions to women and children in conflict settings: a systematic review BMJ Global Health |
| title | Delivering nutrition interventions to women and children in conflict settings: a systematic review |
| title_full | Delivering nutrition interventions to women and children in conflict settings: a systematic review |
| title_fullStr | Delivering nutrition interventions to women and children in conflict settings: a systematic review |
| title_full_unstemmed | Delivering nutrition interventions to women and children in conflict settings: a systematic review |
| title_short | Delivering nutrition interventions to women and children in conflict settings: a systematic review |
| title_sort | delivering nutrition interventions to women and children in conflict settings a systematic review |
| url | https://gh.bmj.com/content/6/4/e004897.full |
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