Interventions to address maternal and childhood undernutrition: current evidence.
Study Goal
The researchers aimed to evaluate the impact of Vitamin A supplementation (VAS) on reducing all-cause mortality and infant mortality.
Results Summary
Vitamin A supplementation reduced all-cause mortality by 24% and resulted in a 14% reduction in the risk of infant mortality at 6 months.
Population
Infants and young children (neonatal and child interventions).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
daily iron supplementation | decrease | incidence of anemia | women | 69% | results in a reduction | #1 |
daily iron supplementation | decrease | incidence of low birthweight (LBW) | women | 20% | results in a reduction | #2 |
daily iron supplementation | increase | mean birthweight | women | - | improves | #3 |
MMN supplementation during pregnancy | decrease | number of LBW infants | pregnant women | 14% | significantly decrease | #4 |
MMN supplementation during pregnancy | decrease | small for gestational age (SGA) | pregnant women | 13% | significantly decrease | #5 |
Balanced protein-energy supplementation | decrease | incidence of SGA | - | 32% | reduces | #6 |
Balanced protein-energy supplementation | decrease | risk of stillbirths | - | 38% | reduces | #7 |
Antimalarials | increase | mean birthweight | pregnant women | significantly | increase | #8 |
Antimalarials | decrease | LBW | pregnant women | 43% | associated with a reduction | #9 |
Antimalarials | decrease | severe antenatal anemia | pregnant women | 38% | associated with a reduction | #10 |
educational/counseling interventions | increase | exclusive breastfeeding | - | 43% at 4-6 weeks | increased | #11 |
educational/counseling interventions | increase | exclusive breastfeeding | - | 137% at 6 months | increased | #12 |
Vitamin A supplementation (VAS) | decrease | all-cause mortality | - | 24% | reduces | #13 |
Vitamin A supplementation (VAS) | decrease | risk of infant mortality | - | 14% | results in a reduction | #14 |
Intermittent iron supplementation | decrease | risk of anemia | children | 49% | reduces | #15 |
Intermittent iron supplementation | decrease | iron deficiency | children | 76% | reduces | #16 |
Intermittent iron supplementation | increase | hemoglobin concentration | children | - | significantly improves | #17 |
Intermittent iron supplementation | increase | ferritin concentration | children | - | significantly improves | #18 |
Preventive zinc supplementation | decrease | morbidity from childhood diarrhea | populations at risk of zinc deficiency | - | decreases | #19 |
Preventive zinc supplementation | decrease | morbidity from acute lower respiratory infections | populations at risk of zinc deficiency | - | decreases | #20 |
Preventive zinc supplementation | increase | linear growth | infants and young children | - | increases | #21 |
Preventive zinc supplementation | increase | weight gain | infants and young children | - | increases | #22 |
hand washing with soap | decrease | diarrhea morbidity | - | 48% | significantly reduces | #23 |
water treatment | decrease | diarrhea morbidity | - | 17% | reduction | #24 |
The global burden of undernutrition remains high with little evidence of change in many countries. We reviewed the evidence of the potential nutritional interventions and estimated their effect on nutrition-related outcomes of women and children. Among the maternal interventions, daily iron supplementation results in a 69% reduction in incidence of anemia, 20% in incidence of low birthweight (LBW) and improves mean birthweight. MMN supplementation during pregnancy has been shown to significantly decrease the number of LBW infants by 14% and small for gestational age (SGA) by 13%. Balanced protein-energy supplementation reduces the incidence of SGA by 32% and risk of stillbirths by 38%. Antimalarials when given to pregnant women increase the mean birthweight significantly and were associated with a 43% reduction in LBW and severe antenatal anemia by 38%. Among the neonatal and child interventions, educational/counseling interventions increased exclusive breastfeeding by 43% at 4-6 weeks and 137% at 6 months. Vitamin A supplementation (VAS) reduces all-cause mortality by 24% and results in a 14% reduction in the risk of infant mortality at 6 months. Intermittent iron supplementation in children reduces the risk of anemia by 49% and iron deficiency by 76%, and significantly improves hemoglobin and ferritin concentration. Preventive zinc supplementation in populations at risk of zinc deficiency decreases morbidity from childhood diarrhea and acute lower respiratory infections, and increases linear growth and weight gain among infants and young children. Among the supportive interventions, hand washing with soap significantly reduces diarrhea morbidity by 48%, though it depends on access to water. The effect of water treatment on diarrhea morbidity also appears similarly large with a 17% reduction. Recent research has established linkages of preconception interventions with improved maternal, perinatal and neonatal health outcomes, and it has been suggested that several proven interventions recommended during pregnancy may be even more effective if implemented before conception. These proven interventions, if scaled up have the potential to reduce the global burden of undernutrition substantially.