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LETTER TO EDITOR  
Year : 2021  |  Volume : 46  |  Issue : 1  |  Page : 157-158
 

Effectiveness of nutrition interventions on World Health Organization global nutrition targets: An evidence summary


Indian Institute of Public Health, Gandhinagar, Gujarat, India

Date of Submission20-Feb-2026
Date of Acceptance20-Jul-2013
Date of Web Publication1-Mar-2021

Correspondence Address:
Dr. Ritu Rana
Indian Institute of Public Health, Opp. Airforce Headquarters, Chiloda Road, Gandhinagar - 382 042, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijcm.IJCM_119_20

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How to cite this article:
Rana R, Mavalankar DV. Effectiveness of nutrition interventions on World Health Organization global nutrition targets: An evidence summary. Indian J Community Med 2021;46:157-8

How to cite this URL:
Rana R, Mavalankar DV. Effectiveness of nutrition interventions on World Health Organization global nutrition targets: An evidence summary. Indian J Community Med [serial online] 2021 [cited 2021 Apr 23];46:157-8. Available from: https://www.ijcm.org.in/text.asp?2021/46/1/157/310441




Sir,

Recognizing that accelerated action is needed to address the problem of undernutrition, the 65th World Health Assembly endorsed a comprehensive implementation plan on maternal, infant, and young child nutrition.[1] Under this plan, the World Health Organization (WHO) specified six Global Nutrition Targets-reducing stunting and wasting in children under five, halting childhood obesity, reducing anemia in women of reproductive age, reducing low-birth weight (LBW), and increasing the rate of exclusive breastfeeding (EBF) by 2025. These targets aim to identify priority areas and inspire country-level actions.

Since then, these targets were embedded in several policy documents, including the target 2.2 of the Sustainable Development Goals, to be achieved by 2030. India's National Nutrition Strategy with the vision of ”Kuposhan Mukt Bharat” is also aligned with these targets-the National Nutrition Mission (NNM) 2022 targets.[2] However, a recent national-level analysis of trends in the malnutrition indicators (from 1990 to 2017) suggested slow and minimal progress in achieving NNM 2022, as well as the WHO 2025 targets.[3] Similar trends have been reported for the majority of the low- and middle-income countries (LMICs).[4] Worldwide, in 2018, an estimated 149 million children were stunted and 49 million were wasted.[5]

To accelerate progress on global nutrition targets in LMICs, there is a need to identify high impact interventions. Numerous nutrition interventions, including nutrition-specific and nutrition-sensitive, have been tested for maternal and childhood outcomes, and several systematic reviews (SRs) have synthesized the evidence on the effectiveness of these interventions. While these individual reviews assess the effectiveness of specific interventions and/or outcomes, this might limit their ability to provide a comprehensive evidence base specific to WHO global nutrition targets. To fulfill this gap, we conducted an evidence summary-”effectiveness of nutrition interventions in LMIC.”[6] This evidence summary (meta-review) aimed at synthesizing the evidence on the effectiveness of various nutrition interventions on WHO global nutrition targets-related outcomes in LMICs by reviewing the existing SRs in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

The population included newborns, infants, children, adolescents, women, adults, and the elderly. The interventions included all nutrition-specific and nutrition-sensitive interventions, as mentioned in the lancet 2013 maternal and child nutrition series framework.[7] The outcome measures were the global nutrition targets-stunting, wasting, anemia, low-birthweight, and breastfeeding (we did not include obesity). We conducted a comprehensive search of 21 databases. A double-blind process was followed for screening, quality appraisal, and data extraction. The extracted data were narratively synthesized in line with the review objective, which involved a detailed examination of the summary findings (positive/no impact/mixed impact).

Our search identified 6597 records, of these, 61 were included in the final analysis. A majority included nutrition-specific interventions (n = 57). Most SRs focused on pregnant women, included randomized control trials and were high-medium quality. [Table 1] presents a summary of evidence on the effectiveness of nutrition interventions. Overall, 61 SRs examined the impact of 21 nutrition interventions (specific - 18, sensitive - 3) on LBW (n = 24), stunting (n = 21), wasting (n = 18), anemia (n = 16), and EBF (n = 6).
Table 1: Summary of evidence on effectiveness of nutrition interventions on global nutrition target-related outcome

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Only complementary feeding interventions showed evidence of a positive effect on reducing stunting and wasting. Three interventions-iron supplementations during pregnancy, iron-fortified foods, and Vitamin A supplementation showed evidence of a positive effect on reducing anemia among women. Similarly, another three interventions-micronutrient (single or multiple) supplementation/fortification, Vitamin D supplementation and maternal dietary (energy/protein) supplementation also showed a positive effect on reducing LBW. All breastfeeding interventions (peer support, counseling, and kangaroo mother care) showed a positive effect on improving EBF. The details of the effectiveness of these interventions on global nutrition targets are presented elsewhere.[6]

Globally, more than half of children between 0 and 5 months are not exclusively breastfed and one in every fifth child between 6 and 23 months is not consuming an adequate diet.[4] Unfortunately, either there is no data or low-quality data available (except iron) on implementation and coverage of maternal nutrition interventions-vitamin A, vitamin D, and dietary (energy/protein) supplementation. To be on-track or to fast-track progress on global nutrition targets, policymakers in LMICs could prioritize these interventions.

To conclude, our meta-review identified interventions with evidence of a positive impact on WHO global nutrition target-related outcomes (stunting, wasting, anemia, LBW, and EBF). We hope our evidence summary will provide directions to policymakers, and might inspire the country-level implementation of these interventions.

Financial support and sponsorship

This work was supported by the SARH (DFID) Systematic Review (SR) Programme for South Asia.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Global Targets 2025 to Improve Maternal, Infant and Young Children Nutrition. World Health Organization; 2017.  Back to cited text no. 1
    
2.
Nourishing India: National Nutrition Strategy, Government of India. Government of India. Available from: http://niti.gov.in/writereaddata/files/document_publication/Nutrition_Strategy_Booklet.pdf. [Last accessed on 2019 Sep 01].  Back to cited text no. 2
    
3.
Swaminathan S, Hemalatha R, Pandey A, Kassebaum NJ, Laxmaiah A, Longvah T, et al. The burden of child and maternal malnutrition and trends in its indicators in the states of India: The Global Burden of Disease Study 1990-2017. Lancet Child Adolescent Health 2019;3:855-70.  Back to cited text no. 3
    
4.
Fanzo J, Hawkes C, Udomkesmalee E, Afshin A, Allemandi L, Assery O, et al. 2018 Global Nutrition Report: Shining a Light to Spur Action on Nutrition; 2018.  Back to cited text no. 4
    
5.
United Nations Children's Fund, World Health Organization, World Bank. Levels and Trends in Child Malnutrition: Key Findings of the 2019 Edition of the Joint Child Malnutrition Estimates. Geneva: World Health Organization; 2019.  Back to cited text no. 5
    
6.
Effectiveness of Nutrition Interventions in Low and Middle Income Countries: A Systematic Review; 2018. Available from: https://assets.publishing.service.gov.uk/media/5b102555e5274a18f738df59/10A._Nutriton_Programmes-Evidence_Summary_Report-Final.pdf. [Last accessed on 2019 Sep 20].  Back to cited text no. 6
    
7.
Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al. Evidence-based interventions for improvement of maternal and child nutrition: What can be done and at what cost? Lancet 2013;382:452-77.  Back to cited text no. 7
    



 
 
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