TY - JOUR
T1 - A systematic review and implementation evaluation of feeding programmes for infants and young children
T2 - findings and implications
AU - Kristjansson, E
AU - Francis, D.
AU - Liberato, Selma
AU - Benkhalti- Jandu, M.
AU - Welch, Vivian
AU - Batal, Malek
AU - Greenhalgh, P.
AU - Rader, Tamara
AU - Noonan, Eamonn
AU - Shea, Beverley
AU - Janzen, Laura
AU - Wells, George
AU - Petticrew, Mark
PY - 2013/9
Y1 - 2013/9
N2 - Background and
objectives: Under-nutrition
contributes to five million deaths of children under five each year. Throughout
the life cycle, under nutrition contributes to increased risk of infection,
lowered cognitive performance, chronic disease in adulthood, and mortality. In
order to intervene effectively, we need to understand what works, what doesn’t,
and why. The aims of the present study were: 1to assess the effectiveness of
feeding programs for children aged three months to five years.2 To undertake an
implementation evaluation.
Methods: We included RCTs,
CCTs and CBAs. Programs provided energy and nutrients through: hot or cold
meals, snacks, take-home or home-delivered rations. Recipients had to be aged
three months to five years, from all countries. We used standard systematic
review methods and evaluated implementation, including nutritional quality of
the food.
Results: Searches identified 29387 papers: 290 were retrieved
and 28 studies met inclusion criteria; 26 were from LMIC. Energy provided in 15
studies ranged from 20% to 157% of the recommended daily allowance (RDA) and
protein ranged from 18% to 425% of the RDI. Our meta-analyses showed small (.26
cm) significant effects on height gain in RCTs, but no other effects on growth.
A few studies showed effects on cognitive ability (SMD = 3.06, 95% CI = 2.6 to
3.6) and psychomotor development (SMD = 1.4, 95% CI .56 to 2.2) in RCTs. We
will present results of subgroup analyses by age, initial nutritional status,
nutritional adequacy, and delivery mode. Our implementation review identified
potential reasons for the ineffectiveness of some programs, including:
inadequate energy, redistribution of food within the family, lack of
supervision, pipeline breaks, caregiver stress and child disease.
Conclusion: This review provides evidence that feeding programs for young
children can work, but that many do not. Our review suggests several ways that
program design can be improved.
AB - Background and
objectives: Under-nutrition
contributes to five million deaths of children under five each year. Throughout
the life cycle, under nutrition contributes to increased risk of infection,
lowered cognitive performance, chronic disease in adulthood, and mortality. In
order to intervene effectively, we need to understand what works, what doesn’t,
and why. The aims of the present study were: 1to assess the effectiveness of
feeding programs for children aged three months to five years.2 To undertake an
implementation evaluation.
Methods: We included RCTs,
CCTs and CBAs. Programs provided energy and nutrients through: hot or cold
meals, snacks, take-home or home-delivered rations. Recipients had to be aged
three months to five years, from all countries. We used standard systematic
review methods and evaluated implementation, including nutritional quality of
the food.
Results: Searches identified 29387 papers: 290 were retrieved
and 28 studies met inclusion criteria; 26 were from LMIC. Energy provided in 15
studies ranged from 20% to 157% of the recommended daily allowance (RDA) and
protein ranged from 18% to 425% of the RDI. Our meta-analyses showed small (.26
cm) significant effects on height gain in RCTs, but no other effects on growth.
A few studies showed effects on cognitive ability (SMD = 3.06, 95% CI = 2.6 to
3.6) and psychomotor development (SMD = 1.4, 95% CI .56 to 2.2) in RCTs. We
will present results of subgroup analyses by age, initial nutritional status,
nutritional adequacy, and delivery mode. Our implementation review identified
potential reasons for the ineffectiveness of some programs, including:
inadequate energy, redistribution of food within the family, lack of
supervision, pipeline breaks, caregiver stress and child disease.
Conclusion: This review provides evidence that feeding programs for young
children can work, but that many do not. Our review suggests several ways that
program design can be improved.
U2 - 10.1159/000354245
DO - 10.1159/000354245
M3 - Meeting Abstract
SN - 0250-6807
VL - 63
SP - 541
EP - 541
JO - Annals of Nutrition and Metabolism
JF - Annals of Nutrition and Metabolism
IS - Suppl 1
M1 - PO444
ER -