Abstract

Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: A systematic review

Aishwarya Rao, MPH¹, Shivani Shenoy, MPH¹, Priyanka Sharma, MPH¹, Nusrat Aparna, MPH¹, Deborah Adenikinju, MPH¹, Chukwuemeka Iloegbu, MSc, MPH¹, Shreya Meda, BS¹, John Patena, DrPH, MPH, MA¹, Dorice L. Vieira, MLS, MA, MPH², Joyce Gyamfi, EdD, MS³ and Emmanuel Peprah, PhD¹
(1)New York University, New York, NY, (2)NYU Grossman School of Medicine/NYU Langone Health, Brooklyn, NY, (3)New York University School of Global Public Health, New York, NY

APHA 2023 Annual Meeting and Expo

Background: Malnutrition is a significant contributing factor in delaying progress made to reduce maternal mortality. We aim to analyze the feasibility, adoption, sustainability, and cost-effectiveness of evidence-based interventions (EBI) to reduce maternal malnutrition in low- and middle-income countries (LMICs).

Methods: A systematic review of EBI for maternal malnutrition in LMICs was conducted by retrieving articles from PubMed/Medline, Embase, APA PsycINFO, Cochrane Library, Global Health, and Web of Science. The search strategy included terms for maternal health and nutritional deficiencies.

Results: 149 articles were retrieved. Six articles met the inclusion criteria of being conducted in LMICs and discussed nutritional deficiency in maternal populations. All six studies evaluated adoption and sustainability of EBI. Five studies examined feasibility and cost-effectiveness using Iron-Folic Acid (IFA) supplementation. 1 study focused on micronutrient fortified beverages.

Conclusion: National supplementation programs lack effective delivery platforms which negatively impact its adoption. Some improvement in adoption of IFA supplementation is reported in middle income countries. Disparities in cost and access to micronutrient fortified beverages, IFA and calcium supplements at delivery platforms is a barrier. Poor supply chain highlights gaps in feasibility of implemented interventions. Balanced energy protein supplements is a sustainable approach with evidence of improved birth outcomes in undernourished pregnant women. Barriers that prevented the scalability of effective interventions, included socioeconomic factors such as poverty, discrimination, and low health literacy rates. Equity based holistic approaches to strengthen delivery platforms, access to nutritious food and stakeholder partnerships/ engagements can improve maternal health outcomes in LMICs.

Implementation of health education strategies, interventions and programs Provision of health care to the public Public health or related research