Interventions to improve the nutritional status of children under 5 years in Ethiopia: a systematic review

Abstract

Objective: To conduct a systematic review of experimental or quasi-experimental studies that aimed to improve the nutritional status of under five years of age children in Ethiopia. Design: Embase, MEDLINE/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, and Academic Search Database were used to locate peer-reviewed studies, and Google Scholar and Open Dissertation were used to locate grey literatures. All searches were conducted between 2000 and November 2022. Setting: Ethiopia. Participants: Pregnant women and mothers with children aged 0-59 months. Results: Ten cluster randomised controlled trials (RCTs), six quasi-experimental studies and two individual RCTs were included. Out of the identified 18 studies, three studies targeted pregnant mothers. Our findings showed that almost two-thirds of published interventions had no impact on childhood stunting and wasting, and more than half had no impact on underweight. Some behaviour change communication (BCC) interventions, food vouchers, micronutrient supplementation, and quality protein maize improved stunting. Similarly, BCC and fish oil supplementation showed promise in reducing wasting, while BCC and the provision of quality protein maize reduced underweight. Additionally, water, sanitation and hygiene (WaSH) interventions provided to pregnant mothers and children under two years of age were shown to significantly reduce childhood stunting. Conclusion: Future childhood nutritional interventions in Ethiopia should consider adopting an integrated approach that combines the positive effects of interdependent systems such as BCC, food supplemental programmes (e.g., boosting protein and micronutrients), health interventions (e.g., strengthening maternal and childcare), WaSH and financial initiatives (e.g., monetary support and income schemes).