The Effects of Community Home Visit and Peer Group Nutrition Intervention Delivery Platforms on Nutrition Outcomes in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

• Main Authors: Amynah Janmohamed, Nazia Sohani, Zohra S Lassi, Zulfiqar A Bhutta
• Format: Article
• Language: English
• Published: MDPI AG 2020-02-01
• Series: Nutrients
• Subjects: nutrition; intervention; delivery; systematic review; low and middle-income country
• Online Access: https://www.mdpi.com/2072-6643/12/2/440

Weak delivery systems reduce the potential of evidence-supported interventions to improve nutrition. We synthesized the evidence for the effectiveness of nutrition-specific intervention delivery platforms for improving nutrition outcomes in low and middle-income countries (LMIC). A systematic literature search for studies published from 1997 to June 2018 resulted in the inclusion of 83 randomized controlled trials (RCTs), quasi-randomized, and controlled before&#8722;after studies across a variety of delivery platforms. In this paper, we report on meta-analysed outcomes for community health worker (CHW) home visits and mother/peer group delivery platforms. Compared to care as usual, CHW home visits increased early initiation of breastfeeding (EIBF) (OR: 1.50; 95% CI: 1.12, 1.99; <i>n</i> = 10 RCTs) and exclusive breastfeeding (EBF) (OR: 4.42; 95% CI: 2.28, 8.56; <i>n</i> = 9 RCTs) and mother/peer groups were effective for improving children&#8217;s minimum dietary diversity (OR: 2.34; 95% CI: 1.17, 4.70; <i>n</i> = 4) and minimum meal frequency (OR: 2.31; 95% CI: 1.61, 3.31; <i>n</i> = 3). Pooled estimates from studies using both home visit and group platforms showed positive results for EIBF (OR: 2.13; 95% CI: 1.12, 4.05; <i>n</i> = 9), EBF (OR: 2.43; 95% CI: 1.70, 3.46; <i>n</i> = 12), and &lt; 5 wasting (OR: 0.77; 95% CI: 0.67, 0.89; <i>n</i> = 4). Our findings underscore the importance of interpersonal community platforms for improving infant and young child feeding practices and children&#8217;s nutritional status in LMICs.