Abstract Digest on Maternal and Child Nutrition Research – Issue 21

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This issue of Abstract Digest presents two breakthrough studies that take a critical look at the association of water, sanitation, and handwashing (WASH) interventions with nutrition and a systematic review on enteric dysfunction and child stunting. Other interesting studies include those related to the design, cost and other program elements pertaining to diets for maternal and child health. Here is a list of all the articles included in this issue:

• Troeger and colleagues (2018) have presented disability-adjusted life-years estimates to drive home the point of substantial morbidity burden and long-term growth faltering effect of diarrheal diseases in children younger than five years.

  • • Analyzing evidence on the association of water, sanitation, and handwashing (WASH) interventions with nutrition:
    o The two WASH Benefits cluster-randomised controlled trials in Bangladesh (Luby et al. 2018) and Kenya (Null et al. 2018) did not find additional benefits of integrating water, sanitation, and handwashing with nutrition on linear growth. Menon and Frongillo (2018), commenting on the study findings of these two-well-designed cluster-randomised controlled trials, have highlighted the need to interpret the findings emphasizing the context and with an understanding that specific interventions have restricted ability to fully address multiple determinants of child growth.
    o In a multi-country (Ethiopia, India, Peru, and Vietnam) cohort study, children with access to improved sanitation but not improved water were found to be at lower risk of stunting compared to children without access (Dearden et al. 2017).
    o A systematic review conducted by Gera et al. (2018) has suggested that there may be little or no effect of WASH interventions on the anthropometric indices in children from low- and middle-income countries.
  • In a multi-country study, spanning 8 low- and middle-income countries across 3 continents, following children from birth to 24 months of age, Scharf et al. (2018) found anthropometric measures, particularly head circumference, related to cognitive development but explaining only a low percent of variance.
  • In a systematic review, Harper and colleagues (2018) examined relationship between environmental enteric dysfunction (EED) dysfunction pathways and child stunting and found that evidence exists for the link between inflammation and stunting but that EED is more complex than previously conceptualized.
  • Larson and colleagues (2018) found modest associations between length-for-age and motor development, and motor and all mental development outcomes among 12-18-month-old children in Bihar.
  • Three studies examined factors associated with infant feeding practices:
    o Chanani and colleagues (2018) have discussed factors influencing exclusive breastfeeding practices in Mumbai’s urban informal settlements in the context of a community-based nutrition program for pregnant women.
    o In the first ever systematic review of complementary feeding practices (CFP) in India, Manikam and colleagues (2018) found that appropriate CFPs are not met in India, and knowledge, culture, and parental education are some of the influential factors.
    o Examining patterns of child dietary diversity (DD) in India, using a nationally-representative survey, Gausman and colleagues (2018) found both individual and ecological-level factors to be associated with poor dietary diversity among children and therefore have recommended a population-based approach combined with targeted interventions for at-risk children.
  • More and colleagues (2018) evaluated a large-scale community-based management of acute malnutrition program using a quasi-experimental design and found the wasting prevalence to be lower in the intervention areas.
  • Garg and colleagues (2018) estimated costs of three feeding regimens (centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food) for treating uncomplicated severe acute malnutrition and found no significant difference in the cost per child between the different treatments.
  • Masters and colleagues (2018) studied 12 nutrition-sensitive programs in Ethiopia, Nigeria and India for costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings and found that the total costs varied widely among these programs and influenced improvements in different nutrient intakes among children.
  • Pearson and colleagues (2018) applied the Optima approach, an epidemiological model for assessing burden of disease, to develop a new tool, ‘Optima Nutrition’, which can be used to estimate how to target resources to improve nutrition outcomes.
  • Kadiyala and colleagues (2018) published the study protocol for a cluster- randomised controlled trial for comparing three variants of a nutrition-sensitive agricultural extension intervention to improve maternal and child nutritional outcomes in rural Odisha, India.

Enjoy reading!