Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review
- PMID: 36996036
- PMCID: PMC10062616
- DOI: 10.1371/journal.pgph.0000401
Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review
Abstract
Evidence that nutrition-specific and nutrition-sensitive interventions can improve maternal and child nutrition status in sub-Saharan Africa is inconclusive. Using behaviour change theory and techniques in intervention design may increase effectiveness and make outcomes more predictable. This systematic review aimed to determine whether interventions that included behaviour change functions were effective. Six databases were searched systematically, using MeSH and free-text terms, for articles describing nutrition-specific and nutrition-sensitive behaviour change interventions published in English until January 2022. Titles, abstracts and full-text papers were double-screened. Data extraction and quality assessments followed Centre for Reviews and Dissemination guidelines. Behaviour change functions of interventions were mapped onto the COM-B model and Behaviour Change Wheel. PROSPERO registered (135054). The search yielded 1193 articles: 79 articles met inclusion criteria, ranging from low (n = 30) to high (n = 11) risk of bias. Many that applied behaviour change theory, communication or counselling resulted in significant improvements in infant stunting and wasting, household dietary intake and maternal psychosocial measures. Interventions with >2 behaviour change functions (including persuasion, incentivisation, environmental restructuring) were the most effective. We recommend incorporating behaviour change functions in nutrition interventions to improve maternal and child outcomes, specifically drawing on the Behaviour Change Wheel, COM-B model (SORT B recommendation). To enhance the designs of these interventions, and ultimately improve the nutritional and psychosocial outcomes for mothers and infants in sub-Saharan Africa, collaborations are recommended between behaviour change and nutrition experts, intervention designers, policy makers and commissioners to fund and roll-out multicomponent behaviour change interventions.
Copyright: © 2023 Watson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Conflict of interest statement
The authors have declared that no competing interests exist.
Figures
![Fig 1](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10062616/bin/pgph.0000401.g001.gif)
![Fig 2](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10062616/bin/pgph.0000401.g002.gif)
![Fig 3](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10062616/bin/pgph.0000401.g003.gif)
![Fig 4](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/10062616/bin/pgph.0000401.g004.gif)
Similar articles
-
A systematic review of behaviour change interventions to improve maternal health outcomes in sub-Saharan Africa.PLOS Glob Public Health. 2024 Feb 20;4(2):e0002950. doi: 10.1371/journal.pgph.0002950. eCollection 2024. PLOS Glob Public Health. 2024. PMID: 38377077 Free PMC article.
-
Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217. Cochrane Database Syst Rev. 2022. PMID: 36321557 Free PMC article.
-
Nutritional interventions for preventing stunting in children (birth to 59 months) living in urban slums in low- and middle-income countries (LMIC).Cochrane Database Syst Rev. 2019 Jun 17;6(6):CD011695. doi: 10.1002/14651858.CD011695.pub2. Cochrane Database Syst Rev. 2019. PMID: 31204795 Free PMC article.
-
Interventions for increasing fruit and vegetable consumption in children aged five years and under.Cochrane Database Syst Rev. 2018 May 17;5(5):CD008552. doi: 10.1002/14651858.CD008552.pub5. Cochrane Database Syst Rev. 2018. Update in: Cochrane Database Syst Rev. 2019 Nov 7;2019(11). doi: 10.1002/14651858.CD008552.pub6. PMID: 29770960 Free PMC article. Updated. Review.
-
The effectiveness of interventions to treat severe acute malnutrition in young children: a systematic review.Health Technol Assess. 2012;16(19):1-316. doi: 10.3310/hta16190. Health Technol Assess. 2012. PMID: 22480797 Free PMC article. Review.
Cited by
-
Promoting Supportive and Respectful Maternity Care in Public Health Facilities in Sindh, Pakistan: A Theory-Informed Health System Intervention.Glob Health Sci Pract. 2023 Jun 21;11(3):e2200513. doi: 10.9745/GHSP-D-22-00513. Print 2023 Jun 21. Glob Health Sci Pract. 2023. PMID: 37348940 Free PMC article. Review.
-
A strategic analysis of health behaviour change initiatives in Africa.Glob Health Action. 2023 Dec 31;16(1):2202931. doi: 10.1080/16549716.2023.2202931. Glob Health Action. 2023. PMID: 37129058 Free PMC article. Review.
References
-
- World Health Organization. The double burden of malnutrition: policy brief. World Health Organization,. 2017.
-
- Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, et al.. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet. 2013;382:452–77. - PubMed
-
- Ruel MT, Alderman H, Maternal, Group CNS. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The Lancet. 2013;382:536–51. - PubMed
Grants and funding
LinkOut - more resources
Full Text Sources
Miscellaneous