Facilitators and barriers to implementing complex community-based interventions for addressing acute malnutrition in low- and lower-middle income countries: A scoping review

Background: Community-based nutrition interventions have been established as the standard of care for identifying and treating acute malnutrition among children 6–59 months in low- and lower-middle-income countries. However, limited research has examined the factors that influence the implementation...

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Veröffentlicht in:Nutrition and Health 2024-07, Vol.30 (3), p.447-462
Hauptverfasser: Beggs, Bridget, Bustos, Monica, Brubacher, Laura Jane, Little, Matthew, Lau, Lincoln, Dodd, Warren
Format: Artikel
Sprache:eng
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Zusammenfassung:Background: Community-based nutrition interventions have been established as the standard of care for identifying and treating acute malnutrition among children 6–59 months in low- and lower-middle-income countries. However, limited research has examined the factors that influence the implementation of the community-based component of interventions that address severe acute malnutrition and moderate acute malnutrition among children. Aim: The objective of this review was to identify and describe the facilitators and barriers in implementing complex community-based nutrition interventions to address acute malnutrition among children in low- and lower-middle-income countries. Methods: This review used a systematic search strategy to identify existing peer-reviewed literature from three databases on complex community-based interventions (defined as including active surveillance, treatment, and education in community settings) to address severe acute malnutrition and moderate acute malnutrition in children. Results: In total, 1771 sources were retrieved from peer-reviewed databases, with 38 sources included in the review, covering 26 different interventions. Through an iterative deductive and inductive analysis approach, three main domains (household and interpersonal, sociocultural and geographical; operational and administrative) and eight mechanisms were classified, which were central to the successful implementation of complex community-based interventions to address acute child malnutrition. Conclusion: Overall, this review highlights the importance of addressing contextual and geographical challenges to support participant access and program operations. There is a need to critically examine program design and structure to promote intervention adherence and effectiveness. In addition, there is an opportunity to direct resources towards community health workers to facilitate long-term community trust and engagement.
ISSN:0260-1060
2047-945X
DOI:10.1177/02601060241253327