Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review
Open Access
- 30 March 2023
- journal article
- review article
- Published by Public Library of Science (PLoS) in PLOS Global Public Health
- Vol. 3 (3), e0000401
- https://doi.org/10.1371/journal.pgph.0000401
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.Funding Information
- National Institute for Health Research (17\63\154)
- National Institute for Health Research (17\63\154)
- National Institute for Health Research (17\63\154)
- National Institute for Health Research (17\63\154)
- National Institute for Health Research (17\63\154)
- National Institute for Health Research (17\63\154)
This publication has 114 references indexed in Scilit:
- The 6 domains of behavior change: the missing health system building blockGlobal Health: Science and Practice, 2013
- Peer Support and Exclusive Breastfeeding Duration in Low and Middle-Income Countries: A Systematic Review and Meta-AnalysisPLOS ONE, 2012
- The behaviour change wheel: A new method for characterising and designing behaviour change interventionsImplementation Science, 2011
- Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African adolescents: a cluster-randomised controlled trialPsychology & Health, 2011
- Improving the utilization of health and nutrition services: experience from the Catholic Relief Services supported the Development Assistance Programme in GhanaPrimary Health Care Research & Development, 2011
- The Role of Behavioral Science Theory in Development and Implementation of Public Health InterventionsAnnual Review of Public Health, 2010
- Improving nutritional status through behavioural change: lessons from MadagascarJournal of Development Effectiveness, 2009
- Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to changeSocial Science & Medicine (1982), 2004
- Development of a Measure of the Motives Underlying the Selection of Food: the Food Choice QuestionnaireAppetite, 1995