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4 Results for Health Topics

4.3 Nutrition

4.3.1 Nutrition

  • Seventy-seven papers were selected out of 2535 published papers searched; twenty-two papers were included from grey literature [1].
  • Nearly half (35 papers) of papers were from the ‘A’ category of evidence, 24 papers were category B, 18 papers were category C [2].
  • There is increasing interest in evidence-based intervention in humanitarian crises, with 70% of all studies conducted since 1980 being published in the last decade. Furthermore, the proportion of high quality papers increases over time. Most papers [3] were of moderate quality (34/77), a quarter were of high quality (18/77) and a third of low quality (25/77). In category A, 18 papers were of high quality, 27 were moderate and 1 out of 46 was of low quality, whereas no paper was of high quality in category B, eight were moderate and 23 out of 31 were of low quality.
  • The majority of studies employed a cross-sectional design (29 papers), a third used follow up/monitoring data of beneficiaries enrolled in programmes (27 papers), several studies were of cohort [4] and RCT design (nine and six papers respectively), and the rest were cost-effectiveness, mix-method and case control studies (3%, 4% and 1% respectively).
  • The majority of studies were conducted in Africa (72%), a fifth in Asia (18%) and few in Europe, Middle-East and Caribbean (4%, 3% and 1% respectively) (Figure 13).
  • Half (37 papers) of the studies assessed were during an armed conflict, a third (26 papers) responded to a natural disaster and a fifth (15 papers) were in zones affected by both type of emergencies (Figure 14).
  • Half (40 papers) of the studies were conducted during acute humanitarian crises, more than a third (30 papers) in stabilised context, 5 (6.5%) where in place before emergency (preparedness) and 2 (2.6%) were including different stages of emergencies.

 

  • The interventions assessed were mainly addressing micro-nutrient deficiencies and the treatment of Severe Acute Malnutrition (SAM) (18 and 16 papers respectively). Several were Targeted Supplementary Feeding Programmes (TSFP), Blanket Supplementary Feeding Programmes (BSFP) and General Food Distributions (GFD) interventions (11, 8 and 8 papers respectively). Only four studies examined Infant and Young Child Feeding (IYCF) practices (Figure 15).
  • The health outcome of more than half the studies (41 papers) was acute malnutrition followed by micro-nutrient deficiencies (24.7%) [5] , of which anaemia was mainly examined (76.5%). Several studies examined chronic malnutrition [6] (15.6%) (Figure 16).

 

  • Interventions addressing micro-nutrient deficiencies, GFD, TSFP and the treatment of SAM have been assessed since the end of the 1980s/early 1990s. The diversity of interventions studied has increased over time. Only since 2003 have studies about IYCF interventions been published and only since 2005 have studies on micro-finance and voucher schemes (in “other category”) been published. All preparedness interventions were BSFP and their assessments were published after 2008 (Figure 17).

[1] 26 initially selected: two not retrieved; one was qualitative, one was published and is included in the published literature.

[2] Need assessments and surveys alone were excluded.

[3] The level of quality of studies was assessed for category A and B papers (77 out of 100).

[4] Including two prospective cohorts, and one study using both retrospective and prospective cohorts.

[5] Micro-nutrient deficiency category includes: two studies on Vitamin B3, one on Vitamin B1, one on vitamin C, one on iodine and one on multiple micronutrients (Iron, Vit A, Thiamin, Zinc). Anaemia is excluded from this category

[6] Included in “multiple” and “anaemia and under-nutrition7” categories. Under-nutrition in this case includes acute and chronic malnturition, underweight (no micronutrient deficiencies)

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