Impact of interventions on diets and nutrition outcomes in crises contexts

This study investigates general impact pathways of nutrition interventions conducted in contexts of shocks, conflicts and crises (SCCs) on dietary patterns and malnutrition in all its forms in low- and middle-income countries (LMICs). The study considers these effects from the perspectives of both the food environment and the broader food system.
It shows that interventions have the potential to mitigate the adverse effects of SCCs on dietary patterns and malnutrition, though with different levels of efficiency.
Interventions targeting dietary intake with support from health and childcare systems had the most measurable impacts on improving nutrition outcomes, while interventions focusing on improving food accessibility and own food production showed promising improvements in dietary patterns.

The Nutrition Research Facility (NRF) conducted a series of consultations with decision-makers in EU Member States, EU partner countries, within Delegations of the EU in partner countries and within the European Commission, in order to identify their current concerns in relation to nutrition issues in development contexts. This question arose from a consultation workshop focusing on Asian countries. A high interest was particularly expressed by Uzbekistan, the Philippines, Yemen and Bangladesh, countries that are recurrently suffering from SCCs.

The study employs a systematic literature review complemented by a secondary analysis involving multidisciplinary experts to validate an impact pathway framework at both regional and national levels.
Data for mapping impact pathways were derived from 87 relevant studies across 13 reviews and 71 mentioned interventions from 3 structurally distinct reviews, identifying 8 general intervention impact pathways leading to dietary and nutrition outcomes.
The secondary analysis aims at validating the impact pathways identified in the systematic review while uncovering regional nuances in the effectiveness of nutrition interventions. This component will be conducted through an e-Delphi study, engaging a diverse panel including researchers, policymakers, practitioners, and representatives from humanitarian organisations and civil society.

This study identified 8 general pathways through which nutrition interventions lead to changes in diet and nutrition outcomes in low- and lower-middle-income countries (LMICs) affected by shocks, conflicts, and crises (SCCs).
Intervention pathways focused on food consumption, consumer awareness and behaviour change and on supporting systems, such as supplementation, enhancing maternal capacity and child feeding with support from health and childcare systems, showed positive results on improving nutrition outcomes (increased birthweight and height, reductions in moderate and severe acute malnutrition, mortality, anaemia, wasting, stunting, and underweight, as well as increased height-for-age and weight-for-age z scores).
Pathways focused on interventions aiming to increase food accessibility and in food production and supply chains through cash transfers, food aid, food vouchers, and income from agriculture or own food production, demonstrated improvements in dietary outcomes (improved child feeding, dietary quantity, quality, and diversity).
In contrast, pathways focused on interventions involving women’s participation in agriculture and broader agri-food policies showed weaker and mixed effects on both dietary and nutrition outcomes.

Adopting integrated approaches informed and contextualised by scientific evidence is crucial to address the complex interactions between agricultural practices, policies, food systems, consumer behaviours, and socio-economic factors in improving dietary patterns and nutrition outcomes in LMICs under SCCs contexts.

The findings can better inform strategies for building resilience and improving food security in crises’ contexts, in alignment with sustainable development and global nutrition goals.

Main contact: Luis Goulao

Organisation: ISA – School of Agriculture, University of Lisbon

Email address: goulao@isa.utl.pt

National Taiwan University