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Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review

Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review
Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review

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.

2767-3375
e0000401
Watson, Daniella
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Mushamiri, Patience
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Beeri, Paula
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Rouamba, Toussaint
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Jenner, Sarah
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Proebstl, Simone
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Kehoe, Sarah H
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Ward, Kate A
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Barker, Mary
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Lawrence, Wendy
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INPreP study group
Watson, Daniella
26005c9f-779f-407b-b7e4-b7c9b812b6be
Mushamiri, Patience
cbdb00bc-b510-4585-bd10-540e682c2f7b
Beeri, Paula
f43cf17d-fdd5-4c5b-ba13-851f32d81c28
Rouamba, Toussaint
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Jenner, Sarah
6de57ea6-89f7-4bed-8e76-bad5ed5957e8
Proebstl, Simone
7f428564-a651-4357-b85c-579c4ae9bf40
Kehoe, Sarah H
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Ward, Kate A
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Barker, Mary
374310ad-d308-44af-b6da-515bf5d2d6d2
Lawrence, Wendy
e9babc0a-02c9-41df-a289-7b18f17bf7d8

Watson, Daniella, Mushamiri, Patience, Beeri, Paula, Jenner, Sarah, Proebstl, Simone, Kehoe, Sarah H, Ward, Kate A, Barker, Mary and Lawrence, Wendy , INPreP study group (2023) Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review. PLOS Global Public Health, 3 (3), e0000401. (doi:10.1371/journal.pgph.0000401).

Record type: Article

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.

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Accepted/In Press date: 28 February 2023
e-pub ahead of print date: 30 March 2023
Published date: 30 March 2023
Additional Information: 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.

Identifiers

Local EPrints ID: 476652
URI: http://eprints.soton.ac.uk/id/eprint/476652
ISSN: 2767-3375
PURE UUID: 8f691a57-fda0-49d2-9d8e-464826bb602b
ORCID for Sarah Jenner: ORCID iD orcid.org/0000-0002-4644-5027
ORCID for Kate A Ward: ORCID iD orcid.org/0000-0001-7034-6750
ORCID for Mary Barker: ORCID iD orcid.org/0000-0003-2976-0217
ORCID for Wendy Lawrence: ORCID iD orcid.org/0000-0003-1264-0438

Catalogue record

Date deposited: 10 May 2023 17:09
Last modified: 12 Nov 2024 03:04

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Contributors

Author: Daniella Watson
Author: Patience Mushamiri
Author: Paula Beeri
Author: Toussaint Rouamba
Author: Sarah Jenner ORCID iD
Author: Simone Proebstl
Author: Sarah H Kehoe
Author: Kate A Ward ORCID iD
Author: Mary Barker ORCID iD
Author: Wendy Lawrence ORCID iD
Corporate Author: INPreP study group

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