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The present literature review aimed to review the evidence for community-based distribution (CBD) of iron-folic acid (IFA) supplementation as a feasible approach to improve anaemia rates in low- and middle-income countries. The literature review included peer-reviewed studies and grey literature from PubMed, Cochrane Library, LILAC and Scopus databases. Low- and middle-income countries. Non-pregnant women, pregnant women, and girls. CBD programmes had moderate success with midwives and community health workers (CHW) who counselled on health benefits and compliance with IFA supplementation. CHW were more likely to identify and reach a greater number of women earlier in pregnancy, as women tended to present late to antenatal care. CBD channels had greater consistency in terms of adequate supplies of IFA in comparison to clinics and vendors, who faced stock outages. Targeting women of reproductive age through school and community settings showed high compliance and demonstrated reductions in anaemia. CBD of IFA supplementation can be a valuable platform for improving knowledge about anaemia, addressing compliance and temporary side-effects of IFA supplements, and increasing access and coverage of IFA supplementation. Programmatic efforts focusing on community-based platforms should complement services and information provided at the health facility level. Provision of training and supportive supervision for CHW on how to counsel women on benefits, side-effects, and when, why, and how to take IFA supplements, as part of behaviour change communication, can be strengthened, alongside logistics and supply systems to ensure consistent supplies of IFA tablets at both the facility and community levels.

Since 2009, Médecins Sans Frontières has implemented a community management of acute malnutrition (CMAM) programme in rural Biraul block, Bihar State, India that has admitted over 10 000 severely malnourished children but has struggled with poor coverage and default rates. With the aim of improving programme outcomes we undertook a qualitative study to understand community perceptions of childhood undernutrition, the CMAM programme and how these affected health-seeking behaviour. Semi-structured and narrative interviews were undertaken with families of severely malnourished children, non-undernourished children and traditional and allopathic health-care workers. Analysis of transcripts was by qualitative content analysis. Biraul, Bihar State, India, 2010. One hundred and fifty people were interviewed in individual or group discussions during fifty-eight interviews. Undernutrition was not viewed as a disease; instead, local disease concepts were identified that described the clinical spectrum of undernutrition. These concepts informed perception, so caregivers were unlikely to consult health workers if children were 'only skinny'. Hindu and Muslim priests and other traditional health practitioners were more regularly consulted and perceived as easier to access than allopathic health facilities. Senior family members and village elders had significant influence on the health-seeking behaviour of parents of severely malnourished children. The results reaffirm how health education and CMAM programmes should encompass local disease concepts, beliefs and motivations to improve awareness that undernutrition is a disease and one that can be treated. CMAM is well accepted by the community; however, programmes must do better to engage communities, including traditional healers, to enable development of a holistic approach within existing social structures.

The is a conceptual model traditionally used to understand contributing factors of maternal mortality. It posits that most barriers to health services utilisation occur in relation to one of three delays: (1) Delay 1: delayed decision to seek care; (2) Delay 2: delayed arrival at health facility and (3) Delay 3: delayed provision of adequate care. We applied this model to understand why a community-based management of acute malnutrition (CMAM) services may have low coverage. We conducted a Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) over three phases using mixed methods to estimate programme coverage and barriers to care. In this manuscript, we present findings from fifty-one semi-structured interviews with caregivers and programme staff, as well as seventy-two structured interviews among caregivers only. Recurring themes were organised and interpreted using the . Madaoua, Niger. Totally, 123 caregivers and CMAM program staff. Overall, eleven barriers to CMAM services were identified in this setting. Five barriers contribute to Delay 1, including lack of knowledge around malnutrition and CMAM services, as well as limited family support, variable screening services and alternative treatment options. High travel costs, far distances, poor roads and competing demands were challenges associated with accessing care (Delay 2). Finally, upon arrival to health facilities, differential caregiver experiences around quality of care contributed to Delay 3. The was a useful model to conceptualise the factors associated with CMAM uptake in this context, enabling implementing agencies to address specific barriers through targeted activities.

The current study aimed to investigate the relationship between nutrition literacy (NL) and food habits (FH) in adolescents, and the factors affecting the relationship. The study used a cross-sectional design. The data were collected using socio-demographic information forms, the Adolescent Nutrition Literacy Scale (ANLS) and the Adolescent Food Habit Checklist (AFHC). The socio-demographic characteristics of adolescents were analysed using descriptive statistics, and the factors affecting NL and FH were determined using the t test, Mann-Whitney U test and ANOVA. The correlation between ANLS and AFHC scores was tested with correlation analysis, and linear regression analysis was employed to predict the change in the NL of adolescents at the level of FH. The study was conducted in the city of Izmir in Turkey. The study consisted of a total of 467 adolescents. There was a statistically significant relationship between NL of adolescents and their gender, education level of the father, grade, BMI values and daily lifestyle behaviours (DLB), as well as between their FH and DLB. There was a positive and significant relationship between ANLS and AFHC. The ANLS and its subscales were found to have a statistically significant effect on AFHC. According to the linear regression analysis, the nutritional habits of adolescents were found to be significantly affected by NL (β = 0·357). As ANLS scores increased, AFHC scores were determined to increase as well. This finding shows that the FH of adolescents have changed positively with increase in their NL.

Poor diet quality related to inadequate complementary feeding is a major public health problem in low and middle‐income countries including Ethiopia. Low dietary diversity has been linked to negative health outcomes in children. To provide a package of interventions to close nutritional gaps through agriculture, the Sustainable Undernutrition Reduction in Ethiopia (SURE) programme was set up as a multi‐sectoral initiative and the results of combined effects of community‐based and enhanced nutrition services, compared to community‐based alone, on diet diversity and diet quality of complementary feeding of young children are presented. The study used pre‐ and post‐intervention design. Baseline ( n  = 4980) data were collected from May to July 2016, and follow‐up ( n  = 2419) data from December 2020 to January 2021. From 51 intervention districts having the SURE programme, 36 intervention districts were randomly selected for baseline and 31 for the follow‐up survey. The primary outcome was diet quality: minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). Comparing endline to baseline over the 4.5‐year intervention, the use of standard community‐based nutrition services of growth monitoring and promotion increased (16%–46%), as did enhanced nutrition services of infant and young child feeding counselling, and agricultural advising (62%–77%). Women involved in home gardening significantly increased (73%–93%); however, household production of food decreased yet consumption of most own‐grown foods increased. Importantly, MAD and MDD increased four‐fold. The SURE intervention programme was associated with improvements in complementary feeding and diet quality through enhanced nutrition services. This suggests programmes targeted at nutrition‐sensitive practices can improve child feeding in young children. Improved nutrition of young children can result from interventions that combine nutrition and agriculture through joint household visits by health and agriculture extension workers. Use of standard nutrition services increased over time when presented with other services that include enhancements that increase men's participation. Improvements in complementary feeding and diet quality of infant and young child feeding are achieved through enhancement of nutrition services over and above community‐based services.

Food pantries play a critical role in combating food insecurity. The objective of the present work was to systematically review and synthesize scientific evidence regarding the effectiveness of food pantry-based interventions in the USA. Keyword/reference search was conducted in PubMed, Web of Science, Scopus, Cochrane Library and CINAHL for peer-reviewed articles published until May 2018 that met the following criteria. food pantry and/or food bank in the USA; study design: randomized controlled trial (RCT) or pre-post study; outcomes: diet-related outcomes (e.g. nutrition knowledge, food choice, food security, diet quality); study subjects: food pantry/bank clients. Fourteen articles evaluating twelve distinct interventions identified from the keyword/reference search met the eligibility criteria and were included in the review. Five were RCT and the remaining seven were pre-post studies. All studies found that food pantry-based interventions were effective in improving participants' diet-related outcomes. In particular, the nutrition education interventions and the client-choice intervention enhanced participants' nutrition knowledge, cooking skills, food security status and fresh produce intake. The food display intervention helped pantry clients select healthier food items. The diabetes management intervention reduced participants' glycaemic level. Food pantry-based interventions were found to be effective in improving participants' diet-related outcomes. Interventions were modest in scale and usually short in follow-up duration. Future studies are warranted to address the challenges of conducting interventions in food pantries, such as shortage in personnel and resources, to ensure intervention sustainability and long-term effectiveness.

An absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy. A scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand. The search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between 'healthy' and 'unhealthy' foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one's capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model. The lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps.

A community-based participatory nutrition promotion (CPNP) programme, involving a 2-week group nutrition session, attempted to improve child feeding and hygiene. The implementation, utilization and influence of the CPNP programme were examined by programme impact pathway (PIP) analysis. Five CPNP programme components were evaluated: (i) degree of implementation; (ii) participants' perception of the nutrition sessions; (iii) participants' message recall; (iv) utilization of feeding and hygiene practices at early programme stage; and (v) participants' engagement in other programmes. Habro and Melka Bello districts, Ethiopia. Records of 372 nutrition sessions, as part of a cluster-randomized trial, among mothers (n 876 in intervention area, n 914 in control area) from a household survey and CPNP participants (n 197) from a recall survey. Overall, most activities related to nutrition sessions were successfully operated with high fidelity (>90 %), but a few elements of the protocol were only moderately achieved. The recall survey among participants showed a positive perception of the sessions (~90 %) and a moderate level of message recall (~65 %). The household survey found that the CPNP participants had higher minimum dietary diversity at the early stage (34·0 v. 19·9 %, P=0·01) and a higher involvement in the Essential Nutrition Action (ENA) programme over a year of follow-up (28·2 v. 18·3 %; P<0·0001) compared with non-participants within the intervention area. Our PIP analysis suggests that CPNP was feasibly implemented, promoted a sustained utilization of proper feeding behaviours, and enhanced participation in the existing ENA programme. These findings provide a possible explanation to understanding CPNP's effectiveness.

To examine the relationship between the dietary quality of Canadian children and adults and household food insecurity status. Dietary intake was assessed with one 24-h recall. Households were classified as food secure or marginally, moderately or severely food insecure based on their responses to the Household Food Security Survey Module. We applied multivariable analyses of variance to determine whether % energy from ultra-processed foods, fruit and vegetable intake, Healthy Eating Index (HEI) scores, macronutrient composition and micronutrient intakes per 1000 kcal differed by food insecurity status after accounting for income, education and region. Analyses were run separately for children 1-8 years and 9-18 years and men and women 19-64 years of age. Ten provinces in Canada. Respondents to the 2015 Canadian Community Health Survey-Nutrition, aged 1-64 years, with complete food insecurity data and non-zero energy intakes, N 15 909. Among adults and children, % energy from ultra-processed foods was strongly related to severity of food insecurity, but no significant trend was observed for fruit and vegetable intake or HEI score. Carbohydrate, total sugar, fat and saturated fat intake/1000 kcal did not differ by food insecurity status, but there was a significant negative trend in protein/1000 kcal among older children, a positive trend in Na/1000 kcal among younger children and inverse associations between food insecurity severity and several micronutrients/1000 kcal among adults and older children. With more severe household food insecurity, ultra-processed food consumption was higher, and diet quality was generally lower among both adults and children.