Table 2.
Description of studies included
|
Author |
Country |
Design |
Population |
Intervention |
Comparator |
Results- outcome of interest |
||
|---|---|---|---|---|---|---|---|---|
| Feeding frequency | Energy intake | Dietary diversity | ||||||
| Bhandari N 2001 |
India |
RCT |
Nutritionists, Caregivers and their children. |
Intervention group received nutrition training from the trained nutritionists. Description of training duration for nutritionists was not provided. |
Comparison group’s health workers were not trained to provide n = 106 |
No details |
At 9 months |
No details |
| (Intervention-n = 104, Control 106) |
• I: 978kj/day; IQR 406–1371 |
|||||||
| • C: 577kj/day; IQR 196–1250 | ||||||||
| • P < 0.05 | ||||||||
| At 12 months | ||||||||
| • I: 1417kj/day; IQR 723–2253 | ||||||||
| • C: 924kj/day; IQR 474–1471 | ||||||||
| |
• P < 0.05 |
|
||||||
| Santos I 2001 |
Brazil |
Cluster RCT |
Doctors (Intervention-17, Control-16) and pairs of caregivers and their children (Intervention-218, Control-206) |
Nutrition counseling component of WHO’s Integrated Management of Childhood Illness (IMCI) given for 20 hours to doctors in the intervention group. The trained doctors provided counseling to caregivers. |
16 doctors did not receive nutrition counseling training. They offered general care to caregivers and their children |
No details |
At <18 months |
Compared to Control, Intervention group had higher proportion of dietary diversity (also see Table 5) |
| • Intervention: 3827.5 kJ/day; SD 1230.9 | ||||||||
| • Control: 3546.8 kJ/day; SD 1058.1 | ||||||||
| • P = 0.3 | ||||||||
| Bhandari N 2004 |
India |
Cluster RCT |
Health and nutrition workers; pairs of caregivers and their children |
Health and nutrition workers in the 4 intervention communities received nutrition training. They cared for 552 child-mother pairs. |
Health and nutrition workers in 4 communities without nutrition training. They cared for 473 child-mother pairs. |
At 9 months: |
At 9 months: |
Compared to Control, Intervention group had high proportion of dietary diversity (see Table 5) |
| • I: 4.4; SD 1.5 |
• I: 1556 kJ/Day; SD 1109 |
|||||||
| • C: 3.9; SD 1.7 |
• C: 1025 kJ/Day; SD 866 |
|||||||
| At 18 months |
• P < 0.01 |
|||||||
| • I: 5.9; SD 1.2 |
At 18 months |
|||||||
| C: 5.4; SD 1.3 |
• I: 3807 kJ/Day; SD 1527 |
|||||||
| • C: 2577 kJ/Day; SD 1058 | ||||||||
| Penny ME 2005 |
Peru |
Cluster RCT |
Health care workers and pairs of caregivers and their children |
Health care workers in 6 health facilities received nutrition-training intervention; 187 babies were enrolled and their caregivers were counseled by these health workers. |
Health care workers in 6 health facilities without the nutrition training intervention. They gave care to 190 babies enrolled in these facilities. |
No details |
At 9 months: |
Dietary diversity at 18 months was higher in intervention group than the control group (Table 5) |
| • I: 450 kcal/day | ||||||||
| • C: 400 kcal/day | ||||||||
| At 18 months | ||||||||
| • I: 960 kcal/day | ||||||||
| • C: 800 kcal/day | ||||||||
| • P = 0.001 | ||||||||
| Zaman S 2008 |
Pakistan |
Cluster RCT |
Community Health Workers and pairs of caregivers and their children |
Health workers in 18 health centers received a 5 half days nutrition training using the WHO’s IMCI training module for nutrition. They recruited and gave counseling and consultation to151 child-mother pairs |
Health workers in other 18 health centers without nutrition training intervention recruited and cared for 169 pairs of mothers and children |
No details |
• P < 0.01No details |
Intervention group had a higher proportion on all the food items consumption compared to the control group (Table 5) |
| Shi L 2010 |
China |
Cluster RCT |
Primary healthcare providers; pairs of mothers and infants |
Health care providers received nutrition training on complementary feeding, breastfeeding, and counseling skills. They counseled and provided care for 294 pairs of caregivers and their children. |
Health workers from township hospitals did not receive nutrition training. Recruited and cared for 305 pairs of caregivers and their children. |
At 9 months |
No details |
Intervention group had a higher proportion on all the food items consumed compared to the control group (Table 5) |
| • I: 3.77; SD 1.62 | ||||||||
| • C: 2.53; | ||||||||
| SD1.82 | ||||||||
| • P < 0.001 | ||||||||
| At 12 months | ||||||||
| • 4.17 | ||||||||
| • I: 2.90; SD 1.85 | ||||||||
| • P < 0.001 | ||||||||
| Vazir S 2012 |
India |
Cluster RCT |
Community health workers (Village health workers) n = 60 and 511 pairs of mothers and their children |
Village health workers received supervised training on how to counsel mothers/caregivers on complementary feeding, and responsive feeding. Caregivers who received such counseling also received standard care. |
Village health workers did not receive training. They provided only standard of care to caregivers and their children. |
No details |
At 9 months |
Intervention groups (complementary and responsive feeding groups) had a higher proportion on all the food items consumption compared to the control group (Table 5) |
| • I: 348 kcal/day; IQR 229,540 | ||||||||
| • C: 209 kcal/day; IQR 122,338 | ||||||||
| • P < 0.005 | ||||||||
| At 15 months | ||||||||
| • I: 569 kcal/day; IQR 539,618 | ||||||||
| • C: 460; IQR 429,489 | ||||||||
| P < 0.005 | ||||||||
| Roy SK 2005 |
Bangladesh |
RCT |
Nutritionists, medical officer, and health assistants |
Two-week nutrition training was conducted for health workers. The training included nutrition education, counseling, and anthropometry. Trained health workers provided counseling to mothers of moderately malnourished children on complementary feeding. |
Mothers of a control group received normal care from health workers who received no nutrition training |
Feeding frequency >3 times/day |
No details |
No details |
| At 3 months | ||||||||
| I: 98%, C: 54% | ||||||||
| At 6 months | ||||||||
| I: 97%, C: 58% | ||||||||
| Pachon H 2002 |
Vietnam |
Cluster RCT |
Community health workers and 240 pairs of caregivers and their children |
Training implementers (health workers) who are also health volunteers received nutrition training to implement intensive nutrition rehabilitation sessions for ten months. Counseling for caregivers was done twice a week for nine months. |
Health workers were not trained to implement intensive nutrition rehabilitation sessions. |
At 2–6 months |
At 2–6 months |
No details |
| • I: 4.6; SD 1.3 |
• I: 662.7 kcal/day; SD 301.0 |
|||||||
| • C: 4.2; SD 1.1 |
• C: 597.4 kcal/day; SD 275.7 |
|||||||
| • P < 0.01 |
• P < 0.1 |
|||||||
| At 12 months |
At 12 months |
|||||||
| • I: 4.9; SD 1.5 |
• I: 826.9 kcal/day SD 324.4 |
|||||||
| • C: 4.4; SD 1.5 |
• C: 718.4 kcal/day SD 330.0) |
|||||||
| P < 0.01 |
• P < 0.01 |
|||||||
| Kilaru A 2005 |
India |
Cluster RCT |
Auxiliary nurse midwives, community health workers |
Auxiliary nurse midwives, community health workers received nutrition training from MCH consultant (pediatrician and nutritionists). They provided counseling to 173 caregivers and their children |
Normal standard of care provided by auxiliary nurse midwives who did not receive any special nutrition training |
At 7-11 months Feeding frequency >4 times/day |
No details |
At 11 months |
| • I: 78% |
Feeding at least 5 types/day |
|||||||
| • C: 51% |
• I: 42% |
|||||||
| • P < 0.001 |
• C: 19% |
|||||||
| P = 0.01 | ||||||||
Footnotes.
I - Intervention group, C - Control group, P - P value, SD - Standard deviation, IQR - Inter quartile range, CI - Confidence Interval.