Interventions To Manage Malnutrition Among Preschool Children (3-6 Years): A Systematic Review and Meta-Analysis
Keywords:
Malnutrition, Preschool children, Nutritional interventions, Supplementation, Fortification, Randomized controlled trials, 3-6 yearsAbstract
Background: Malnutrition among preschool children (ages 3–6 years) remains a global health issue, particularly in low- and middle-income countries. This age group is especially vulnerable due to their rapid growth and development, and effective interventions are crucial to mitigate the associated risks of stunting, wasting, and micronutrient deficiencies.
Objective: To systematically review and assess the effectiveness of various interventions aimed at managing malnutrition among preschool children aged 3–6 years.
Methods: This review adhered to PRISMA guidelines and was registered with PROSPERO. A comprehensive search was conducted across databases including PubMed, Cochrane and Scopus. Studies were included if they were randomized controlled trials or quasi-experimental studies published in English from January 2014 to February 2025, involving children aged 3–6 years diagnosed with malnutrition. Interventions evaluated included fortified foods, general nutritional supplementation, micronutrient supplementation, educational programs, and water and sanitation interventions. Risk of bias was assessed using the Cochrane Risk of Bias tool, and a qualitative synthesis was performed due to heterogeneity in outcomes and study designs.
Results: Fourteen RCTs involving approximately 10,386 children were included. Interventions such as iron-fortified complementary foods, oral nutritional supplements, and nutrition education demonstrated improvements in anthropometric measures (e.g., weight-for-age and height-for-age) and biochemical markers (e.g., hemoglobin, serum ferritin). However, pooled estimates from four studies revealed no statistically significant difference in weight (SMD = 0.24; 95% CI: -0.26 to 0.74) or height (SMD = 0.08; 95% CI: -0.18 to 0.35) between intervention and control groups, with substantial heterogeneity.
Conclusion: Multiple interventions, particularly those involving nutritional supplementation and fortification, show promise in managing malnutrition among preschool children. However, the effectiveness varies by context, highlighting the need for tailored strategies. Further high-quality research is needed to address gaps and inform scalable, context-sensitive public health policies
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