Strategies to reduce malnutrition in children: what works in low-resource settings?

Child malnutrition in low-and-middle-income countries remains persistently high, driven by converging biological, social, economic, environmental, and conflict-related factors. As progress slows and vulnerabilities intensify, this review synthesises emerging evidence from recent years to identify effective strategies and future directions for reducing undernutrition in resource-constrained settings.

Recent literature demonstrates that nutrition-sensitive interventions, including women's empowerment, social protection, WASH, immunisation, kitchen gardens, and biofortification, address key underlying drivers of child malnutrition and contribute to improved growth and dietary diversity. Building on these foundations, nutrition-specific strategies such as antenatal micronutrient supplementation, optimal infant and young child feeding practices, fortified complementary foods, and emerging approaches like microbiota-directed foods and fermentation have shown measurable gains in growth and nutritional status. Across the evidence base, integrated and multisectoral delivery models consistently outperform standalone programs, with particularly strong results when nutrition is combined with health services, social protection, community-based platforms, or climate- and conflict-responsive strategies.

Current evidence underscores a shift toward integrated, layered, and context-responsive programming as the most effective path to reducing child malnutrition. Future research should prioritise implementation models that bridge nutrition-specific and nutrition-sensitive domains, strengthen health and community systems, and adapt to climate and humanitarian pressures.