A Scoping Review of Nutrition-Specific and Nutrition-Sensitive Interventions Addressing All Forms of Malnutrition in...

The main objective of our scoping review was to synthesize the research evidence on the outcomes of interventions seeking to address all forms of malnutrition in Nepal. Globally, the triple burden of malnutrition-encompassing undernutrition, micronutrient deficiency, and overnutrition leading to overweight or obesity-poses a significant risk to health and well-being. In Nepal, various nutrition-related interventions have been implemented, but the evidence on the outcomes remains scattered. We used Arksey and O'Malley's 5-stage framework and synthesized the existing interventions addressing all forms of malnutrition in Nepal. Three major databases (Medline, Scopus, and Web of Science) were searched up to December 2024, and the search results were screened using the Rayyan screening tool. The findings are presented as a narrative synthesis. Our review included 58 studies, the majority of which focused on pregnant women and children under the age of 5, with most interventions lasting from 1 to 3 years. Most interventions (n = 48) were nutrition-specific, 3 were nutrition-sensitive, and 7 were both. Nutrition-specific interventions primarily targeted micronutrient supplementation, whereas nutrition-sensitive interventions addressed broader structural inequalities, such as financial support; access to water, sanitation, and hygiene; and provision of a maternal influenza vaccine. Surprisingly, none of the interventions addressed overweight and obesity, the nutritional needs of adult males and elderly populations, digital applications to reach remote communities, or the promotion of nutrient-rich forgotten foods such as iron-rich minor millets, buckwheat, and beans. The government of Nepal prioritizes a multisectoral nutritional policy; however, our findings indicate that implementation consists largely of sectoral nutrition-specific interventions, with unclear mandates across federal, provincial, and local levels. Implementing multisectoral nutrition-sensitive interventions by prioritizing localized production, promoting behavioral change strategies, and integrating nutrition security programs might help Nepal to address all forms of malnutrition and achieve long-term nutritional outcomes.