A Systematic Review of the Impact of Nutrition Education and Counseling on Anemia Prevalence and Iron Status in Women of Reproductive Age

Abstract

Using modified GRADE (Grading of Recommendations Assessment, Development and Evaluation) and CHERG (Child Health Epidemiology Reference Group) approaches, we systematically reviewed the scientific evidence of the impact of nutrition education and counseling (NEC) delivered to females 11–49 years of age on anemia and iron status. From a systematic search of Pubmed, Embase, Popline, Web of science and CINAHL, we identified 6 randomized controlled and 7 quasi‐experimental studies. Of the 13 studies reviewed 5 provided NEC only; 2 provided NEC as part of a comprehensive package of behavior change messages; and 6 provided NEC with nutrition support. Three studies were in developed and 10 in developing countries. Of the 11 studies with data on anemia prevalence, 6 reported significant reductions in the intervention group compared to the comparison group. Six of 8 studies reported significant increases in mean hemoglobin levels. Of the 7 studies reporting on iron status, none reported a significant impact. These observations were consistent for pregnant and nonpregnant women and different categories of NEC. Variability in the exposure outcome precluded the use of meta‐analysis.ConclusionNEC delivered alone or with nutrition support appears to positively impact anemia prevalence and hemoglobin levels but not iron status in women and adolescent girls.Funding provided by the Bill and Melinda Gates Foundation