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Role of education and communication interventions in promoting micronutrient status in India – what research in the last two decades informs

ABSTRACT Micronutrient deficiencies, majorly iron, iodine, vitamin-A, pose a serious threat to public health in many developing countries, including India. A surfeit of nutrition and health programs was developed to address micronutrient malnutrition in India, covering many aspects of lifecycle. The importance of nutrition education and communication is emphasized in public health nutrition policies. Concomitantly, there is a surge in various interventional studies with the integration of nutrition education and communication. However, there is a lack of clarity on the overall impact of community level nutrition education/communication interventions on micronutrient (mal)nutrition in India, which may be due to the lack of critical evaluation of the nutrition education/communication components in these studies. Given this background, this article reviews the studies conducted in the last two decades in India. This systematic review identified and analyzed the studies that aimed to use nutrition education and communication as intervention methods to promote micronutrients’ intake and status among various age groups. Using four online databases and systematic library search, research articles published from 1994 to 2016 were collected based on pre-defined inclusion/exclusion criteria. Data on general information, intervention, and key outcome measures were extracted. Inferences from findings of studies were drawn; factors that contributed to the success or failure of the interventions were analyzed by developing a framework. Systematic internet and library search resulted in 1250 published papers. After applying inclusion and exclusion criteria, 19 research papers (with five studies covering nutrition education + supplementation; one study with nutrition education + supplementation + psychosocial intervention and the rest only education/communication) were selected for the review. This paper discusses the contextual factors in the area of intervention, audience targeted, methods of communication used, messages delivered, and outcomes thereof. It suggests that integrated multiple strategies may work and a critical examination is needed to address macro and micro issues of micronutrient-related communication for developing sustainable communication interventions.