Effect of Integrating Social and Behavior Change Communication Strategies in Nutrition-Sensitive Social-Protection Programs on Specific Nutritional Outcomes: A Systematic Review.

Abstract

Context: Achieving adequate nutrition for vulnerable populations is central to the second Sustainable Development Goal. Nutrition-sensitive social-protection programs combined with social and behavior change communication (SBCC) interventions can support this goal, particularly in developing countries. However, systematic evidence on the impact of integrating SBCC strategies into these programs is limited, especially concerning anthropometric outcomes, dietary diversity, food consumption, and food security.

Objective: This systematic review aimed to assess the importance of integrating SBCC interventions into nutrition-sensitive social-protection programs for optimal nutritional outcomes.

Data sources: PubMed, Web of Science, EMBASE, ScienceDirect, and Google Scholar databases were searched for original research articles before December 2024.

Data extraction: A total of 15 publications, involving data from multiple households, mothers, and children, were identified. All extracted data were compiled, compared, and critically analyzed.

Data analysis: The review included 7 randomized controlled trials, 5 cluster-randomized trials, and 3 descriptive studies. Most studies demonstrated significant improvements in maternal and child dietary diversity, household food consumption, and minimum meal frequencies. Knowledge and practices around exclusive breastfeeding and complementary feeding also improved substantially. Among children, stunting, wasting, and underweight prevalence decreased significantly, with effect sizes indicating meaningful public health impacts. However, the sustainability of these outcomes depended on the follow-up duration. Notably, none of the included studies exhibited a high risk of bias, reinforcing the reliability of the findings.

Conclusion: Integrating SBCC into nutrition-sensitive social-protection programs is effective in achieving clinically significant nutritional outcomes for vulnerable populations. While the findings suggest sustained benefits, further research is needed to determine optimal entry points, effective messaging, advocacy strategies, and communication channels. This is particularly critical for lower-and middle-income countries, where malnutrition remains a critical challenge.

Systematic review registration: PROSPERO registration no. CRD42023452510.