Hidden hunger and child undernutrition in South Asia : a meta-ethnographic systematic review

Background and Objectives: South Asia hosts the largest proportion of undernourished children in the world. Hidden hunger and undernutrition continue to be a major global health concern in the region. A systematic review looking at factors and drivers for hidden hunger and child undernutrition was undertaken. Methods and Study Design: This review was conducted using the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analysis guidelines. Five computerized databases were searched: CINAHL, EMBASE, PubMed, PsycINFO and Scopus, in addition to various grey literature sources. Results: A total of 3601 articles were retrieved from databases and 25 studies from grey literature, 98 studies met our inclusion criteria. Included studies were assessed for quality by validated tools. A Meta-ethnographic narrative approach was used to analyse the findings. The most commonly reported factors for child undernutrition were maternal education, poor dietary diversity and rural residence. Conclusions: Based on findings we propose a model to mainstream context specific nutrition behavioural change along with nutrition specific and sensitive interventions aimed at targeting gender, social and cultural factors and norms.