Mapping policies and evidence addressing childhood malnutrition in India: a global scoping review of systematic reviews and India policy gap map.

BACKGROUND

Child undernutrition remains a leading contributor to mortality, morbidity and impaired development in low-income and middle-income countries, particularly in India where rates of stunting and underweight persist despite broad policy and programme investments. The critical window for intervention is the first 1000 days, from conception to age 2, when both maternal and child factors influence lifelong outcomes.

OBJECTIVES

To map the review level evidence on interventions to prevent and reduce child and maternal malnutrition across health, education, environment and engineering sectors in India, and assess the degree of alignment with current policy strategies targeting the first 1000 days.

ELIGIBILITY CRITERIA: Included sources were systematic reviews, meta-analyses and WHO guidelines published in English, addressing interventions for pregnant women, mothers of infants and children under 5 in India or other low-income/middle-income country settings.

SOURCES OF EVIDENCE: Evidence was identified via searches of MEDLINE, Cochrane Library, CINAHL, ERIC, GEOBASE, Engineering Village, and relevant policy reports and guidelines, up to July 2025.

CHARTING

METHODS

Reviews were screened, and data were extracted on intervention design, implementation context, sectoral focus, population, outcomes, strength of evidence and evidence gaps.

RESULTS

A total of 155 reviews met eligibility. Multisectoral approaches integrating nutrition, Water, Sanitation and Hygiene(WASH), education and social support showed the strongest impact for preventing stunting and improving child growth, particularly when targeted early. Intervention coverage and effectiveness were limited by gaps in cross-sector coordination, infrastructural constraints, poor supervision and exclusion of the youngest and poorest populations. Prevention in the first 1000 days yielded greatest benefits, but implementation challenges persist.

CONCLUSIONS

India's efforts against childhood malnutrition require integrated, context-specific and prevention-focused strategies. Mapping review evidence to policy reveals strengths and gaps, with lessons relevant for improving child and maternal nutrition in other high-burden regions.