Peer-reviewed article
Implementing school-based nutrition interventions in low- and middle-income countries: a scoping review of implementation strategies, frameworks, and outcomes.
Oleksandr Kamyshnyi, Iryna Halabitska, Pavlo Petakh, Sanju Bhattarai, Abhijit Sen ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined how school-based nutrition interventions are implemented in low- and middle-income countries, looking at the strategies, theories, and outcomes reported across eight studies from Nepal, Ghana, Pakistan, Tanzania, and India. Implementation strategies commonly included teacher-led delivery, staff training, community engagement, and integration into existing school systems. Major barriers to implementation were limited funding, poor infrastructure, staff workload, weak coordination between organisations, and limited monitoring. The review found that most studies did not clearly report whether interventions reached all intended children, whether they were delivered as planned, or whether benefits lasted after the study ended.
Key points
- Eight studies met inclusion criteria, conducted across Nepal, Ghana, Pakistan, Tanzania, and India
- Implementation strategies included teacher-led delivery, training, stakeholder engagement, external partnerships, and integration into school systems
- Reported barriers: limited funding, inadequate infrastructure, staff workload, weak coordination, limited monitoring, and dependence on external or parent contributions
- Implementation reporting was incomplete, particularly for reach, fidelity, and sustainability
- Future studies need clearer reporting of implementation processes and outcomes to support adaptation and scale-up
Limitations
The review was restricted to two databases (PubMed and Scopus) and English-language publications only, so relevant evidence from other sources and languages may have been missed. The small number of included studies (eight) limits the depth of conclusions that can be drawn about implementation strategies and outcomes across different contexts.
Abstract
School-based nutrition interventions are widely used to improve nutrition among children and adolescents in low- and middle-income countries. This scoping review examined implementation strategies, theories, models, frameworks, and implementation outcomes reported for school-based nutrition interventions in these settings. We included English-language primary studies conducted in school settings in low- and middle-income countries if they reported implementation strategies, implementation outcomes, theories, models or frameworks, barriers, facilitators, adaptation, sustainability, scale-up, or implementation processes. PubMed and Scopus were searched, and reference lists of included studies and relevant reviews were screened. Records were screened independently by two reviewers, and data were synthesized descriptively and thematically. The search identified 1,985 records, and eight studies met the inclusion criteria. The studies were conducted in Nepal, Ghana, Pakistan, Tanzania, and India. Implementation strategies included teacher-led delivery, training, stakeholder and community engagement, external partnership support, and integration into school systems. Reported barriers included limited funding, inadequate infrastructure, staff workload, weak coordination, limited monitoring, and dependence on external or parent contributions. Separately, implementation reporting was incomplete, particularly for reach, fidelity, and sustainability. Because the search was restricted to two databases and English-language publications, some relevant evidence may have been missed. Future studies should report implementation processes and outcomes more clearly to support adaptation, scale-up, and long-term delivery.