Peer-reviewed article
Mega-map of systematic reviews and evidence and gap maps on the interventions to improve child well-being in low- and middle-income countries
Ashrita Saran, Howard White, Kerry Albright, Jill Adona ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This mega-map synthesises systematic reviews and evidence gap maps on interventions to improve child well-being in low- and middle-income countries. The authors identified 333 systematic reviews and 23 evidence gap maps published since 2000, covering health, education, social protection, water and sanitation, and governance. Most reviews focus on traditional health and education interventions, but significant gaps exist in social protection, and in evidence for vulnerable populations including children with disabilities and minority groups. About 69% of reviews are assessed as low or medium quality, indicating that while the volume of research is growing, the rigour of evidence synthesis remains a challenge.
Key points
- 333 systematic reviews and 23 evidence gap maps identified on child well-being interventions in LMICs since 2000
- Publication rates have increased year-on-year, but distribution across regions and intervention types is uneven
- Most reviews concentrate on traditional health and education domains, with limited evidence in social work and social protection
- About 69% of reviews are assessed as low or medium quality using AMSTAR-2 rating scale
- Clear evidence gaps exist for vulnerable populations, particularly children with disabilities and minority groups, and for programmes explicitly addressing equity or disadvantaged groups
Limitations
This is a meta-synthesis of existing reviews rather than a direct assessment of intervention effectiveness. It cannot tell us which specific interventions work best for particular child well-being outcomes, only where evidence syntheses have or have not been conducted and their overall quality.
Abstract
Background: Despite a considerable reduction in child mortality, nearly six million children under the age of five die each year. Millions more are poorly nourished and in many parts of the world, the quality of education remains poor. Children are at risk from multiple violations of their rights, including child labour, early marriage, and sexual exploitation. Research plays a crucial role in helping to close the remaining gaps in child well-being, yet the global evidence base for interventions to meet these challenges is mostly weak, scattered and often unusable by policymakers and practitioners. This mega-map encourages the generation and use of rigorous evidence on effective ways to improve child well-being for policy and programming. Objectives: The aim of this mega-map is to identify, map and provide an overview of the existing evidence synthesis on the interventions aimed at improving child well-being in low- and middle-income countries (LMICs). Methods: Campbell evidence and gap maps (EGMs) are based on a review of existing mapping standards (Saran & White, 2018) which drew in particular of the approach developed by 3ie (Snilstveit, Vojtkova, Bhavsar, & Gaarder, 2013). As defined in the Campbell EGM guidance paper; "Mega-map is a map of evidence synthesis, that is, systematic reviews, and does not include primary studies" (Campbell Collaboration, 2020). The mega-map on child well-being includes studies with participants aged 0-18 years, conducted in LMICs, and published from year 2000 onwards. The search followed strict inclusion criteria for interventions and outcomes in the domains of health, education, social work and welfare, social protection, environmental health, water supply and sanitation (WASH) and governance. Critical appraisal of included systematic reviews was conducted using "A Measurement Tool to Assess Systematic Reviews"-AMSTAR-2 rating scale (Shea, et al., 2017). Results: We identified 333 systematic reviews and 23 EGMs. The number of studies being published has increased year-on-year since 2000. However, the distribution of studies across World Bank regions, intervention and outcome categories are uneven. Most systematic reviews examine interventions pertaining to traditional areas of health and education. Systematic reviews in these traditional areas are also the most funded. There is limited evidence in social work and social protection. About 69% (231) of the reviews are assessed to be of low and medium quality. There are evidence gaps with respect to key vulnerable populations, including children with disabilities and those who belong to minority groups. Conclusion: Although an increasing number of systematic reviews addressing child well-being topics are being published, some clear gaps in the evidence remain in terms of quality of reviews and some interventions and outcome areas. The clear gap is the small number of reviews focusing explicitly on either equity or programmes for disadvantaged groups and those who are discriminated against.