Abstract
OBJECTIVES: Existing data on nutrient intake and status among infants and young children in low- and middle-income countries comes from disparate sources of varying quality and representativeness. Decision-makers are further challenged by incomplete guidance on how to interpret the heterogenous data for program and policy planning. This study describes results of testing a novel method for categorizing the magnitude of dietary nutrient gaps among children 6–23 months at the national level and rating the quality of evidence using data from Tanzania. METHODS: We reviewed scientific articles and grey literature containing information on biochemical nutrient status and dietary intake of children 6–23 months and broader population groups as well as food availability data and household consumption and expenditure surveys and summarized the evidence in a detailed report. Three independent reviewers, one from Tanzania, with expertise in child nutrition and complementary feeding use pre-specified criteria and a scoring template to review the evidence report and rank the magnitude of the gap (none, small, moderate, large, or unknown) and quality of the evidence (none, suggestive, or clear) for 13 common problem nutrients. Scores were combined to produce a simple evidence gap chart to aid decision-makers. RESULTS: Preliminary findings from the evidence report suggest iron, vitamin A, and calcium are clearly lacking in the complementary feeding diet nationally with suggestive evidence for inadequate energy and quality protein. Evidence for other common problem nutrients is low in quality or missing. Final rankings and concordance of the reviewers of the magnitude of each nutrient gap and quality of the evidence will be presented at Nutrition 2019. CONCLUSIONS: Reviewing the literature on complementary feeding nutrient gaps from a range of sources and providing a scoring template allows nutrition experts to easily quantify gaps of common problem nutrients and rank the quality of evidence. The combined scoring charts provide robust but clear and simple guidance to inform program design and identify critical evidence gaps. FUNDING SOURCES: Ministry of the Foreign Affairs of the Netherlands.