Bridging the gap in pediatric nutrition: a narrative review of nutritional support strategies and their impact on child health inequalities

Childhood malnutrition is an urgent public health concern that negatively influences vulnerable populations and strengthens inequities in health. Child malnutrition occurs both as a result of undernutrition and overnutrition, both of which disrupt child physical growth and mental development and, in turn, lead to long-term health consequences that may extend into adulthood, as well as perpetuate cycles of malnutrition intergenerationally. The purpose of this narrative review is to evaluate nutritional support strategies through locally relevant policies, community engagement and support, health care systems, and household-level supports to assess their effectiveness in reducing disparities in child health outcomes. Evidence has demonstrated that policy, community, and health-care-integrated strategies have been most effective in reaching disadvantaged children. Examples of effective policy strategies include food fortification, subsidies, and cash transfer initiatives, which improve the availability and access to adequate and appropriate foods for disadvantaged children. Community and household-level program strategies help improve the diversity of children's diets, adherence to eating programs, and caregiver practices. The quality of care improves when nutrition assessment and counseling are integrated into primary health care, thereby enhancing the early identification and management of malnutrition. Evidence indicates that culturally relevant, equity-focused, and multi-level interventions produce the greatest improvements in child nutrition and health equity. Therefore, context-specific and sustainable strategies are vital for closing the childhood nutrition gap and ultimately ensuring those children's growth, cognitive development, and long-term health outcomes are optimal throughout the world.