More information is needed about the nutritional status of the millions of children living within institutionalized care to fully address their right and need for healthy development. Taken together, these findings suggest a need for greater focus on improving nutrition for younger children in institutions, especially those with disabilities. Data quality was often poor: as well as suboptimal reporting of anthropometry, few looked for or described disabilities, despite disability being common in this population and having a large potential impact on nutrition status. Micronutrient deficiencies and obesity were also prevalent. Of the studies reviewed, children living within institutionalized care were commonly malnourished, with undernutrition affecting young children particularly. This study highlights the limited amount of evidence-based data available on the nutritional status of children in institutions. Children living within institutions were more malnourished than community peers, although children living in communities were also often below growth standards. Younger children were typically more malnourished than older children, with a few exceptions. Half the studies with dietary information found inadequate intake or diet diversity.
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Skin conditions or infections ranged from 10-31% and parasites from 6-76%. The prevalence of HIV was from 2-23% and anemia from 3-90%. Overweight/obesity ranged from 10-32% and small head circumference from 17-41%. Prevalence of undernutrition varied between ages, sites and countries: stunting ranged from 9-72% wasting from 0-27% underweight from 7-79% low BMI from 5-27%. Only five (20%) included information on children with disabilities and reported prevalence from 8-75%. Low birth weight prevalence ranged from 25-39%. Ten (40%) of the studies focused on children >5 years, seven (28%) on children <5 years, seven (28%) covered a wide age range and one did not include ages. Two (8%) studies reported data from multiple countries, nine (36%) were from Asia, four (16%) from Africa, three (12%) from Eastern Europe, four (16%) from the European Union and one (4%) from each of the remaining regions (Middle East, South America and the Caribbean).
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The review is registered on PROSPERO: CRD42019117103.įrom 3,602 titles screened, we reviewed 98 full texts, of which 25 papers were eligible. Studies that included information on anthropometry or micronutrient status of children living within institutionalized care were eligible for inclusion.
We searched four databases (Pubmed/Medline, CINHAL Plus, Embase and Global Health Database) for relevant articles published from January 1990 to January 2019. This review aimed to evaluate currently available data on the nutrition status of children living within institutionalized care. There are an estimated 2.7 million children living within institutionalized care worldwide. Lower prenatal risk and better institutional relational care were associated with Improving weight over time.ĭiscussion highlights the role of children's physical features at birth, prenatal risk, and caregiver's cooperation with the child in explaining differential trajectories. Physical characteristics at birth were associated with trajectories across all domains. Data were analyzed using latent class analysis, yielding diverse patterns of growth for each feature, and relations with child characteristics, early family risk factors, and institutional relational care were investigated.įor each growth feature, 4 classes emerged: "Persistently Low," "Improving," "Deteriorating," and "Persistently High." Younger age at admission was a risk factor for impaired physical growth across all domains.
Weight, height, and head circumference were measured on 4 occasions, beginning at admission. To identify and analyze diverse longitudinal trajectories of physical growth of institutionalized children and their relation to child, family, and institutional factors.Ĥ9 institutionalized children were studied for 9 months after admission.