Prevalence, determinants, intervention strategies and current gaps in addressing childhood malnutrition in Vietnam: a systematic review

Abstract

AbstractBackground Childhood malnutrition in all forms is a major public health issue worldwide. This review aimed to systematically examine the prevalence and determinants, and identify the potential interventions and current gap in addressing malnutrition including undernutrition, overnutrition and micronutrient deficiencies (MNDs) in Vietnamese children aged 0–18 years old. Methods Embase, Scopus, PubMed, and Web of Science were systematically searched through June 2022 to identify relevant articles published within the past 25 years. Study selection and data extraction were performed by one reviewer and checked for accuracy by the other two reviewers in accordance with PRISMA guideline. Risk of publication bias was assessed using American Dietetic Association Quality Criteria Checklist. Results 81 studies that met the inclusion criteria were included. Undernutrition have been decreased over time but still 22.4%, 5.2% and 12.2% of children under 5 were stunted, wasted and underweight, respectively. Prevalence of MNDs varied by age, regions or socio-economic groups, with 11.4–89.9%, 11–90%, 23–87%, 11–58% and 8–20% of Vietnamese children were anaemic and iron, zinc, vitamin D and retinol deficient, respectively. Overweight and obesity is now on the rise (7.4–22%). The key determinants of undernutrition/MNDs included living in rural areas, children with low birth weight, and poor socio-economic status, whereas living in urban and affluent areas, having an inactive lifestyle and being a boy were associated with increased risk of overweight or obesity. Nutrition specific intervention studies including supplementation and food fortification consistently showed improvements in anthropometric indices and micronutrient biomarkers, and national nutrition sensitive programmes also provided nutritional benefits on child’s growth and eating behaviours, but lack of data on childhood overweight. Conclusion Stunting is still prevalent at 20% in Vietnamese children (< 5years) despite a significant reduction over the decade. MNDs remain to be a serious problem, whilst overweight and obesity are rapidly rising requiring attention and intervention. This finding highlights the needs for double duty actions to simultaneously and effectively address different forms of childhood malnutrition in Vietnam. However, evidence on the potential intervention strategies, especially on MNDs and overnutrition are still limited to inform policy decision, thus future researches are warranted.