Quality improvement initiatives in maternal, infant, young child, and adolescent nutrition (MIYCAN) in India: A scoping review.

Abstract

High burden of malnutrition (underweight, stunting, wasting, and overweight) is a serious public health challenge in India, affecting large number of children and women of reproductive age. A comprehensive overhaul of health and nutrition services is required to the manage nutrition through the life-cycle approach. Quality improvement (QI) has become an essential element for healthcare in recent time and the same perspective should be extended to nutrition also. The objective of this scoping review was to identify array of the QI interventions for Maternal, Infant, Young Child, and Adolescent Nutrition (MIYCAN) services in healthcare settings in India. Systematic search was conducted using PubMed, Scopus, and Embase for all studies till January, 2025. The studies that merely assessed how well the services are meeting quality standards and studies that did not have any active intervention were excluded. Review process initially identified 642 records. After removing duplicates and screening for eligibility, 29 studies were included in the current scoping review. No study was identified for adolescent group. Key nutritional interventions identified were breastfeeding, anthropometry, antenatal care, nutritional supplementation, and human milk donation. Review shows that QI methodologies can be effectively applied to various specific groups within the MIYCAN framework, leading to significant improvements in health and nutrition outcomes. QI interventions are relatively simple, low-cost, and when implemented systematically, lead to the significant impact. The review demonstrates usefulness of QI based MIYCAN targeted nutritional interventions such as breastfeeding, nutritional supplementation, anthropometric assessments, antenatal care, and increasing access to donor milk.