Systematic review on the impacts of agricultural interventions on food security and nutrition in complex humanitarian emergency settings.

Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little evidence on child nutrition. Our review underscores the need for more rigorous research on the impacts of agricultural interventions in complex humanitarian emergency settings.

School-Based Nutrition Programs in the Eastern Mediterranean Region: A Systematic Review.

This systematic review aims at documenting government-led school nutrition programs/interventions in countries of the Eastern Mediterranean Region (EMR). A systematic review of the available literature on this topic was conducted between 25 October 2022 and 15 November 2022 using 15 electronic databases as well as grey literature. The search was limited to materials published post 2000 in English, Arabic, or French. Articles/Reports were included in the review if they provided information on school-based nutrition programs/interventions developed, adopted or implemented by a governmental entity in the EMR countries, irrespective of study design. In total, 158 documents were retained until 16 May 2023. School-based programs/interventions were categorized into 13 types. In total, 298 school-based nutrition programs/interventions were identified. The most common were school meals and school feeding programs (all EMR countries) followed by nutrition education within the curriculum (77% of countries), extracurricular nutrition education (64%), standards for school canteens or foods/beverages available in schools (64%), and training of school staff (59%). Approximately half reported the inclusion of fruit and vegetable schemes (54%) or the establishment of hygienic cooking facilities (50%), while less than half reported standards for the marketing of food/beverages (45%), bans/standards for vending machines, milk feeding schemes, or micronutrient supplementation programs (41%). The least common interventions were school gardens (32%) and take-home rations (14%). Countries with the lowest gross domestic product and lowest government effectiveness score had the lowest number of programs/interventions. Many of the programs have tackled both school-aged children as well as preschoolers. We were able to identify monitoring and process evaluation for 21 programs in 14 countries. Few programs have undergone impact assessment.

Help-seeking behaviour in women diagnosed with gynaecological cancer: a systematic review.

BACKGROUND: Identifying what prompts or hinders women's help-seeking behaviour is essential to ensure timely diagnosis and management of gynaecological cancers. AIM: To understand the factors that influence the help- seeking behaviour of women diagnosed with gynaecological cancer. DESIGN AND SETTING: Systematic review and narrative synthesis of studies from high-income settings worldwide. METHOD: Five databases were searched for studies, of any design, that presented factors related to the help-seeking behaviour of women diagnosed with a gynaecological cancer. Data from the articles were extracted and presented using narrative synthesis, which was both inductive and deductive. The COM-B (capability, opportunity, motivation, behaviour) model of behaviour change was used as a framework. RESULTS: In total, 21 studies were included in the review. Inductive synthesis presented three main themes of factors related to the help-seeking behaviour of women diagnosed with gynaecological cancer: patient factors, such as knowledge of symptoms; emotional factors, including previous healthcare experience, embarrassment, and trust; and practical factors, including time and resources. Deductive synthesis demonstrated that capability (namely, symptom knowledge), opportunity (having the required time and overcoming the cultural taboos surrounding gynaecological symptoms), and motivation (believing that seeking help is beneficial) are all required to initiate help-seeking behaviour. CONCLUSION: Although it is a journey of defined steps, the help- seeking behaviour of women with symptoms diagnosed with gynaecological cancer is influenced by personal and societal factors. Interventions to improve help seeking will need to address the specific identified factors, as well as capability, opportunity, and motivation.