What Approaches are Most Effective at Addressing Micronutrient Deficiency in Children 0–5 Years? A Review of Systematic Reviews

M. Campos Ponce*, K. Polman, N. Roos, F. T. Wieringa, J. Berger, C. M. Doak

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Introduction Even though micronutrient deficiency is still a major public health problem, it is still unclear which interventions are most effective in improving micronutrient status. This review therefore aims to summarize the evidence published in systematic reviews on intervention strategies that aim at improving micronutrient status in children under the age of five. Methods We searched the literature and included systematic reviews that reported on micronutrient status as a primary outcome for children of 0–5 years old, had a focus on low or middle income countries. Subsequently, papers were reviewed and selected by two authors. Results We included 4235 reviews in this systematic review. We found that (single or multiple) micronutrient deficiencies in pre-school children improved after providing (single or multiple) micronutrients. However home fortification did not always lead to significant increase in serum vitamin A, serum ferritin, hemoglobin or zinc. Commercial fortification did improve iron status. Cord clamping reduced the risk of anemia in infants up to 6 months and, in helminth endemic areas, anthelminthic treatment increased serum ferritin levels, hemoglobin and improved height for age z-scores. Anti-malaria treatment improved ferritin levels. Discussion Based on our results the clearest recommendations are: delayed cord clamping is an effective intervention for reducing anemia in early life. In helminth endemic areas iron status can be improved by anthelminthic treatment. Anti-malaria treatment can improve ferritin. In deficient populations, single iron, vitamin A and multimicronutrient supplementation can improve iron, vitamin A and multimicronutrient status respectively. While the impact of home-fortification on multimicronutrient status remains questionable, commercial iron fortification may improve iron status.

Original languageEnglish
Pages (from-to)4-17
Number of pages14
JournalMaternal and Child Health Journal
Issue numberSupplement 1
Early online date4 Jun 2018
Publication statusPublished - 15 Jan 2019

Bibliographical note

Special Issue: Improving policies to combat micronutrient deficiencies in Southeast Asia : The SMILING experience
Issue Editors: Jacques Berger, Nanna Roos, Frank Tammo Wieringa


Acknowledgements The authors would like to thank Eline Freriks and Mirthe Klein Haneveld for their help in the May 2016 search. This study was performed in the context of the SMILING (“Sustainable Micronutreint Interventions to controL deficiencies and Improve Nutritional status and General Health in Asia”) project that was funded by the European commission in the 7th framework programme for research and technological development (GA 289616).

FundersFunder number
European commission in the 7th framework programmeGA 289616
Seventh Framework Programme289616


    • Anthelmintics
    • Anti-malaria treatment
    • Cord clamping
    • Deficiency
    • Fortification
    • Micronutrient


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