Open research questions in Child Nutrition and Water Access

What the literature leaves open

• The high heterogeneity observed in the meta-analysis. The limited availability of data on the economic burden of podoconiosis. The difficulty in distinguishing podoconiosis from other diseases, such as lymphatic filariasis.

  The health and economic burden of podoconiosis in East Africa: A systematic review and meta-analysis of health outcomes with narrative synthesis of economic evidence · 2026 · DOI

• the search was limited to studies published in English between 2011 and 2023, - health facility-based studies were excluded, - studies that reported the cost of podoconiosis program interventions were excluded

  The health and economic burden of podoconiosis in East Africa: A systematic review and meta-analysis of health outcomes with narrative synthesis of economic evidence · 2026 · DOI

• Based on the findings of this study, the following recommendations are proposed to improve health worker adherence to the National Diarrhoea Management Guidelines among children under five years in public health facilities. The County Department of Health should institutionalize quarterly Integrated Management of Childhood Illness (IMCI) refresher training for all health workers involved in outpatient management of children under 5. The training should emphasize dehydration assessment, appropriate use of ORS and zinc, rational antibiotic prescribing, caregiver counselling, and accurate documentation to address the identified gaps in adherence. The County Department should also establish a quarterly supportive supervision programme using standardized supervision checklists based on the National Diarrhoea Management Guidelines. Supervisory visits should incorporate mentorship, clinical audits, and immediate feedback to reinforce adherence to recommended practices. In collaboration with the Kenya Medical Supplies Authority (KEMSA), the County should strengthen supply chain management by implementing routine monitoring of ORS, zinc, and other essential paediatric commodities to minimize stock-outs and ensure uninterrupted availability of treatment supplies.

  Determinants of Health Worker Adherence to National Diarrhoea Management Guidelines for Under-Five Children in Public Health Facilities in Embakasi Region, Nairobi County · 2026 · DOI

• The study faced challenges in terms of limited attention from the global health agenda and limited funding. The study also faced challenges in terms of the lack of awareness about NTDs among the study population. The study had to deal with the issue of field defecation being rampant in the study community.

  Relative burden of neglected tropical diseases among school-age children in rural and urban slum settings in Eastern Ethiopia · 2026 · DOI

• There is no sufficient evidence about the specific burden of NTDs and its essential determinants in eastern Ethiopia. The study identifies a need for collaborative efforts among stakeholders to prevent and control NTDs.

  Relative burden of neglected tropical diseases among school-age children in rural and urban slum settings in Eastern Ethiopia · 2026 · DOI

• Investigating the effectiveness of different communication channels in reaching the public, - Examining the relationship between awareness and behavioral compliance, - Studying the impact of environmental sanitation on public health

  Determinants of Residents’ Participation in Environmental Sanitation Programmes in Akure, Nigeria · 2026 · DOI

• The study identifies a gap in the understanding of residents' participation in environmental sanitation programmes. The study notes that awareness does not necessarily translate into a felt sense of responsibility or a 'cue to action'. The study highlights the need to understand the factors influencing residents' participation in environmental sanitation.

  Determinants of Residents’ Participation in Environmental Sanitation Programmes in Akure, Nigeria · 2026 · DOI

• The study identifies challenges in achieving sustainable WASH outcomes, including the need for integrated interventions and proper hygiene behavior. The paper highlights the challenge of ensuring microbiological water safety in schools. The study also identifies the challenge of managing fecal sludge in schools.

  Integrated Assessment of Water, Sanitation, and Hygiene (WASH) Practices in Government Primary Schools of Bangladesh · 2026 · DOI

• study focused on a specific urban administrative area (DSCC Zone-1), - limited to government primary schools, - no comparison with non-government schools

  Integrated Assessment of Water, Sanitation, and Hygiene (WASH) Practices in Government Primary Schools of Bangladesh · 2026 · DOI

• The study identifies a gap in understanding the relationship between Campylobacter colonization and undernutrition in infants in rural eastern Ethiopia, - The study highlights the need for further research on the impact of Campylobacter colonization on child growth and development

  Campylobacter colonization and undernutrition in infants in rural eastern Ethiopia — a longitudinal community-based birth cohort study · 2025 · DOI

• The study identifies regional and demographic disparities in the global burden of nutritional deficiencies. The study finds that the global burden of nutritional deficiencies remains substantial, with a total of 1,845,246,558 cases in 2021. The study highlights the need for enhanced healthcare access in high-risk SDI regions to further mitigate NDs's global impact.

  Analysis of study Global Burden of Disease in 2021: global, regional, and national burden of nutritional deficiency from 1990 to 2021 · 2025 · DOI

• further study to address the disparities in NDs incidence rates in different locations - more research on the dual burden of malnutrition in countries like Nepal

  Analysis of study Global Burden of Disease in 2021: global, regional, and national burden of nutritional deficiency from 1990 to 2021 · 2025 · DOI

• More research focused on the long-term effectiveness of CIAF-based interventions, - Research on the integration of CIAF into global health frameworks to improve malnutrition policies in LMICs, - Studies on the applicability of CIAF in various LMIC settings

  Composite Index of Anthropometric Failure to assess malnutrition in low- and middle-income countries across Africa, Asia, and Europe: a state-of-the-art review · 2025 · DOI

• There is a lack of research on the application of CIAF in low- and middle-income countries. The debate over the inclusion of obesity within the CIAF index is unresolved. There is a significant gap in research regarding the integration of CIAF into national health policies and its long-term effectiveness in reducing malnutrition.

  Composite Index of Anthropometric Failure to assess malnutrition in low- and middle-income countries across Africa, Asia, and Europe: a state-of-the-art review · 2025 · DOI

• There is a scarcity of studies on the prevalence and predictors of stunting among children under five in urban areas of Ethiopia. Most studies conducted in low-and middle-income countries have shown that growth faltering typically begins during pregnancy and by 2 years of age.

  A community-based study to assess the prevalence and predictors of stunting among under-five children in Sheger City, Oromia, Ethiopia · 2025 · DOI

• The study identifies challenges in accessing improved water sources, sanitation, and handwashing practices in rural areas. The study also notes challenges in collecting data, including the need for systematic random sampling and data quality control.

  Water, sanitation, and hygiene service inequalities and their associated factors among urban slums and rural communities in Eastern Ethiopia · 2024 · DOI

• Further studies should investigate the longitudinal effects of WaSH service inequalities on health outcomes, - Research should focus on developing targeted interventions to improve WaSH services in rural areas, - Studies should explore the impact of socioeconomic factors on WaSH service access and utilization

  Water, sanitation, and hygiene service inequalities and their associated factors among urban slums and rural communities in Eastern Ethiopia · 2024 · DOI

• Longitudinal studies to assess the impact of improved WASH facilities on MHH outcomes, - Intervention studies to evaluate the effectiveness of WASH improvements in FSW venues, - Research on the cost-effectiveness of WASH interventions in FSW venues

  Water, sanitation and hygiene at sex work venues to support menstrual needs · 2024 · DOI

• Limited evidence is available about open defecation practices among households with latrines, - The study was conducted in a specific district in Ethiopia, - The sample size was estimated using a single population proportion formula

  Open defecation practice among households with latrines in rural communities of Ararso District, Somali Region, Eastern Ethiopia · 2024 · DOI

• Limited studies on the relapse of acute malnutrition in Ethiopia. Lack of knowledge on factors associated with relapse. Need for improved treatment outcomes and reduced relapse rates.

  Acute malnutrition relapse and associated factors among 6–59 months old children treated in the community-based management of acute malnutrition in Dessie, Kombolcha, and Haik towns, Northeast Ethiopia · 2024 · DOI

• The impact of dietary diversity on children's health in Ethiopia remains unclear. There is a lack of understanding of the association between dietary diversity and undernutrition in children aged 6-23 months. The study aims to address this research gap by examining the association between minimum dietary diversity and undernutrition among children aged 6-23 months in Ethiopia.

  The influence of minimum dietary diversity on undernutrition among children aged 6–23 months in Ethiopia: a multilevel mixed-effect analysis based on 2019 Ethiopian mini demographic and health survey · 2024 · DOI

• However, the complex, non-linear determinants of household WASH access are poorly understood, limiting targeted NTD control.

  Predicting and Explaining WASH Inequities in Nigeria A Machine Learning Approach to Accelerate NTD Elimination · 2026 · DOI

• Although schools are recognized as key platforms for promoting healthy eating behaviors, school food environment (SFE) remain poorly documented in this island context.

  Adolescents’ exposure to unhealthy foods and beverages in and around schools in urban Comoros: a cross-sectional mixed-methods study · 2026 · DOI

• Although schools are recognized as key platforms for promoting healthy eating behaviors, school food environment (SFE) remain poorly documented in this island context.

  Adolescents’ exposure to unhealthy foods and beverages in and around schools in urban Comoros: a cross-sectional mixed-methods study · 2026 · DOI

• Although inadequate diet and infections are well-established determinants, the influence of household environmental factors such as indoor air pollution, unsafe drinking water, poor sanitation and improper waste disposal remains underexplored in developing countries.

  Effect of Environmental Factors on Undernutrition Among Children Under 5 Years in Rural Puducherry, Southern Part of India—A Community‐Based Cross‐Sectional Study · 2026 · DOI

Most-cited papers in Child Nutrition and Water Access

• Maternal and child undernutrition and overweight in low-income and middle-income countries · The Lancet · 2013 · 6,522 citations
• Maternal and child undernutrition: global and regional exposures and health consequences · The Lancet · 2008 · 4,524 citations
• Maternal and child undernutrition: consequences for adult health and human capital · The Lancet · 2008 · 3,040 citations
• What works? Interventions for maternal and child undernutrition and survival · The Lancet · 2008 · 1,590 citations
• Long term consequences of early childhood malnutrition · Oxford Economic Papers · 2006 · 847 citations
• Farm production diversity is associated with greater household dietary diversity in Malawi: Findings from nationally representative data · Food Policy · 2014 · 480 citations
• Estimating child mortality due to diarrhoea in developing countries · Bulletin of the World Health Organization · 2008 · 401 citations
• Sustaining healthy diets: The role of capture fisheries and aquaculture for improving nutrition in the post-2015 era · Food Policy · 2016 · 397 citations
• Food security: The challenge of the present · Geoforum · 2018 · 390 citations
• The Impact of Improving Nutrition During Early Childhood on Education among Guatemalan Adults · The Economic Journal · 2009 · 387 citations

Most recent work

• Short stature and food habits as determining factors for the low productivity of sugarcane labourers in the State of Alagoas, north-eastern Brazil · Archivos Latinoamericanos de Nutrición · 2026
• Malnutrition and double burden of disease: the African dilemma of non-communicable disease · Frontiers in Sustainable Food Systems · 2026
• Exploring acute malnutrition, acute watery diarrhea, dietary diversity, and vaccination coverage among internally displaced children in Yemen: A cross-sectional study · Public Health · 2026
• Prevalence and Determinants of Undernutrition Among Children Under Five in Coastal Bangladesh: A Community‐Based Study · Food Science & Nutrition · 2026
• Factors Associated With Composite Anthropometric Failures ( CIAF ) Among Under Five Children in Lesotho: An Insight From the 2023 to 2024 Demographic and Health Survey Data · Food Science & Nutrition · 2026
• Impact pathways of a homestead food production programme on women’s dietary diversity in Bangladesh · Nature Food · 2026
• The physiology of poverty: gut microbiome and pathways to child stunting · Philosophical Transactions of the Royal Society B Biological Sciences · 2026
• Rice Bran Supplements the Nutritional Density of Ready‐to‐Use Therapeutic Foods: A Targeted Nutrient and Non‐Targeted Metabolomic Analysis · Food Science & Nutrition · 2026
• Effect of Environmental Factors on Undernutrition Among Children Under 5 Years in Rural Puducherry, Southern Part of India—A Community‐Based Cross‐Sectional Study · Child Care Health and Development · 2026
• A meta-analysis of gut microbiome research in malnourished African populations: a natural language processing approach · Philosophical Transactions B · 2026

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