# Evidence‐Based Behavioral Interventions to Improve the Double‐Duty Actions Impacting the Dual Burden of Malnutrition: A Scoping Review

## TL;DR

This scoping review identifies effective behavioral interventions in sub-Saharan Africa and Asia to improve breastfeeding, child nutrition, and antenatal care, addressing both stunting and obesity.

## Contribution

The study provides the first scoping review of evidence-based behavioral interventions targeting the dual burden of malnutrition.

## Key findings

- Training health extension workers and peer mentors in community settings is a promising approach.
- Community-based women's groups and home visiting improve adoption of double-duty actions.
- Facility-based and community-based education interventions successfully recruit pregnant women and mothers.

## Abstract

There are three double‐duty actions that prevent both stunting and obesity, the dual burden of malnutrition, that can be implemented at health clinics worldwide. They are breastfeeding, young child nutrition, and antenatal care and women's nutrition. There is no scoping review that provides a summary of evidence‐based interventions that increase the double‐duty actions. Inclusion criteria included articles from 2010 to 2024, included interventions to improve breastfeeding, young child nutrition, and antenatal care, did not restrict the intervention to supplementation alone, and were set in sub‐Saharan Africa or Asia. Using keyword search across platforms, two reviewers screened abstracts, full papers, conducted and validated data extraction using Covidence. Thirty‐six studies were included in the final analysis. Interventions included facility‐based and community‐based education and mentoring. The interventions successfully recruited pregnant women and women with young children in community settings. The most promising practices for successfully increasing breastfeeding best practices, young child nutrition, and antenatal care included training of health extension workers and peer mentors to support education and social support through community‐based women's groups and home visiting. Implementation science methods should be explored for context‐specific adaptation and implementation.

No scoping review summarizes evidence‐based behavioral interventions that improve double duty actions to prevent stunting and obesity. Inclusion criteria included articles from 2010 to 2024, behavioral interventions to improve breastfeeding, young child nutrition, and antenatal care, and were set in sub‐Saharan Africa or Asia. The most promising practices for increasing breastfeeding, young child nutrition, and antenatal care involved training of health extension workers and peer mentors to provide education and social support in the community along with women's groups.