Researchers looked at hundreds of studies to understand how different programs help families—especially mothers and children—eat better food and stay healthier. They studied four types of programs: giving families money or food, helping farmers grow nutritious crops, improving water and sanitation, and school meal programs. The good news? These programs work! When families get cash or food help combined with nutrition education, they eat more variety. Farm programs that teach nutrition also help. The research shows that combining these efforts across different parts of society—like schools, farms, and health programs—is the best way to fight hunger and malnutrition worldwide.

The Quick Take

  • What they studied: Do programs that help families get food, improve farming, provide clean water, and offer school meals actually help kids grow better and eat healthier foods?
  • Who participated: Researchers reviewed 260 different studies from around the world that tested these types of programs with mothers and children, mostly in countries where hunger is a bigger problem.
  • Key finding: Programs that give families money or food work better when they also teach people about nutrition. Farm programs that focus on growing nutritious food help families eat more variety. When programs combine multiple approaches (like food help plus education), they work even better.
  • What it means for you: If you live in or work with communities facing food insecurity, these programs—especially when combined together—can meaningfully improve what families eat and how healthy children become. However, success depends on how well programs are designed and run in each community.

The Research Details

This was a systematic review and meta-analysis, which means researchers looked at hundreds of existing studies to find patterns and combine results. They started with a very broad search for any programs designed to improve nutrition outside of hospitals and clinics—things like cash assistance, farming help, water systems, and school meals. They then did deeper dives into specific programs and measured their effects on how diverse people’s diets were and how well children grew. For some programs, they combined numbers from many studies (meta-analysis), while for others, they summarized what studies showed (narrative synthesis). They also looked at how the local situation—like whether a community was rural or urban—affected whether programs worked well.

This approach is important because individual studies can be small or show mixed results. By looking at many studies together, researchers can see the bigger picture of what actually works. The researchers also paid attention to how programs were run in different places, which helps explain why some programs succeed in one location but struggle in another.

The researchers pre-registered their plan before doing the analysis, which reduces bias. They looked at 260 studies initially and added 72 more through targeted searches, showing thorough work. The fact that they used both statistical analysis (meta-analysis) and careful reading of studies (narrative synthesis) strengthens their conclusions. However, the journal impact factor is unknown, and the studies they reviewed varied in quality, which means some findings are stronger than others.

What the Results Show

Cash transfer programs—where families receive money or food—improved dietary diversity (the variety of foods families eat) with a moderate effect size. When these programs also included education about nutrition, the effect was much stronger, nearly three times bigger. This suggests that teaching families how to use money or food wisely matters just as much as giving it to them.

Farming programs that focus on growing nutritious crops also improved dietary diversity, especially when they included nutrition education. Interestingly, adding education to farm programs didn’t make them work better for dietary diversity specifically, though it may help in other ways.

School feeding programs showed promise for helping children grow taller and healthier. Programs that improve water, sanitation, and hygiene (clean bathrooms, handwashing) worked best when combined with other nutrition efforts rather than standing alone.

Homestead food production—where families grow food at home—appeared to reduce anemia (low iron in the blood), which is a common problem in children and pregnant women.

The research found that combining multiple approaches works better than single programs. For example, a program that provides food AND teaches nutrition AND improves water systems likely works better than just one of these alone. The studies also showed that how well a program works depends heavily on local conditions—what works in one village might need changes to work in another.

This research builds on earlier work showing that nutrition matters for child development. Previous studies often looked at single programs in isolation. This review is important because it shows that programs work better together and that education is a key ingredient for success. The findings support what health experts have been saying: you can’t fight malnutrition with just one approach.

The studies reviewed had different quality levels—some were very rigorous, others less so. The researchers couldn’t always combine results from different studies because they measured things differently. Some important outcomes, like whether children stayed healthy long-term, weren’t measured in many studies. The research mostly comes from lower-income countries, so results might be different in wealthier nations. Finally, the studies varied in how well they were designed, which means some findings are more reliable than others.

The Bottom Line

Strong evidence supports combining cash or food assistance with nutrition education for families. Moderate evidence supports farm programs focused on nutritious crops, especially with education. School feeding programs show promise for child growth. Water and sanitation improvements work best as part of larger nutrition programs. Confidence levels: High for cash transfers with education, Moderate for agricultural programs, Moderate for school feeding, Moderate for combined approaches.

Policymakers and program designers in countries with high rates of child malnutrition should pay attention. Families struggling with food insecurity can benefit from these programs. Health workers and educators can use this to advocate for better nutrition programs. Parents should know that education about nutrition is just as important as receiving food or money. This research is less relevant for wealthy countries with strong food systems, though some principles may apply.

Dietary diversity improvements may appear within months of program start. Child growth improvements typically take 6-12 months to become noticeable. Anemia reduction may take several months to a year. Long-term health benefits could take years to fully appear. Results depend heavily on program quality and how long families participate.

Want to Apply This Research?

  • Track the variety of different food groups eaten each day (grains, proteins, vegetables, fruits, dairy). Count how many different colors of foods appear in meals. This directly measures dietary diversity, which is what these programs improve.
  • If using an app to support nutrition programs: Log daily meals to see food variety patterns. Set reminders to try one new nutritious food weekly. Track which family members eat what to ensure everyone gets diverse nutrition. Use the app to learn nutrition tips that complement any assistance programs.
  • Weekly review of food variety scores. Monthly check-ins on whether dietary diversity is increasing. Track any changes in energy levels or health markers if available. Compare current diet variety to baseline to see progress over time.

This research summary is for educational purposes and should not replace professional medical or nutritional advice. The studies reviewed focus primarily on low-income countries and may not apply to all populations. If you or your family are experiencing food insecurity or malnutrition, consult with a healthcare provider, registered dietitian, or local health department for personalized guidance. Program effectiveness depends on local implementation and individual circumstances. Always discuss major dietary or program changes with a qualified healthcare professional.