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. 2020 Oct 28;16(4):e1116.
doi: 10.1002/cl2.1116. eCollection 2020 Dec.

Mega-map of systematic reviews and evidence and gap maps on the interventions to improve child well-being in low- and middle-income countries

Ashrita Saran  1 , Howard White  2 , Kerry Albright  3 , Jill Adona  4
Affiliations

Mega-map of systematic reviews and evidence and gap maps on the interventions to improve child well-being in low- and middle-income countries

Ashrita Saran et al. Campbell Syst Rev. .

Abstract

Background: Despite a considerable reduction in child mortality, nearly six million children under the age of five die each year. Millions more are poorly nourished and in many parts of the world, the quality of education remains poor. Children are at risk from multiple violations of their rights, including child labour, early marriage, and sexual exploitation. Research plays a crucial role in helping to close the remaining gaps in child well-being, yet the global evidence base for interventions to meet these challenges is mostly weak, scattered and often unusable by policymakers and practitioners. This mega-map encourages the generation and use of rigorous evidence on effective ways to improve child well-being for policy and programming.

Objectives: The aim of this mega-map is to identify, map and provide an overview of the existing evidence synthesis on the interventions aimed at improving child well-being in low- and middle-income countries (LMICs).

Methods: Campbell evidence and gap maps (EGMs) are based on a review of existing mapping standards (Saran & White, 2018) which drew in particular of the approach developed by 3ie (Snilstveit, Vojtkova, Bhavsar, & Gaarder, 2013). As defined in the Campbell EGM guidance paper; "Mega-map is a map of evidence synthesis, that is, systematic reviews, and does not include primary studies" (Campbell Collaboration, 2020). The mega-map on child well-being includes studies with participants aged 0-18 years, conducted in LMICs, and published from year 2000 onwards. The search followed strict inclusion criteria for interventions and outcomes in the domains of health, education, social work and welfare, social protection, environmental health, water supply and sanitation (WASH) and governance. Critical appraisal of included systematic reviews was conducted using "A Measurement Tool to Assess Systematic Reviews"-AMSTAR-2 rating scale (Shea, et al., 2017).

Results: We identified 333 systematic reviews and 23 EGMs. The number of studies being published has increased year-on-year since 2000. However, the distribution of studies across World Bank regions, intervention and outcome categories are uneven. Most systematic reviews examine interventions pertaining to traditional areas of health and education. Systematic reviews in these traditional areas are also the most funded. There is limited evidence in social work and social protection. About 69% (231) of the reviews are assessed to be of low and medium quality. There are evidence gaps with respect to key vulnerable populations, including children with disabilities and those who belong to minority groups.

Conclusion: Although an increasing number of systematic reviews addressing child well-being topics are being published, some clear gaps in the evidence remain in terms of quality of reviews and some interventions and outcome areas. The clear gap is the small number of reviews focusing explicitly on either equity or programmes for disadvantaged groups and those who are discriminated against.

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Figures

Figure 1
Figure 1
Conceptual framework of mega‐map. Source: Authors' own design (adapted from UNICEF's strategic goals)
Figure 2
Figure 2
PRISMA for child well‐being mega‐map
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Figure 3
Number of systematic reviews and EGMs. EGM, evidence and gap map
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Figure 4
Trends in publication of systematic reviews by interventions over time
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Figure 5
Trends in publication of EGMs by interventions over time. EGM, evidence and gap map
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Figure 6
Number of studies for early childhood development interventions by study theme and quality
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Figure 7
Number of studies for health and nutrition interventions by study theme and quality
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Figure 8
Number of studies for education interventions by study theme and quality
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Figure 9
Number of studies for social work and welfare by study theme and quality
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Figure 10
Number of studies for social protection by study theme and quality
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Figure 11
Number of studies for environmental health including WASH by study theme and quality
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Figure 12
Number of studies for governance by study theme and quality
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Figure 13
Number of studies by UNICEF strategic goals
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Figure 14
Number of studies by population subgroup
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Figure 15
Number of systematic reviews by region
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Funders of systematic reviews
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Figure 17
Most funded systematic review sectors
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Figure 18
Funders of evidence and gap maps
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Figure 19
Priority areas and gaps in evidence
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