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Review
. 2025 May 1:36:100589.
doi: 10.1016/j.lansea.2025.100589. eCollection 2025 May.

Policies and programmes to improve preconception nutrition in South Asia

Avishek Hazra  1 , Tashi Choedon  1 , Monica Shrivastav  1 , Raj Kumar Verma  2 , Cheshta Gulati  1 , Dhammica Rowel  3 , Abner Daniel  3 , Preetu Mishra  4 , Naveen Paudyal  5 , Naureen Arshad  6 , Muhammad Salman  6 , Wisal Khan  6 , Khadija Khalif Osman Warfa  7 , Muhammad Amin  7 , Ahmadwali Aminee  7 , Ireen Akhter Chowdhury  8 , Kinley Dorji  9 , Indrani Chakma  9 , Aishath Shahula Ahmed  10 , Hari Prasad Pokhrel  11 , Danielle Schoenaker  12   13   14 , Jane Hirst  15 , Ranadip Chowdhury  16 , Naomi M Saville  17 , Faith Miller  17 , Zivai Murira  18 , Vani Sethi  18
Affiliations
Review

Policies and programmes to improve preconception nutrition in South Asia

Avishek Hazra et al. Lancet Reg Health Southeast Asia. .

Abstract

The health and health behaviours of women before conception significantly influence maternal and child health outcomes. Despite growing evidence supporting preconception nutrition care, data on the implementation of related policies and programmes remains limited. This paper reviews public policies and programmes delivering preconception nutrition interventions in eight South Asian countries, targeting married pre-pregnant women aged 15-49 years and identifies the systems bottlenecks in programme implementation. Most countries, except Sri Lanka, lack universal programmes for health and nutrition screening, provision of essential micronutrients, counselling on healthy eating and treatment for at-risk women. Even in countries, where supportive policies exist, implementation of comprehensive nutrition services for pre-pregnant women faces significant bottlenecks across six health system building blocks. Addressing these barriers is critical to improving intervention effectiveness, programme implementation, and informed decision-making. Further testing of a proposed comprehensive algorithm for preconception nutrition in diverse country contexts across South Asia is necessary.

Keywords: Policies and programs; Preconception care; Preconception nutrition; South Asia; Women's nutritional care and support.

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Conflict of interest statement

This work was funded by UNICEF Regional Office for South Asia (ROSA) contract number 43386162. The funder, UNICEF Regional Office of South Asia, was involved in the design of the review, provided oversight in its conduct and are coauthors (ZM, VS). The corresponding author had full access to all the data and the final responsibility to submit it for publication. Co-authors ZM and VS are employees of UNICEF Regional Office for south Asia which funded this study. Other authors have no conflicts of interest. The authors declare no other conflicts of interest. The statements in this publication are the views of the author(s) and do not necessarily reflect the policies or the views of UNICEF. The designations employed in this publication and the presentation of the material do not imply on the part of the UNICEF the expression of any opinion whatsoever concerning the legal status of any country or area, or of its authorities or the delimitations of its frontiers.

Figures

Fig. 1
Fig. 1
Five essential nutrition interventions for improving women’s nutritional care and support - before, between and beyond pregnancy.
Fig. 2
Fig. 2
Five Actions for women's nutritional care and support—before, between and beyond pregnancy.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO) WHO; Geneva: 2013. Preconception care: maximizing the gains for maternal and child health. A policy brief.
    1. Ramakrishnan U., Grant F., Goldenberg T., Zongrone A., Martorell R. Effect of women's nutrition before and during early pregnancy on maternal and infant outcomes: a systematic review. Paediatr Perinat Epidemiol. 2012;26(s1):285–301. - PubMed
    1. Dalmiya N., Kupka R., Tyler V., et al. 2021. Nutrition guidance series unicef programming guidance maternal nutrition acknowledgements.
    1. World Health Organization . 2013. Preconception care: Maximizing the gains for maternal and child health. Policy brief.
    1. World Health Organization Regional Office for South-East Asia . 2014. Preconception care Report of a regional expert group consultation. New Delhi, India.

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