For this comprehensive narrative review, we evaluated both nutrition-specific and nutrition-sensitive interventions. Nutrition-specific approaches are those that address the immediate determinants of nutrition (e.g., food and nutrient intake, diet-related practices and behaviors, disease, etc.), whereas nutrition-sensitive approaches are those that address the underlying determinants of nutrition (e.g., food security, access to resources, safe and hygienic environments, adequate health services, etc.) (5, 12). We evaluated the following nutrition-specific interventions described by Bhutta et al. (13, 14): nutrition counseling and education, micronutrient supplementation and fortification, protein and energy supplementation, and lipid-based supplementation. We also included the following nutrition-sensitive approaches described by Ruel and Alderman (5) and Bhutta et al. (14): health care; family planning; water, sanitation, and hygiene (WASH); empowerment; income-generation; education; and social protection. For each intervention, we 1) described the scale and coverage of the intervention, when available; 2) summarized the evidence of effectiveness for women's health and nutrition outcomes; and 3) described and evaluated the target population and delivery platforms, as described in the published articles and as summarized in Table 1. The delivery of interventions included the physical platforms, as well as the adherence and the implementation challenges of the different interventions.
In low- and middle-income countries, health care services often respond to acute health needs and many focus on maternal–child health (105, 106, 110, 112). The use of preventative care is limited, and there are concerns about the capacity of health systems to address noncommunicable diseases, such as diabetes, in low- and middle-income settings (108, 112). This has implications for the reach of integrated health care interventions across the life course. Maternal and reproductive health care is often sought by women when they are pregnant and in the early years of their children's lives (3, 113). Even so, many women visit health facilities late in their pregnancy or not at all (114–116). For adolescents and adult women, care is often not sought until they are sick (3, 117, 118). This is problematic for older women, in particular, as screening and treatment for age-related health issues, such as diabetes, cancer, and hypertension, require access to preventative health care services (3).
Abortion is the intentional termination of pregnancy, as compared to spontaneous termination (miscarriage). Abortion is closely allied to contraception in terms of women's control and regulation of their reproduction, and is often subject to similar cultural, religious, legislative and economic constraints. Where access to contraception is limited, women turn to abortion. Consequently, abortion rates may be used to estimate unmet needs for contraception. However the available procedures have carried great risk for women throughout most of history, and still do in the developing world, or where legal restrictions force women to seek clandestine facilities. Access to safe legal abortion places undue burdens on lower socioeconomic groups and in jurisdictions that create significant barriers. These issues have frequently been the subject of political and feminist campaigns where differing viewpoints pit health against moral values.
Getting enough water also is important. Many experts recommend at least eight 8-ounce glasses of water daily—more if you exercise frequently or are exposed to extremes of heat and cold. The 2010 Dietary Guidelines for Americans emphasize drinking more water and other calorie-free beverages, along with fat-free or low-fat milk and 100 percent fruit juices, instead of calorie-packed regular sodas.