Barriers and Facilitators to Cognitive Participation in Peer Support for Complementary Feeding in LMICs
A Theory‐Informed Systematic Review
Bibliographic Data
| ID | 15537342 |
|---|---|
| Authors | Asnake Ararsa Irenso (0000-0002-1071-9823, Deakin University, corresponding author), Hirbo Shore (University of Southern Queensland), Karen Campbell (0000-0002-4499-3396, Deakin University), Rachel Laws (0000-0003-4328-1116, Deakin University) |
| Year | 2026 |
| Volume | 22 |
| Issue | 1 |
| Publication date | 2026-01-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Maternal and Child Nutrition (JOURNAL) |
| Journal identifiers | ISSN: 1740-8695 • E-ISSN: 1740-8709 |
| Publisher | Wiley (PUBLISHER • GB) |
| DOI | 10.1111/mcn.70154 |
| OpenAlex | W7118780193 |
| Language | EN |
| References cited | 70 |
Suboptimal complementary feeding practices remain a significant challenge in LMICs. Peer support shows promise in improving these practices; however, their long‐term success hinges on sustained engagement and integration into existing support systems, aspects that remain poorly understood. This theory‐led systematic review aimed to understand why people participate, support, and continue using peer support for complementary feeding practices. The literature search covered studies conducted between January 1990 and February 2025. This pragmatic, Normalisation Process Theory‐led review employs an integrative mixed‐methods synthesis. We conducted a theory‐informed systematic review guided by the four subconstructs of cognitive participation, presenting the findings narratively into barriers and facilitators. While peer‐led complementary feeding promotion involves multiple actors at different levels, few studies directly included family members and caregivers beyond mothers, thereby limiting their cognitive participation. Most studies were donor‐driven. Financial, structural, sociocultural, training, and capacity‐related factors strongly influence peer‐led complementary feeding support. Their influences were not fixed; what served as facilitators in the initial stages of studies became barriers later, and vice versa. Household and local leaders and gatekeepers constrained peer support early in the interventions, but this later reversed with their involvement. Incentives boosted interest and increased enrolment. However, this also led to volunteers being less motivated and to attrition when resources were limited. Weak supportive supervision diminished the legitimacy of peer support, causing a loss of confidence in volunteers' skills. Keeping the momentum of early implementation stages requires a predictable funding model, primarily from domestic sources, and sustained engagement in the intervention. This can address multifaceted operational problems, ranging from recruitment to embedding the intervention in the health system. Political commitment, especially when translated into operational support, can strengthen the financial sustainability of peer support programmes
Attrition · Cognition · Incentive · Legitimacy · Limiting · Peer support · Promotion (chess · Social support · Breastfeeding Practices and Influences · Child Nutrition and Water Access · Food Security and Health in Diverse Populations
Effective interventions to address maternal and child malnutrition
What works? Interventions for maternal and child undernutrition and survival
Using Normalization Process Theory in feasibility studies and process evaluations of complex healthcare interventions
Community participation in health services development, implementation, and evaluation
The PRISMA 2020 statement
Effect of home visits by community health workers on complementary feeding practices among caregivers of children aged 6–23 months in 10 districts of Bangladesh
Evaluating the effectiveness of Community Health Worker home visits on infant health
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Social norms and their influence on eating behaviours
The effect of participatory women's groups on infant feeding and child health knowledge, behaviour and outcomes in rural Bangladesh
Using Normalization Process Theory as a Practical Tool Across the Life Course of a Qualitative Research Project
Undoing Aid
Collective Action Theory and the Dynamics of Complex Societies
| Citation velocity | historical |
|---|---|
| Highly cited | No |