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ObjectiveIdentify and describe the available evidence on the effects food systems interventions on food security and nutrition outcomes in low-income and middle-income countries.MethodsAn adapted version of the high-level panel of experts food systems framework defined the interventions and outcomes included studies. Included study designs were experimental and quasi-experimental quantitative impact evaluations and systematic reviews. Following standards for evidence gap maps developed by 3ie, a systematic search of 17 academic databases and 31 sector-specific repositories in May 2020 identified articles for inclusion. Trained consultants screened titles/abstracts, then full texts of identified articles. Studies meeting eligibility criteria had meta-data systematically extracted and were descriptively analysed. Systematic reviews were critically appraised.ResultsThe map includes 1838 impact evaluations and 178 systematic reviews. The most common interventions, with over 100 impact evaluations and 20 systematic reviews each, were: provision of supplements, fortification, nutrition classes, direct provision of foods and peer support/counselling. Few studies addressed national-level interventions or women’s empowerment. The most common final outcomes were: anthropometry, micronutrient status, and diet quality and adequacy. Intermediate outcomes were less studied.Most evaluations were conducted in sub-Saharan Africa (33%) or South Asia (20%). Many studies occurred in lower-middle-income countries (43%); few (7%) were in fragile countries. Among studies in a specific age group, infants were most frequently included (19%); 14% of these also considered mothers.Few evaluations considered qualitative or cost analysis; 75% used randomisation as the main identification strategy.DiscussionThe uneven distribution of research means that some interventions have established impacts while other interventions, often affecting large populations, are underevaluated. Areas for future research include the evaluation of national level policies, evaluation of efforts to support women’s empowerment within the food system, and the synthesis of dietary quality. Quasi-experimental approaches should be adopted to evaluate difficult to randomise interventions.

Reduction of food waste in low-and-middle-income countries (LMICs) can provide multi-layered benefits for their sustainable development, through improved food security, enhanced income as well as the creation of environmentally friendly secondary markets. Food systems, however, are often characterised by a complex network of actors across the value chain, where a parochial intervention at a local scale does not always achieve a globally optimal outcome. Here, we systematically reviewed 8318 studies for the current evidence associated with the impact of interventions pursuing food waste reduction in LMICs. We first classified interventions by the target stage within the value chain and by the mechanism of action, and then further based on whether they are primarily designed to prevent or mitigate (recycle, reuse, remanufacture, repurpose and recover) the wastage of the commodity. We found a near-complete disconnect between preventive and mitigative interventions amongst the studies, with the former only investigated at production, storage and transportation stages and the latter only at wholesale and consumption stages. No identified study employed preventive and mitigative measures together to explore the combined level of efficacy. We also identified a strong bias in favour of material-based interventions, with little attention given to knowledge-based alternatives or local capacity building.

Background The purpose of this study is to assess the level of knowledge, attitudes, and willingness to organ donation among the general public in China. Methods The study population consisted of 4274 participants from Eastern, Central and Western China. The participants’ knowledge, attitudes and willingness to organ donation were collected by a self-designed questionnaire consisting of 30 items. Knowledge is measured by 10 items and presented as a 10 point score, attitudes is measured by 20 items using a 5-step Likert scale and total score ranged between 0 and 80; while the willingness to donate is assessed as binary variable (0 = No; 1 = Yes). A logistic regression model was used to assess the association of knowledge and attitudes with willingness to organ donation, controlling for demographic and socioeconomic confounders. Results The questionnaire response rate was 94.98%. The mean score (± SD) of the general public’s knowledge to organ donation was 6.84 ± 1.76, and the mean score (± SD) of attitudes to organ donation was 47.01 ± 9.07. The general public’s knowledge and attitudes were the highest in Eastern China, followed by West and Central China. The logistic regression model indicated a positive association between knowledge and the willingness to organ donation (OR = 1.12, 95%CI: 1.08, 1.17; P