Background
The 2023 WHO guideline on the prevention and management of wasting and nutritional oedema covered priority areas for guidance including around the management of severe wasting and nutritional oedema. One of the new recommendations outlines the quantity of ready‐to‐use therapeutic food (RUTF) to cover full energy requirements for infants and children to recover, including the possibility of providing a lower quantity once children are no longer severely wasted and do not have nutritional oedema.
There are additional questions of interest around the use of RUTF and other dietary approaches, beyond what was addressed in the 2023 WHO guideline around the use of RUTF. One question is around whether children with SAM can recover while using specific dietary approaches other than RUTF. There are many contexts with high prevalence of wasting and nutritional oedema where RUTF is not procured, and/or scenarios where there are frequent or ongoing stockouts of RUTF, yet there are no specific WHO recommendations on dietary approaches for severe wasting and nutritional oedema apart from RUTF.
Some researchers have also raised the point that there may be unintended consequences around the use of RUTF, related to rapid weight gain from the use of this product, including risk of noncommunicable diseases later in life. Furthermore, coverage remains low, with only one in three children having access to RUTF for management of severe wasting and nutritional oedema according to UNICEF.
Scope
There is a lack of WHO guidance on dietary approaches in cases where RUTF is unavailable and in contexts where RUTF is not used. There is even more urgency considering the shifting global health landscape with further challenges in procuring RUTF. We therefore propose a systematic review to evaluate other dietary approaches apart from RUTF, which can also include enhanced home diets, for management of severe wasting and nutritional oedema in infants and children.
How to apply for this call, concept note and budget
Interested author(s)/teams are invited to submit a concept note (5-6 pages) by sending an email to WHO at nfs@who.int no later than 15 November 2025. The subject heading of the email should read as, “Systematic review on dietary approaches apart from RUTF.”
The concept note should include a proposal containing (in a single document) the following:
- The lead author and host institution with overall responsibility for the systematic review and contributors.
- The specific competencies and contributions of each author or team member, explicitly stated. Interested author(s)/teams must have experience with conducting complex systematic reviews and should provide references of reviews that they have published in peer-reviewed journals. Interested author(s)/teams should have members with complementary skills and competencies including knowledge of the technical area, experience with systematic reviews, and excellent writing capabilities. Ideally, one of the contributors should be an information technologist or research librarian.
- Details of a proposed systematic review protocol, including:
- background and justification for the review
- eligibility criteria including study designs which may be kept broad
- a draft search strategy and databases to be searched
- methods around meta-analysis and/or methods for synthesis without meta-analysis
- plan for risk of bias and GRADE assessments
- Budget (US $). This should outline the total amount for the systematic review including an approximate breakdown of personnel vs. institutional/other costs. It is expected that WHO will provide technical input throughout the process.
Timeline
- 15 November 2025 – Interested authors or teams submit concept notes and budget to WHO
- 1 January 2026 – Systematic review protocol submitted in PROSPERO
- 1 July 2026 – Draft systematic reviews submitted
- 1 September 2026 – Final systematic reviews submitted to WHO (with access to GRADE Evidence Profiles in GRADEPro)