Prevention of iron deficiency and iron deficiency anaemia in Indigenous children under 5 years of age in Australia, New Zealand, USA and Canada: protocol for a scoping review

Background: The World Health Organization (WHO) estimates global prevalence of anaemia in children under 5 years of age to be approximately 40%. Prevalence of anaemia greater than 20% is classified by the WHO as a moderate public health problem, while prevalence greater than 40% is a severe public health problem. A 2011 systematic review found the prevalence of anaemia in Indigenous populations constituted a moderate to severe public health problem. Iron deficiency is the most common cause of anaemia in children globally, and a leading cause of disability in children under the age of 5 years. The most common causes of iron deficiency anaemia in children under 5 years, low iron stores at birth, low iron intake, and blood loss and/or malabsorption from frequent gastrointestinal infections, are entirely preventable and disproportionately affect disadvantaged and marginalized populations including Indigenous populations. Despite this, there appears to be limited evidence to suggest which primary, secondary and tertiary prevention interventions are effective and appropriate, especially in Indigenous populations of Western colonised countries, where general population prevalence of anaemia suggests iron deficiency anaemia in children is a relatively minor problem. We aim to conduct a scoping review to systematically map research on interventions for prevention of iron deficiency and iron deficiency anaemia in Indigenous children under 5 years of age in Australia, New Zealand, USA and Canada, and identify existing gaps in knowledge. Methods: This scoping review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) Guidelines. A comprehensive search of multiple databases will be conducted. A two-stage screening process, comprising abstract/title screening followed by full-text screening, will be independently conducted by two reviewers. Data will be extracted from papers included in the scoping review by the first author using a data extraction tool which will be iteratively developed in conjunction with Project Advisory Group. All extracted data will be cross-checked by a second independent reviewer. The Medical Research Council (MRC) /the National Institute for Health and Care Research (NIHR) framework for complex interventions (UK) and the consolidated criteria for strengthening the reporting of health research involving Indigenous Peoples (CONSIDER) statement will be used to guide extraction and synthesis. The data will be presented graphically or in tabular form. A narrative summary will accompany the tabulated and/or charted results and will describe how the results relate to the review’s objective and question/s.