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 Table of Contents  
SHORT COMMUNICATION
Year : 2014  |  Volume : 2  |  Issue : 2  |  Page : 266-268

Formulating a comprehensive strategy to counter the menace of malnutrition in developing countries


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

Date of Web Publication11-Nov-2014

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, 3rd Floor, Sembakkam Post, Kancheepuram-603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2321-4848.144393

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  Abstract 

The indispensable role of optimal nutrition in ensuring absolute health status and holistic development of a society is well acknowledged. Malnutrition is considered as a disease of human society that can begin in the womb and eventually lasts till the death. A wide range of socio-cultural and infectious parameters have been determined that can ultimately precipitate malnutrition. Considering the multi-factorial origin of the disease, the strategy to combat malnutrition should also be comprehensive and multi-pronged comprising measures to combat the condition at every level concurrently in the entire nation. The corrective policy essentially requires the coordinated approach of different stakeholders and should be targeted at four different levels - family, community, national, and international. To conclude, diet is a crucial element in the natural history of many public health-related diseases, and owing to the multiple factors that eventually determine the dietary habits, a comprehensive approach is the need of the hour.

Keywords: Diet, developing countries, family, malnutrition, lifestyle disorders


How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Formulating a comprehensive strategy to counter the menace of malnutrition in developing countries . Arch Med Health Sci 2014;2:266-8

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Formulating a comprehensive strategy to counter the menace of malnutrition in developing countries . Arch Med Health Sci [serial online] 2014 [cited 2019 Oct 17];2:266-8. Available from: http://www.amhsjournal.org/text.asp?2014/2/2/266/144393


  Introduction: Diet and Dietary Habits Top


The indispensable role of optimal nutrition in ensuring absolute health status and holistic development of a society is well acknowledged. [1] In fact, the dietary habits of an individual are one of the key factors associated with the early onset of lifestyle disorders or an unfavorable public health outcome such as low birth weight, malnourishment (undernutrition or overnutrition or imbalance or specific deficiency), maternal and infant mortality, etc., especially in resource poor countries. [1],[2]

Current status

Currently, most of the developing nations are experiencing a rapid transition in their socio-economic, demographic, nutrition, and health care delivery system-related parameters, owing to which they are experiencing affluence-related hazards (viz. diseases of longevity), poverty, undernutrition, and communicable diseases. [3],[4],[5],[6] On a social note, food does not only refer to something that meets the nutritional requirement of the body - but it is much more as it is an indirect indicator of security and human civilization. [2],[3]


  Determinants of Malnutrition Top


The nutrition-related public health concerns such as hunger and malnutrition are present across the globe to such an extent that eradication of extreme poverty and hunger has been regarded as the millennium development goal-1. [1] Malnutrition is considered as a disease of human society (of man-made origin), which can begin in the womb and eventually lasts till the death. A wide range of determinants such as infection (diarrhea, intestinal worm infestations, measles, whooping cough, malaria, tuberculosis, etc.); cultural determinants (food habits like staple diet, customs, beliefs, traditions and attitudes like avoiding a dietary constituent by a specified section of population or hot/cold type of food; religious dietary prohibitions; food fads; wrong cooking practices like draining away the rice water at the end of cooking or prolonged boiling in open pans; faulty child rearing practices such as encouraging pre-lacteal feeds or not giving colostrums or premature curtailment of exclusive breastfeeding, etc.; and miscellaneous practices like women will eat only after men have finished their meals); socio-economic parameters (viz. illiteracy, poor awareness about the type of food to be consumed, non-sanitary environment, large family, low per capita income, and less allocation of family income for foods); inadequate food production in proportion to the population needs; inequitable distribution of the food products within the different sections of the society; poor coordination between the health sector and the other stakeholders that together determine the nutritional status of an individual; and adoption of ineffective health education strategies by the health care professionals; have been determined, which interacts with each other in different proportions and ultimately precipitates malnutrition. All these factors vary from region to region and influence the nutritional status of people in heterogeneous settings. [1],[7],[8],[9],[10],[11],[12]


  Comprehensive Strategy to Address Malnutrition Top


Considering the multi-factorial origin of the disease, the strategy to combat malnutrition should also be comprehensive and multi-pronged comprising measures to combat the condition at every level concurrently in the entire nation. [2],[3] The corrective policy essentially requires the coordinated approach of different stakeholders such as nutrition, food technology, health administration, health education, marketing. [2],[3] All the planned strategies should be targeted at four different levels as described below:

  1. Family level: As the family plays an important role in shaping the food habits of their members, and because these habits are passed from one generation to another, the primary target of bringing about an improvement in the nutritional status of a the community is family. Nutrition education is the most effective tool identified at the family level and in order to maximize the output, both the husband and the wife should be involved. The nutrition education should emphasize on the selection of locally available nutrient rich foods, and importance/constituents of a balanced diet. In addition, identification and correction of faulty dietary practices, promotion of breastfeeding, refinement in infant and child feeding practices, meeting the nutritional needs of a pregnant/lactating woman, and practice of kitchen gardening should also be considered. Finally, members should be counseled with the help of trained community workers to avail the benefits of maternal and child welfare/family planning and immunization schemes. [8],[10],[13],[14],[15]
  2. Community level: From a community perspective, the idea is to assess the nutrition problem in terms of the extent, distribution and types of nutritional deficiencies; the population groups at risk; and the dietary and non-dietary factors attributed in the causation of malnutrition. The desired information can be elicited with the help of diet survey and community-based studies, done in a representative group of population. This is eventually followed up by implementing cost-effective strategies such as direct nutrition intervention strategies targeted against the vulnerable population groups identified in the diet survey. However, the permanent solution is to rectify the basic cause of malnutrition by ensuring the availability of foods both in quantity and quality to those who are either suffering or are at risk to develop malnutrition. In other words, nutritional surveillance is done to identify the whereabouts of malnutrition and then corrective measures in the form of nutritional supplementation and nutritional rehabilitation are implemented. [1],[2],[4],[5],[9],[16] The integrated child development services scheme, mid-day meal scheme, and specific nutrition supplemental strategies are some of the successful community-level cost-effective strategies implemented for the benefit of the vulnerable group of population. [1],[4]
  3. National level: At the national level, focus shift toward measures such as ensuring socio-economic development of the rural/tribal sector; augmenting agricultural production in proportion to the population needs; strengthening of public distribution system to warrant easily accessible and equitably distributed food in different sections of society; stabilization of population; implementation of nutrition intervention programs for the prevention and control of prevalent public health nutritional concerns like endemic goitre/anemia/nutritional blindness, etc.; and finally by expanding the indirect health and nutrition benefits of other national health programs such as family welfare or malaria control program, etc. [1],[3],[4] In addition, there is a need to develop nutritional policy addressing the nutritional concerns of all types of individuals across the country, to ensure food security, to provide training to the nutrition experts on a regular basis, and to devise newer technologies to aid vulnerable group of people in maintaining their nutrition. [2],[17],[18],[19]
  4. International level: As discussed earlier that food and nutrition are the global public health concerns, there is immense need and scope to establish linkage not only with the local agencies or non-governmental organization but also with the international agencies like World Health Organization, United Nations Children's Fund, Food and Agriculture Organization, etc. This collaboration helps the countries to develop sustainable and long-term nutrition interventions and further allow external monitoring and supervision against the battle of malnutrition. [1],[2],[11],[18]



  Conclusion Top


To conclude, diet is a crucial element in the natural history of many public health-related diseases, and owing to the multiple factors that eventually determine the dietary habits, a comprehensive approach is the need of the hour to control the problem of diseases associated with either excess or deficiency of specific nutrients.

 
  References Top

1.Park K. Nutrition and health. In: Park K, editor. Textbook of Preventive and Social Medicine. 20 th ed. Jabalpur: Banarsidas Bhanot; 2009. p. 565-8, 794-6.  Back to cited text no. 1
    
2.Gerlach SC, Loring PA. Rebuilding northern foodsheds, sustainable food systems, community well-being, and food security. Int J Circumpolar Health 2013;72.  Back to cited text no. 2
    
3.Herder R, Demmig-Adams B. The power of a balanced diet and lifestyle in preventing cardiovascular disease. Nutr Clin Care 2004;7:46-55.  Back to cited text no. 3
    
4.Price S. Understanding the importance to health of a balanced diet. Nurs Times 2005;101:30-1.  Back to cited text no. 4
    
5.Shrivastava SR, Shrivastava PS. A longitudinal study of maternal and socio-economic factors influencing neonatal birth weight in pregnant women attending an urban health centre. Saudi J Health Sci 2013;2:87-92.  Back to cited text no. 5
  Medknow Journal  
6.Nucci LB, Schmidt MI, Duncan BB, Fuchs SC, Fleck ET, Santos Britto MM. Nutritional status of pregnant women: Prevalence and associated pregnancy outcomes. Rev Saude Publica 2001;35:502-7.  Back to cited text no. 6
    
7.Cuzzocrea F, Larcan R, Lanzarone C. Gender differences, personality and eating behaviors in non-clinical adolescents. Eat Weight Disord 2012;17:e282-9.  Back to cited text no. 7
    
8.Skafida V. The family meal panacea: Exploring how different aspects of family meal occurrence, meal habits and meal enjoyment relate to young children's diets. Sociol Health Illn 2013;35:906-23.  Back to cited text no. 8
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9.Drewnowski A. The economics of food choice behavior: Why poverty and obesity are linked. Nestle Nutr Inst Workshop Ser 2012;73:95-112.  Back to cited text no. 9
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10.Allegri C, Turconi G, Cena H. Dietary attitudes and diseases of comfort. Eat Weight Disord 2011;16:e226-35.  Back to cited text no. 10
    
11.Serra-Majem L, Bach-Faig A, Raidó-Quintana B. Nutritional and cultural aspects of the Mediterranean diet. Int J Vitam Nutr Res 2012;82:157-62.  Back to cited text no. 11
    
12.Zeeni N, Gharibeh N, Katsounari I. The influence of sociocultural factors on the eating attitudes of Lebanese and Cypriot students: A cross-cultural study. J Hum Nutr Diet 2013;26:45-52.  Back to cited text no. 12
    
13.Kelly B, Flood VM, Yeatman H. Measuring local food environments: An overview of available methods and measures. Health Place 2011;17:1284-93.  Back to cited text no. 13
    
14.Hume A, O'Dea K, Brimblecombe J. "We need our own food, to grow our own veggies…" Remote aboriginal food gardens in the top end of Australia's northern territory. Aust N Z J Public Health 2013;37:434-41.  Back to cited text no. 14
    
15.Lee A, Mhurchu CN, Sacks G, Swinburn B, Snowdon W, Vandevijvere S, et al. INFORMAS. Monitoring the price and affordability of foods and diets globally. Obes Rev 2013;14:82-95.  Back to cited text no. 15
    
16.Wrieden W, Peace H, Armstring J, Barton K. A short review of dietary assessment methods used in National and Scottish research studies, 2003. Available from: http://multimedia.food.gov.uk/multimedia/pdfs/scotdietassessmethods.pdf [Last accessed on 2014 Jan 22].   Back to cited text no. 16
    
17.Levy LB. Dietary strategies, policy and cardiovascular disease risk reduction in England. Proc Nutr Soc 2013;72:386-9.  Back to cited text no. 17
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18.Parker W, Steyn NP, Mchiza Z, Nthangeni G, Mbhenyane X, Dannhauser A, et al. Dietitians in South Africa require more competencies in public health nutrition and management to address the nutritional needs of South Africans. Ethn Dis 2013;23:87-94.  Back to cited text no. 18
    
19.Ali NM, Shahar S, Kee YL, Norizan AR, Noah SA. Design of an interactive digital nutritional education package for elderly people. Inform Health Soc Care 2012;37:217-29.  Back to cited text no. 19
    



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