17. Enhancing Child Growth and Nutrition Lessons for Action

Abstract

This document is the 17th and final chapter in a book that identifies priorities for action to enhance child growth and nutrition in developing countries. The chapter seeks to establish the role of community participation as a common element in an array of nutritional interventions. The discussion of individual and household behavior agrees with the evidence that household members make rational decisions. Nutrition interventions can therefore affect needy households by: 1) changing the goals and preferences of the malnourished individual or caretaker 2) changing the power structure in the households and/or 3) alleviating existing resource constraints. While the community and household may be the focus of nutrition interventions national policies (such as food pricing strategies or breast-feeding promotion) can have strong effects on food supply and nutrition. The success of policies however depends upon local implementation and communities have an important role in diagnosing and solving nutrition problems. Because nutrition problems are location-specific their solutions must also be location-specific. Although the content of nutritional interventions is rarely generalizable across communities the process followed by successful programs may be replicated. Projects should be flexible and should be designed and monitored so that they benefit the poorest communities. The most urgent research needs include 1) applied research on the implementation of nutrition projects 2) research on the political economy and institutional issues that affect national and regional support of nutrition interventions 3) research on the nutritional effects of broader government policies 4) identification of additional successful projects and 5) development of evaluation methods. Training is needed for community residents public sector employees and those engaged in economic analysis of the nutritional effects of policies and programs.