Preparing food and nutrition / primary health care programs: experiences from Cameroon and Liberia.

Abstract

This article describes a process for identifying major food and nutrition problems and their determinants in Liberia and the Cameroon. The article describes the process of applying the information to an operational strategy and developing a plan of operations. The appendices provide a detailed checklist for assessing nutritional problems and their causes, a sample card for prioritizing interventions, and a food and nutrition primary health care program plan of action. The assessment required visits to various ministries and local international agencies offices. These visits yielded 20-35 documents pertaining to an analysis of malnutrition. The documents were read and relevant passages were underscored. The objective was to establish a list of macro- and more immediate microdeterminants of the existing poor health and nutrition situation. The underscored passages, which were referenced by document and page number, were clipped and pasted into a shorter document that was organized by topic. Liberia's final abstract was 30 pages long and included 13 topical headings. The Cameroon document was not organized by topic and resulted in a 96-page final document. The author made attempts to fill in missing data and to resolve contradictory information. The final documents were used to prepare the checklist in appendix A. The checklist and Basic Background Documents were prepared by the author and representatives from each of the agencies providing data. This core group of planners worked over a 7-10 week period. An extended group of policy reviewers met to discuss the first draft and revisions. The review raised the level of awareness of technical personnel. Cards were developed to describe each proposed plan of action. These cards were organized into a coherent order and sequence by the core group. Continual review resulted in the establishment of priorities. The operational strategies were developed and incorporated in national 5-year plans.