Nutritional Situation Research Articles

Nutritional Care in German Hospitals - Results of a Survey Among Physicians

Malnutrition affects 20-30% of hospitalized patients and is associated with increased morbidity and mortality. Regular screening and multiprofessional nutrition teams are crucial for detection and treatment. The aim of this survey is to assess the nutritional medical care situation in German acute care hospitals.The online survey was conducted between 11/2022 and 08/2023, distributed through medical professional societies, and personalized for chief physicians registered in the German Hospital Registry. The survey is based on an instrument from Fulda University.182 physicians participated in the survey, with 53% indicating that their hospital has a nutrition team, which is most often affiliated with the gastroenterology department. In 88% of nutrition teams, a specialist physician, mostly a gastroenterologist, is involved. Common issues addressed by the nutrition teams include malnutrition, parenteral/enteral nutrition, and the transition process. In hospitals with nutrition teams, 83% conduct regular screening for malnutrition, compared to 47% in hospitals without nutrition teams. The most frequently used screening tool is the NRS-2002. In clinics with nutrition teams, 57% automatically involve the team when screening is positive. In facilities without nutrition teams, standardized procedures are often not possible due to staffing shortages.The study reveals an unequal nutritional medical care situation in German hospitals. Hospitals with nutrition teams screen more frequently for malnutrition. Improved financing and standardization are necessary to optimize the nutritional medical care situation.

Insecticide-free reduction of Myzus persicae aphids on sweet pepper (Capsicum annuum L.) through MgSO4-faciliated amino acid and sugar reallocation

Fruits of sweet pepper (Capsicum annuum L.) are among the most consumed fresh fruits, however, their production can be affected by aphids, which feed on the amino acids in the leaves. Mg2+ in leaves plays a crucial role in the reallocation of amino acids from source organs (leaves) to sink organs (fruits). We hypothesize that foliar application of Mg2+ can reduce free amino acid concentration in leaves by promoting their transfer to sink fruits, thereby compromising aphid colonization by reducing their nutritional basis. To test this, a two-factorial experiment was conducted with sweet pepper subjected to aphid infestation with and without leaf MgSO4 application. The concentration of amino acids, sugars, organic acids and mineral nutrients was analysed in the leaves, leaf phloem sap and fruits. Mg2+application decreased the concentrations of amino acids and sugars that are key for aphid nutrition in both the leaf and phloem sap and increased the size and number fruits, indicating an increased sink strength in response to Mg2+. This response was accompanied by a reduced number of aphids on the entire plant. In results, the sugar and amino acid concentration in the phloem got less attractive for the aphids. We conclude that Mg2+ worsens the nutritional situation for aphids by facilitating the reallocation of metabolites to form fruits.

Determinants of stunting in children aged 0–59 months in three regions of Burkina Faso

The Sahel is a region particularly characterized by undernutrition in several forms. In Burkina Faso, where several interventions have been carried out across the past several years, the nutritional situation of children under five years of age is still characterized by persistent stunting in the Est, Sahel, and Cascades regions. This study aims to understand the factors associated with the high prevalence of chronic malnutrition in these regions. National nutrition survey data as well as data from the Ministry of Water and Sanitation were used for bivariate and multivariate statistical analyses to identify factors statistically associated with stunting in children aged 0–59 months who participated in the national nutritional surveys from 2009 to 2019. Around one in ten mothers in all regions had no schooling at all. The improving of IYCF practice has a positive impact on the reduction of the prevalence of chronic malnutrition among children in the Cascades, Est and Sahel regions. In the three target regions, gender and province were significantly associated with stunting. Fever, diarrhea, vitamin A supplementation, household size, and maternal education level were also associated with stunting but only in the Sahel and Cascades regions. Overall, the results of the study show that the fight against stunting must be carried out in a multisectoral approach and target certain provinces particularly because stunting is not uniformly present in all provinces.

Evaluation of nutritional and nosological status of students at Felix Houphouet-Boigny University in Cote d'Ivoire

Introduction: Health of students is an essential factor in acquisition of knowledge and in development of human capital in general. Aim: This study was conducted in order to descriptive the nutritional and health situation of students of Felix Houphouët University of Côte d'Ivoire. Methodology: In fact, a nutritional and health assessment survey was carried out from October 15, 2016 to February 17, 2017 in a population of 1228 students dominated by male with middle-aged of 22.5-year-old. Results: It revealed a panoply of diseases with a predominance of digestive disorders. According to the literature and previous studies done at Felix Boigny University, this could be linked to exposure to stress, inadequate environmental and dietary conditions. This nosological situation is not without consequence on the nutritional state, indeed the prospective analysis of the body mass index of the surveyed, showed a nutritional state quite degraded with 5.29% of leanness, 9, 13% overweight and 2.20% obesity. Conclusion: In view of these results we note that the health status of students is precarious and stationary with respect to the results of previous studies. Faced to this worrying situation, it is urgent to carry out awareness campaigns on all university campuses in the country to improve the nutritional behavior, nosological status and nutritional status of students.

Unraveling the nutrition and health situation of adults in geographically isolated and disadvantaged areas (GIDA) and non-GIDA in the Philippines: A comparative study.

Background: Geographically Isolated and Disadvantaged Areas (GIDA) are communities physically and socioeconomically separated from mainstream society (non-GIDA) and lack comprehensive nutrition and health assessments. Aim: This study aimed to assess the nutritional and health status and determine the factors associated with chronic energy deficiency (CED) and overweight/obesity among adults, 20-59 years old, residing in GIDA and non-GIDA. Methods: Data of the 20,381 adults collected in the Expanded National Nutrition Survey were analyzed. Multivariate logistic regression analyses were performed to determine the predictors of CED and overweight/obesity. Results: Chronic energy deficiency and current smoking were significantly higher in GIDA, while overweight/obesity, alcohol consumption, elevated blood pressure, and insufficient physical activity were higher in non-GIDA (p < 0.001). Higher odds of CED was associated with food insecurity (adjusted odds ratio [AOR]: 1.5, p < 0.001; AOR: 1.3, p < 0.001) and current smoking (AOR: 1.4, p = 0.001; AOR: 1.3, p < 0.001) in both GIDA and non-GIDA while poor wealth (AOR: 1.5, p < 0.001) only in non-GIDA. Higher odds of overweight/obesity was associated with higher age ≥30 years (AOR: 2.1, p < 0.001; AOR: 1.9, p < 0.001), being female (AOR: 1.7, p < 0.001; AOR: 1.3, p < 0.001), with grade level completed (AOR: 1.7, p = 0.004; AOR: 1.2, p = 0.038), urban residence (AOR: 1.2, p = 0.035; AOR: 1.3, p < 0.001), hypertension (AOR: 2.4, p < 0.001; AOR: 2.3, p < 0.001), and insufficient physical activity (AOR: 1.1, p = 0.020; AOR: 1.1, p = 0.027) in both GIDA and non-GIDA. Conclusions: Malnutrition affects GIDA in almost the same magnitude. The double burden of malnutrition and health inequity in GIDA underscores the greater need for comprehensive policies and stronger programs directed toward underserved areas.

Problems posed by vitamin D in early childhood

More and more functions related to vitamin D and more pathologies related to its deficiency are known. The deficiency that exists in vitamin D is known at all ages, sexes and throughout the world. But beyond the existing deficiencies in each population group, in this article we intend to analyze how the nutritional situation of this vitamin in pregnant women and during lactation can have influence on the future health of their offspring.

Examining cost and affordability of nutrient adequate diets alongside a novel combined market score derived from Fill the Nutrient Gap food price data in the west Sahel

Extensive food price data collected for three Fill the Nutrient Gap nutrition situation analyses were used to calculate two metrics – cost and affordability of nutrient-adequate diets – to assess food and nutrition security at subnational level in the late-dry season and beginning of the dry season in Mauritania. A unique market scoring classification was derived using retail food price data collected in Burkina Faso, Mali, and Mauritania to assess on food price and food assortment (availability) across markets in the three countries. Diet cost and affordability was examined alongside three structural drivers of food insecurity – rainfall, infrastructure (roads) and conflict – to understand how they may have influenced nutritious food prices, diversity and non-affordability during the late-dry season during the period of analysis. Results showed that more diverse low-cost markets and lower non-affordability of nutrient-adequate diets were observed in Burkina Faso's well-connected agricultural areas experiencing no conflict, while limited higher-cost markets were observed in central pastoral areas of Mauritania, and pastoral, agropastoral and some agricultural areas experiencing conflict in Burkina Faso and Mali. In agricultural Mali, despite having diverse low-cost markets, low nutrient-adequate diet cost, sufficient rainfall, seemingly well-connected road networks, these combined factors did not guarantee nutrient-adequate diet affordability, highlighting economic barriers faced by households. Regions affected by both harsh climatic conditions and conflict are at higher risk of high food prices and non-affordability.

‘Counselling is not just providing information’: perceptions of caregivers and stakeholders on the design of nutrition and health counselling interventions for families with young children in rural Kenya

BackgroundGlobally, a fifth of the children continue to face chronic undernutrition with a majority of them situated in the Low- and Middle-Income Countries (LMIC). The rising numbers are attributed to aggravating factors like limited nutrition knowledge, poor feeding practices, seasonal food insecurity, and diseases. Interventions targeting behaviour change may reduce the devastating nutrition situation of children in the LMICs.ObjectiveFor the co-design of a Behaviour Change Communication (BCC) intervention for young children in rural Kenya, we aimed to identify the experiences, barriers, facilitators, and preferences of caregivers and stakeholders regarding nutrition and health counselling.DesignWe employed a qualitative study design and used a semi-structured interview guide. The in-depth interviews were recorded, transcribed, and analysed using content analysis, facilitated by the software NVivo.SettingHealth and Demographic Surveillance System (HDSS) area in Siaya County, rural Kenya.ParticipantsWe interviewed 30 caregivers of children between 6 and 23 months of age and 29 local stakeholders with experience in implementing nutrition projects in Kenya.ResultsNutrition and health counselling (NHC) was usually conducted in hospital settings with groups of mothers. Barriers to counselling were long queues and delays, long distances and high travel costs, the inapplicability of the counselling content, lack of spousal support, and a high domestic workload. Facilitators included the trust of caregivers in Community Health Volunteers (CHVs) and counselling services offered free of charge. Preferences comprised (1) delivering of counselling by CHVs, (2) offering individual and group counselling, (3) targeting male and female caregivers.ConclusionThere is a disconnect between the caregivers’ preferences and the services currently offered. Among these families, a successful BCC strategy that employs nutrition and health counselling should apply a community-based communication channel through trusted CHVs, addressing male and female caregivers, and comprising group and individual sessions.

Delayed Sowing Can Improve Potassium Utilization Efficiency and Grain Potassium Concentration in Winter Wheat

Economic consumption and environmental impacts due to potassium (K) inputs in agriculture are gaining increasing attention. It is urgent to improve K use efficiency (KUE) for agricultural development. Delayed sowing has been shown to maintain grain yield in winter wheat. Still, there needs to be more information regarding the effect of sowing date on crop K status evaluated by the K nutrition index (KNI), KUE, K uptake efficiency (UPE), K utilization efficiency (UTE), and grain K concentration (GKC). Here, we assessed Shannong23 and Tainong18 winter wheat cultivars with three sowing date treatments composed of 26 September (early sowing), 8 October (normal sowing), and 22 October (late sowing) in the 2021–2022 and 2022–2023 growing seasons. The influences of sowing date on the KNI, tillering, grain yield formation, KUE, UPE, UTE, K transport, and GKC were examined. Our study indicated that late sowing in winter wheat was an almost optimal K nutritional situation, whereas early and normal sowing were under situations of excess K. As sowing was delayed, aboveground K uptake (AGK), UPE, and spike number per unit area decreased; UTE and grain number per spike increased; and grain yield and KUE were unchanged. A positive correlation between KNI and UPE and spike number per unit area and a negative correlation between KNI and UTE and grain number per spike were found, whereas no significant correlation between KNI and KUE was observed. Late sowing promoted K transport from pre-anthesis accumulation in vegetative organs to grain, resulting in a higher GKC, which could lead to high grain quality and K recovery. Therefore, late sowing winter wheat can use K more efficiently and increase GKC, implying that delayed sowing can reduce K input, favoring sustainable agriculture development.

Caregivers' experiences and practices for malnourished children undergoing tuberculosis treatment in Eswatini.

Eswatini is one of the countries affected by malnutrition and tuberculosis (TB) and some cases remained untreated. These two conditions are major public health problems. This study aimed to explore and describe caregivers' experiences and practices of children's nutrition during treatment. Baylor College of Nursing Children's Foundation - Eswatini (BCMCF-SD). A qualitative study following a narrative design used purposive sampling to identify 12 caregivers of malnourished children and informed consent obtained. In-depth interview used semi-structured interview guide and digital voice recorder. Field notes were taken, transcribed, translated and analysed using NVivo version 11. Two themes emerged as home's nutritional situation and health facility's nutritional support. The study found that most of the caregivers gave children unbalanced diet, while those less than a year were mixed-fed. Some caregivers reported experience of lost breadwinners, unemployment and high number of children than what the family could afford. The caregivers' practices around food by prescription included inadequate supply of the ready-to-use therapeutic food and sharing of prescribed food supplies with other healthy children. During treatment, children's caregivers need short health education and support. The Ministry of Health in Eswatini should consider using some comic books to guide that. Moreover, upscale vocational training promotes entrepreneurship and agricultural activities. Association of malnutrition and TB outcomes has provided evidence-based information for more comprehensive integration between nutrition programmes and tuberculosis programmes. The study's findings contributed to the growing body of knowledge about the association between malnutrition and diagnosed drug-susceptible TB among children aged from 0 - 15 years.

Multidisciplinary study of the health and nutritional status of persons living in households at risk of poverty with children in Germany (MEGA_kids): Study design and methods.

Background: In Germany, the nutritional situation of adults and children living in households at risk of poverty has been insufficiently studied so far. Aim: The aim of the mixed-methods study MEGA_kids is to gain a deeper understanding of the nutritional situation including socioeconomic, behavioral, and attitudinal factors and health characteristics among persons living in families at risk of poverty. Method: MEGA_kids is a mixed-methods cross-sectional study consisting of four modules combining quantitative and qualitative methods. The first module (A) applies self-administered questionnaires to assess the individual's diet, household food insecurity, and several other factors among adults and children of 500 households. Cash receipts are used to assess household's food expenses. For the second module (B), a semistructured interview guide is used to identify factors influencing food security and nutritional quality from the perspective of a subsample of module A (n = 20). The third module (C) applies the participatory World Café technique to explore experiences and generate ideas for tailored support measures for a healthy diet from the perspective of 40 parents participating in module A. Finally, the fourth module (D) investigates the knowledge and usage of existing nutrition-related preventive measures among 200 parents at risk of poverty by using an online questionnaire. Conclusion: By providing a comprehensive picture of nutritional aspects of families living at risk of poverty, MEGA_kids will guide officials to target and prioritize public health nutrition measures, inform policy makers to implement and improve healthy policies and, finally, identify research gaps to be prioritized.

Nutritional Status of Children in the PROFISEM Intervention Zone: Logone Occidental and Wadi-Fira in Chad

In Chad, as in most sub-Saharan African countries, the nutritional situation remains a major concern, and is an underlying cause of many other health problems. The aim of this study is to assess the nutritional status of children aged 6 to 59 months in the provinces of Logone Occidental and Wadi-Fira, in order to contribute to a better management of nutritional problems. The study was carried out between August 16 and October 10, 2022, and involved 207 children aged 6 to 59 months in Wadi-Fira, and 63 aged 6 to 59 months in Logone Occidental. Data collection was carried out using a questionnaire and measurements to collect data on the children's socio-demographic characteristics and anthropometry. Analysis of the children's nutritional status was based on the z-score of nutritional indices and edema according to 2006 WHO references. Analysis of the results showed that the prevalence of global acute malnutrition is 18.84%, chronic malnutrition affects 30.9% and underweight affects 32.9% of children in Wadi Fira. In Logone Occidental, about 1/10 child (9.20%) suffers from acute malnutrition, 33.6% from chronic malnutrition and 22.8% from underweight. In Wadi-Fira, the nutritional situation is considered critical, with more than one child on 15 suffering from global or moderate acute malnutrition. In Logone Occidental, the nutritional situation is precarious for both forms of acute malnutrition. The nutritional situation in both provinces needs a reinforcement of current actions in the fight against malnutrition.

Efficient detection of nutrient deficiencies and development of corrections in avocado through the Compositional Nutrient Diagnosis (CND)

Mexico is the main producer of avocado (Persea americana Mill.), contributing 31% of the world supply, which provides the country with an annual income of more than 2 billion dollars. The increase in national production is the result of a larger cultivated area, and not an increase in yields. In the State of Mexico, Mexico around 10 thousand hectares are cultivated with avocado trees, although 77% of the producers do not have specialized technical advice that offers reliable information on crop nutrition. This lack of advice and technical support detracts from volume and quality of production. The objective of this research was to carry out the nutritional diagnosis of an avocado orchard in Tejupilco, State of Mexico, Mexico, through the Compositional Nutrient Diagnosis (CND), and to generate specific fertilization recommendations for the study area, for which leaf and soil analyses were carried out. Each nutrient determined in the leaf analysis (N, P, K, Ca, Mg, S, Fe, Mn, Zn, Cu, and B) was compared with its optimal concentration according to literature. The CND yielded relative deficiency or excess indices that determined the order of nutritional limitation. Zn, B, S, and K deficiencies were detected in all sampled areas, while P, Mn, and Cu were deficient only in some areas. N, Ca, Mg, and Fe did not show nutritional limitation. Recommendations were formulated to address each of the nutritional deficiencies and the problem of sodicity revealed by the soil analysis. This is the first work in which the CND is used to assess the nutritional situation of avocado orchards in the world.

Examining Patterns and Trends of Household Food Consumption of in the City of Ati (Chad)

Households in Ati face high food consumption costs which determine different states of food and nutritional security. This study was carried out with the aim of analyzing household food consumption in order to contribute to better knowledge of the food and nutritional situation and to inform stakeholders working in the field of food security so that they can better guide their intervention strategies. A prospective, cross-sectional descriptive research survey was adopted for the study and was conducted from 15 April to 14 June 2022 in the city of Ati. The study involved 135 households selected in the neighborhoods of the city of Ati. Data were collected using a questionnaire survey form and then processed using Excel 2016. The food consumption score was used to reflect dietary diversity, frequency of consumption as well as household nutritional intake relative to products and food groups consumed individually. Results showed that more than a third of households (38.52%) consumed at least 3 meals per day and more than half of the households surveyed (54.07%) had 2 meals per day. The group of cereals and tubers is the most consumed by the majority of households. The results show that 30.60% of households surveyed had a poor ACS, 63.60% had a borderline ACS and 5.80% had an acceptable ACS. It emerges that 76.6% of households have low AMDS, 17.9% have average diversity and only 5.50% have good dietary diversity.

A Qualitative Exploratory Study of the Political Commitment for Nutrition Programming: A Case Study of Anambra and Kebbi States of Nigeria.

In Nigeria, varying levels of malnutrition across states present a critical challenge to public health, demanding tailored policy responses. This paper delves into the specific issues and dynamics influencing nutrition programs in the country. Advocating for nutrition-sensitive actions requires analyzing context-specific political commitment. This article presents a case study on two Nigerian states with varying malnutrition profiles to explore the political economy of nutrition. The study used stakeholder analysis, in-depth interviews, and semi-structured interviews through workshops, incorporating the Political Commitment Rapid Assessment Tool. The objective was to measure political commitment, the window of opportunity for action, and stakeholder analysis. The results showed that despite having a significant child malnutrition problem, Kebbi State received a high political commitment to nutrition, with proportions ranging from 0.67 to 1 in each of the six domains measured. On the other hand, Anambra State, where malnutrition was less severe, had varying commitment levels. Institutional commitment was marginally high (0.67), expressed commitment was high (0.71), and budgetary commitment was lower at 0.33. Kebbi had better support for programs dependent on foreign donors than Anambra. Both states need to use media to increase awareness about nutrition issues. When the nutrition situation is severe, foreign donors' influence grows. In conclusion, there are opportunities for strategic framing and advocacy of the nutrition profile of the states. Local state media can be effective, and institutional coordination committees that include various sectors already facilitate commitment to nutrition actions. However, individual, uncoordinated sectoral action can counterbalance the benefits of these committees. Further possibilities to generate political commitment for nutrition in the states are available. This study not only offers insights into the effectiveness of political strategies in addressing malnutrition but also lays the groundwork for future research and provides actionable recommendations for government policymaking.

South-to-South parental migration patterns and excess weight among children: Insights from a national cross-sectional study in Colombia.

Evidence from Latin America suggests that children embedded in South-to-North migrant networks (i.e. relatives who live abroad, typically in the United States) are at increased risk of excess weight. It is unclear if the same findings apply to children embedded in Latin American intraregional migration or South-to-South migration networks. To compare excess weight among Colombian children embedded in South-to-South migration networks (n = 334) to children with non-migrant parents (n = 4272) using Colombia's 2015 National Survey of the Nutritional Situation. Prevalence ratios (PRs) for excess weight (BMI z-score ≥1) by parent migration history were estimated using weighted multivariable logistic regression adjusting for demographics, child behaviours, community and household indicators, including household food insecurity. Most migrant parents returned to Colombia from Venezuela (84%) and reported higher household food insecurity rates than non-migrant parents (59% versus 32%). Models excluding household food insecurity showed that excess weight among children with migrant parents was 51% lower (PR = 0.49; 95% CI 0.25, 0.98) than among children with non-migrant parents. After adjustment for household food insecurity, no statistically significant differences were found. Colombian children with return migrant parents from Venezuela experienced less excess weight than children with non-migrant parents, but higher rates of food insecurity in migrant households might partially explain this difference. This study calls attention to two serious public health concerns for Colombian children-those who have excess weight and those who lack sufficient food, particularly among migrant returnees (a situation that may have worsened since the COVID-19 pandemic).

A Brief History of Child Nutrition Situation and Programme Interventions in Bangladesh

Since the independence in 1971, Bangladesh has madesteady progress in improving nutrition status of childrenin the country. As per the first nutrition survey afterindependence, “Nutrition Survey of Rural Bangladesh1975-76” carried out by the Institute of Nutrition and FoodScience (INFS), Dhaka University, revealed that 31% of12-23 months children and 28% of 24-35 months oldchildren were acutely malnourished; and 74% of children0-59 months old were stunted (moderate and severe). Nineout of ten families (i.e., 89%) were deficient in vitaminintake. The first nutrition survey in East Pakistan which is nowBangladesh, was conducted in 1962-64 but did not providemuch child-related data but found that over two-thirds ofthe daily diet consisted of rice, which was supplementedby curries, primarily of vegetables or fish, and Lentil.Milk and meat are consumed in small amounts, and fruitintake was only seasonal. Intake of cooking fats and oilswas scanty. The survey revealed that 46% of householdshad inadequate calorie intake. Carbohydrates constitutedabout 83% of the total calorie intake. Moreover, 85% ofthe people did not meet their recommended level of dailyprotein intake where almost 70% of protein was fromcereal proteins (plant sources) and only 14% was fromanimal sources. Eighty-four percent of all householdsconsumed less than the acceptable intake value of VitaminA (3,060 IU per person per day) and 40% of the populationhad deficient or low plasma concentration of Vitamin Aand carotene. As a result, night blindness was commonamong children and about 30,000 children became blindeach year. Also, about 25 percent of deaths under five wereattributable to Vitamin A deficiency.

Sociodemographic and nutritional situation of children under six years of age in the Nasa Indigenous Reservation, Iquira, Colombia

Sociodemographic and nutritional situation of children under six years of age in the Nasa Indigenous Reservation, Iquira, Colombia

A survey of nutritional status and support situation in Chinese hospitalized patients with common variable immunodeficiency (CVID)

A survey of nutritional status and support situation in Chinese hospitalized patients with common variable immunodeficiency (CVID)

Progress in the fight against malnutrition in Mozambique: A review of policies, action plans, and nutritional intervention programs

Malnutrition is a public health problem in Mozambique, where 37% of children under five suffer from chronic malnutrition and 4% from acute malnutrition. Since national independence in 1975, action plans have been implemented to reverse this situation. Objective: To analyze the progress made in the fight against malnutrition through the policies, action plans and programmes implemented in the country since independence. Methodology: Documentary study, whose main data sources consisted of Demographic and Health Survey reports, Family Budget Surveys, SMART Surveys, Integrated Classification of Food Security Stages reports, information from FAO databases, as well as other studies on the nutritional situation in the country. The WHO and UNICEF classifications were used to describe the prevalence rates of malnutrition. Results: Except for acute malnutrition, which reduced from high to low between 1997-2023, the prevalence of chronic malnutrition had no statistically significant reductions and remains very high. Factors such as food insecurity, high illiteracy rates, armed conflict in northern Mozambique, poverty, unequal distribution of basic resources between provinces, weak monitoring and evaluation systems in the action plans implemented, poor investment in agriculture, covid-19, as well as the effect of climate change, which constantly affects the country, are the main causes. Conclusion: Despite efforts, malnutrition continues not to show significant reductions, which calls for further study and improvement of policies, as well as the control of risk factors.