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This report has brought together and presented the findings of in-depth case studies of nine community-based nutrition programmes and three desk reviews, and the implications of these findings for programme design and strategy. Inevitably, many of the conclusions are based on judgement and assessment. It cannot pretend to be a statistically valid exercise. The challenge for nutrition planners is to take from this report what is appropriate in their country context and to use it to improve their existing programmes or to design better programmes. To help in this process, FAO has produced a companion volume: “Improving Nutrition Programmes – An Assessment Tool for Action” (FAO, 2002).

The future of nutrition programming holds its own challenges, some of which are beyond the control of nutritionists or their programmes, but all of which demand a flexibility in approach and a willingness and ability to accept new situations, innovative technologies and changes in administrative and institutional structures. We briefly highlight here some of these challenges:

Malnutrition is an impediment to development and its presence indicates that basic physiological needs have not been met. What is observed as malnutrition is not only the result of insufficient or inappropriate food but also a consequence of other conditions, such as poor water supply and sanitation and a high prevalence of disease. Thus, reversing the procedure is complex, because many issues need to be addressed more or less simultaneously, and every situation is different, so that there is no single solution for all. There can only be general guidance on directions to pursue. Experience from lessons learned shows that considerable time is needed to redress a situation (ten years and more), and that a strong supportive political and policy environment remains crucial throughout the period. There is no “quick-fix” to this problem. Once achieved, however, the effect is likely to become permanent, offering a substantial return on investment.

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