Vanuatu is situated in the south west Pacific Ocean. While the rural population follows a predominantly subsistence lifestyle, the urban population has adopted a more westernised lifestyle. Vanuatu's traditional staple foods are root crops, such as yam and taro, although starchy fruits such as plantain and breadfruit are also seasonally important. The consumption of traditional foods was highest in the rural and lowest in the urban areas. Consumption of imports such as rice, fat/oils, canned and fresh meat/fish, milk and bread was highest in the urban and lowest in the rural areas. The rise in non-communicable diseases has been attributed, in part, to this transition away from traditional foods in favour of imported ones. This also has an impact on agricultural production, food security and self-sufficiency in food production (Carlot-Tary et al., 2000).
When comparing the results of the 1983 and 1996 National Nutrition Survey, the nutritional status of children has improved over the years, but children in the second year of life are still at the greatest risk of nutritional insufficiency. In 1983, there was a high prevalence of underweight among children under five years but by 1996, it dropped to a medium prevalence range. In 1983, children in their second year of life had a very high prevalence of underweight, but in 1996, it dropped to a medium prevalence. The number of stunted children under five years increased from a low prevalence in 1983 to a medium prevalence in 1996. Children in their second year of life were the most vulnerable with a high prevalence of stunting found in both studies. Wasting had a medium prevalence, reported in 1996, for all age groups under five years, but again the highest prevalence was among children in their second year of life. Regional differences are difficult to determine, as all studies investigating nutritional status in Vanuatu have involved small sample sizes (Hung, 1983; Carlot-Tary et al., 1996).
Infant feeding practices immediately after birth are encouraging with almost all mothers breast-feeding their babies within the first day of birth. There are no significant differences between urban and rural practices. The length of breast-feeding and abrupt weaning practices however, are of concern, with one-quarter of infants under two months of age receiving complementary foods. The high prevalence of stunting in the second year of life may be attributed to these practices (Carlot-Tary et al., 1996).
Adult malnutrition is in the form of over nutrition, with an increasing prevalence of overweight, obesity, type II diabetes and cardiovascular diseases. In 1996, one-third of the urban and rural women (15 to 49 years) surveyed were either overweight or obese, and more than half of females in the 40 to 49 year age group were overweight or obese. The 1998 survey results showed that the prevalence of overweight and obesity increased to 52% among women older than 20 years (Carlot-Tary et al., 1996; 2000).
Cardiovascular diseases have been the leading cause of mortality for the past decade Hypertension and diabetes are also of concern. Much effort is recommended to implement health awareness programmes to inform the population of these diseases and how to manage or control them.
Other than iron deficiency anaemia, very little has been studied regarding micronutrient deficiencies... In 1991, vitamin A deficiency was investigated and no clinical cases of xerophthalmia were reported. Iodine deficiency disease has not been investigated, although some evidence of goitre exists, and even cretinism, in islands with active volcanoes. Iron deficiency anaemia is well documented, and appears to be decreasing since the introduction of ventilated improved pit toilets and a reduction in malaria incidence. In 1983, the majority of pregnant and lactating women were anaemic but by 1996, the prevalence had reduced to just over half. Still, more research and awareness programmes need to be implemented to provide a better analysis of Vanuatu's health status and to encourage a healthy lifestyle, especially in the urban community (Hung, 1983; Carlot-Tary et al., 1996).