Dear Ms Basset, Dear Mr Raza,
Below are my comments on the suggested five questions, which certainly approach the widespread problem of nutrition- sensitive issues.
Setting the stage: Because of my position of Chair of the Technical Advisory Group on Nutrition of the International Pediatric Association (IPA) nutrition-sensitive issues are of main concern and activity. We were able to detect in LMIC the coexistence of undernutrition and increasing overweight. The last situation went unrecognized by the family and health care and we think it was related to inappropriate promotion of infant formula feeding in the first year of life and later on the dense caloric food consumption.
Nutrition-sensitive programs: In the Sub-Saharan countries we couldn’t detect the presence of such programs in the places where the health care provider cared/ listened the child and mother. Programs are certainly in the high health offices but not at this important step.
Nutrition sensitive aspects: Food industry with its marketing actions among other better known, are using new ways such as the pseudoscientific information for promoting their products.
Institutional arrangements: We were not able to find the actors from any agency for improving Nutrition- sensitive programs whose results are clearly expressed in the last para of your Digest Nº 1185 of 26 August. This empty space is a target for marketing people.
Monitoring and evaluation: Monitoring is difficult because health care providers are not enough motivated, for doing this extra work. Our impression is that Health Authorities are more concerned with acute situation, mainly infectious diseases. Evaluation is more difficult even. We tried a simple program for identifying houses with under/ overweight and giving very basic food information, our feedback was disappointing.
In conclusion:In our opinion the situation is improving concerning underweight ( food access and sanitation) but food education and very basic nutritional principles goes clearly behind. Education should be focused on health care providers but to the general population specially mothers. The open question is: Who is going to plan and deliver this knowledge to this target population?
Should you require additional information, please let me know
With my kindest regards
Manuel Moya
Catedrático E/ E Professor & Head
Chair of the Technical Advisory Group on Nutrition of International Pediatric Association (IPA)
Editor in Chief of IPA Newsletter
Board of Directors of IPA Foundation
Vice-President of European Pediatric Association
Academician of the Real Academia de Medicna
Pediatric Dept. University Miguel Hernández
Ctra Valencia s/n. 03550 S Juan. Alicante. Spain
Manuel Moya