Improving women's and children's nutrition in sub-Saharan Africa : an issues paper

The main sources of malnutrition in Africa, as elsewhere, are inadequate food intake, excessive disease, maternal malnutrition, and deleterious food and health behavior. The authors review several successful innovative approaches to addressing nutrition problems in Africa: the Iringa Nutrition Program in Tanzania, the Zimbabwe Children's Supplementary Feeding Program, the Zaire Weaning Foods Processing Program, and the Senegal Growth Promotion Program. They identify the lessons from these programs, including the need: (a) to involve the community actively in program development; (b) for training in nutrition at all levels, from doctor to village health worker; (c) for strong growth monitoring and nutrition education components; (d) for close supervision, including regular supervisory visits to villages and health huts, discussions with clients, and observations; and (e) for a variety of institutional and financing mechanisms. Africa's nutrition problems require many of the same services as problems elsewhere - growth monitoring, nutrition education, targeted feeding, and food fortification. Africa shares the universal need for good training, management, communications, and information systems. But new and innovative institutional mechanisms are needed to address Africa's nutrition problems. Each country must look for its own institutional strengths and weaknesses in developing nutrition programs.