Strategies to combat malnutrition
Micronutrient malnutrition also negatively impacts the intellectual and physical potential of children. Despite government intervention, around one third of the world's children are affected. Adding fuel to this fire is the emergence of obesity as another public health problem. A major issue is effective implementation of evidence-based policies to address dietary deficits. Particularly, women of reproductive age and children (less than two years old) should have balanced nutrition for their long-term well-being. The SMILING project was a multidisciplinary and multi-sectorial initiative set up to sustainably resolve malnutrition on a large scale. SMILING transnationally collaborated to develop and test intervention strategies that are based on scientific evidence in five SEA countries: Cambodia, Indonesia, Laos, Thailand and Vietnam. These countries represent widely differing levels of malnutrition severity as well as social and economic development. SMILING assessed the magnitude and severity of undernutrition through country-specific food composition tables representing general food consumption and required food composition. They identified vitamin A, iron, zinc and iodine deficiencies as common public health concerns across SEA. Through Optifood, an innovative mathematical linear programming tool, SEA trainees identified country-specific dietary deficiencies. These findings highlighted the need for food supplementation, fortification and diversification as well as nutrition-sensitive intervention. Researchers also considered contextual factors such as political situation, infrastructure, economy and human capacity in nutrition. Stakeholder perception on over 20 key interventions was tested using multiple criteria mapping, with food fortification receiving major focus. Lack of knowledge and lack of commitment were identified as major drawbacks to effective implementation. Based on an analysis of the results, SMILING recommends the development of national nutrition programmes with involvement and education of all stakeholders, particularly policymakers. Project findings are already being integrated into national plans of action in Cambodia, Laos and Vietnam. The results are also being used to improve on various ongoing national programmes in Indonesia and Thailand. In keeping with the United Nations' (UN) Millennium Development Goal of improving nutritional status, effective implementation of nutrition intervention strategies should also improve food and nutritional security.
Keywords
Malnutrition, micronutrient deficiencies, balanced nutrition, food fortification, nutritional status
