Abstract and Keywords
Although there is little disagreement on the magnitude and importance of alleviating malnutrition, its causation and control continue to be the subject of debate and research. Recent evidence suggests that many of the traditional food-based strategies to reduce malnutrition, such as food aid distribution programs, school feeding programs, and food stamps, as well as policies that intervene to affect the price of food such as subsidies and rationing schemes, have proven of limited effectiveness. One important reason is that the critical period of undernutrition is generally in utero and early life. Among the most vulnerable groups, particularly pregnant women and infants, the causes of malnutrition often have little to do with food access and availability. Instead, prenatal care, immunization programs, breastfeeding promotion, and generally raising the quality of child care and nurturing behaviors are paramount. Likewise, improving the sanitary and home environment, including interventions that enhance access to clean water and latrines and behaviors such as hand washing and boiling water, will contribute to reductions in infection and help break the cycle of disease and malnutrition. In the area of food-related interventions, among those that are critical to the production of improved health and nutritional outcomes are food supplementation and fortification schemes that address micronutrient deficiencies. At the same time, there is legitimate concern that misguided food interventions, particularly broad-based price subsidies, food stamps, and food aid may have a range of deleterious consequences. These range from contributing to the epidemic of obesity and related chronic disease, to having a negative impact on farmers and producer incentives and the functioning of food markets.
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