Nutritional problem in the developing countries can't be solved only by the government interventions. Besides, Non-government Organizations (NGOs) have to play strong role in spreading knowledge and training. More emphasis is needed in the child and maternal mortality. If women can be treated properly during the pregnancy, the child will have proper development. So it starts from the family. Government should have strong monitoring on this maternal health and child health. Nutritional problem can be treated if we can educate the mother. Besides, fortified foods can also benefit children to get rid of malnutrition. 

The best long-term solution has always been education!

Specifically education of girls who become mothers all too often sooner than they should. If girls are educated (and treated as equal at level of community and society in general), they are much better equipped to take care of the next generation by educating their children and the good cycle perpetuates, and quality of life improves for everyone!

While you are at it, fire all corrupt and self-serving politicians disguised as national leaders.  ;)

Inform and educate people.

There are global initiatives and international organizations offering practical, financial, and scientific assistance in implementing nutrition-specific policies and programs such as those allying under the Scaling Up Nutrition (SUN) Movement (SUN 2012). The SUN Movement helps countries to also address the institutional failures in nutrition-related governance outlined above and to monitor progress toward their committed nutrition aims.

Improved education especially for women. Diversified agricultural production for most households who depend on subsistence agriculture. improvements in medical care, increased access to medical facilities. Increased awareness and removal of other harmful cultural practices. 

Mohan,

India was free in 1947. A few decades, may be half a century for development can be understandable but to still tag euphemism of "developing nation" with its name seems a bit odd, especially when, as you say, there is a problem of excess as well as shortage. Shall we not begin calling countries like India by their reality: mismanaged nations!  

This will immediately recognize the primary source of problems as mismanagement by their so-called leaders. The characterization of "developing nation" creates an impression of "work in progress", but on practical level it is used to absolve the managing class from their responsibilities while poor infrastructure continues to be neglected and overall quality of life for the majority remains dismal. 

Nutrition is only a small but inextricably linked aspect of a far bigger problem.

Non Governmental organization can play a vital role to tackle Nutritional problems in Under developed countries. They may formulate better policies to reach the deprived of population.

Asif, NGOs do help in many cases but they cannot possibly supplant the primary support infrastructure. Additionally, often times where they are allowed to go, entirely depends on the decisions of host government. NGOs must comply.

All comments above are correct.

However, before education, NGO activities, Government interventions can be effective and sustainable, the income of the poor has to be secured. Therefore, employment and income generation among the poor is the primary tool for fighting malnutrition.

It makes no sense advicing people to eat more protein, if they cannot afford protein-rich food.

According to my current research, one of the root causes that barely nobody mentions is the consideration of food as a pure commodity, and not an essential fuel for human beings. Therefore, as it is totally privatized, you can only get access to food (and even more healthy food) if you have money of private means to produce. Food should be considered a public good, with several dimensions essential to human beings, other than its price in the market. And nutrition should also be considered a global public good, such as education and health. As long as we keep talking about private nutrition, plumpy nuts, increase food access via money and not a Universal Food Coverage, we won't be able to eradicate malnutrition from Earth. More on that can be found in my recent paper.   

Chapter Transition towards a food commons regime: re-commoning food ...

Although employment and income are important, our research (see link below) shows that education, namely mothers' education, is much more effective and important than income.

http://www.fao.org/docrep/010/a1434e/a1434e00.htm

One approach would be to halt the trend toward large-scale monocropping and let farmers continue to intercrop the foods that have sustained them for millenia.

 Friends, thanks for your contribution, everyone try to explore the causes and its solution, but I think if we addresses this problem by taking actions at various levels i.e., on the social determinants, underlying causes and immediate causes then we can tackle only this problem if we keep these points under consideration.

Developing countries are now facing the problem of inappropriate nutrition. The daily diet most of the time do not provide enough quantities of micronutrients.

Our group has done extensive work in area of community nutrition in urban as well as rural areas specially addressing iron deficiency anemia. We have observed educating women regarding nutrition through tutorials and demonstrations  is very effective. We also observed educating adolescent girls in schools have good impact on knowledge regarding healthy eating habits, which they continue to follow in adult life. 

National level studies that analyze the determinants of nutrition while useful to provide broad policy direction often miss out on the issues that challenge local program managers who have to deal with cultural nuances, to say the least. Designing meaningful nutrition interventions that go beyond blanket recommendations made at the national level, require capacity of analyzing data that is often collected by the programs for potential solutions at the local level. Bridging capacity for conducting such analysis is mostly over-looked and the program managers are told to implement the programs designed based on the nationals level studies. Unless solutions are identified at the local levels, they may not be appropriate and sustainable and may be waste of resources. A good example is promoting home gardening in areas where already plenty of fruits and vegetables grown and exported. This is often done with external technical assistance.

This is a good question. The answers thus far are also very reasonable. Yes, intervention through mothers make sense because they are the caregivers at home and often the cooks. However, wider awareness through effective public action has to happen. Schools and sports fields, for example, are great places to get children involved. Governments can easily reach these places because it is the bureaucracy that largely manages these environments. The issue of undernutrition is important, particularly early childhood but the growing problem of obesity in developing countries is going to be a huge issue into the future because people will have to be treated for long periods of time for noncommunicable diseases such as high blood pressure, diabetes, heart disease etc etc so that public health systems will simply collapse. If we learn from the West, we would start early to address these issues at national and local levels.

I fully agree with Siegfried Schönherr's comment above. It is important to analyse and tackle the symptoms, but it is crucial to address the disease. That is, the lack of decent employment for those affected by under-nutrition. At the micro level, I'd focus primarily on the reasons to explain the lack of decent employment (and therefore lack of sufficient income). Secondly I'd analyse the specificities of the market functioning, and perhaps thirdly the technical questions about production.

Mexico has a very good program, originally called Progresa then Oportunidades that gives conditional cash transfers to mothers in order to keep their children in school.  There is a mandatory annual medical check up and talks about nutrition.  It is supposed that some of the money transferred will be used for food.  The program has been very successful in keeping children in school.

Mexico also has the fastest rate of rise in obesity; I hope that mothers and children learn about the urgent need of balanced nutrition (at least stop using carbonated sugar drinks instead of water) soon before the damage to population is too extensive.

In Egypt, malnutrition is a significant public health problem. Iron deficiency prevalence exceeds 50 percent in addition to its high prevalence among children. Calcium and vitamin D deficiency also is a growing problem among all ages as found by many studies. Obesity is rising. Increasing the awareness widely especially among mothers, children and teenagers about healthy nutrition is urgently needed intervention. To decrease the burden of this problem in a faster and effective way awareness should be accompanied by increase the availability of fortified foods.

I do not fully agree with Tausif, the support system to nutrition-program developed by governments and NGOs is working successfully in many areas. Health care programs to both mother and child, mid-day meals etc programs have achieved remarkable results in India.

I think such an effort needs a multi-sectoral response,with ministries of public health taking the lead.Health policies should promote healthy life styles,underlining healthy eating and physical exercises. It is globally recommended that diseases prevention start early in life-preferably in the womb! and continue throughout the life stages;the so-called  life cycle approach. The media can be utilized to promote health,if it is possible to engage them as effectively as possible.There is an urgent need to make a legislation against advertising of junk foods to children.

Arjun,

I am curious what is that you find disagreeable?

There are more than adequate resources in India. But poverty and poor health care for a large portion of population remains the reality of every day life. If the distribution and availability of resources is not addressed by the system of governance itself, none of the stop-gap measures provided by the NGOs will be adequate.

Tausif

Now the rural scenario in India is changed; the size of below poverty-line declined to less than 20%; health care facilities are available; food grains are being made available at affordable rate to poor by the government; the condition is not so worst you arguing.

Arjun, that seems encouraging.

Until you think about how India defines poverty line. Isn't it Rs 32/day? For a family of four that would be about $2 per day. Does it actually buy 2 nutritious meals a day for the family? Putting an arbitrary line somewhere to make number look better (something most politicians try to do if they can get away with it) does not change the reality.

Not too long ago I was reading a report about about the condition of maternity hospitals in India. If the condition is only half as bad as this article claimed, it is awful. Two to three pregnant ladies sharing a bed without a change of linen. Infants and mothers get antibiotics resistant infections from the hospital as well as from each other and lives of many infants cannot be saved.

Perhaps all this is better than it used to be but it seems far from where it needs to be and in humble opinion, rate of progress to protect and serve the general populace could be far better. 

Here is the link for the NY Times article:

http://www.nytimes.com/2014/12/04/world/asia/superbugs-kill-indias-babies-and-pose-an-overseas-threat.html?_r=0

Rs 32 per day per person so for family of four Rs 128 per day which is little higher than 1.25 US dollar.Of course there are bad examples reported in news papers but they cannot be generalized; there are reports/thesis done on the success of nutrition, women and child welfare programs. I hope my dear Tausif is partly convinced.

Arjun,

My getting convinced is hardly of any consequence. You live there and should know far better than I. If you are convinced that the quality life is improving at a satisfactory pace, I'll have to take your word for it. 

But this means that ~$1.25/day for a family of four is sufficient to buy (at least) 2 balanced meals a day, shelter, and have little extra for clothes and other emergencies!

Governments supply basic necessaries at subsidised prices for example 1kg rice at Rs1, 1kg wheat at Rs 2, natural gas Rs 435/14.5 kg etc. cell-phones are being used by poor, housing facility-free sites and financial assistance, free medical and technical education to BPL card-holders.

Do they accept US citizens after retirement?  ;)

To answer your question How can we tackle nutritional problems in developing countries, addressing malnutrition in a sustainable way requires a coordinated approach including food and agriculture systems as well as other sectors such as health, water and sanitation, education, employment and social protection.

We need to adopt a nutrition-enhancing approach to food systems to address both the immediate as well as the underlying or structural causes of malnutrition. Nutrition-enhancing policies and interventions are those that:

·         have improving diets and raising levels of nutrition as explicit objectives

·         target the most vulnerable and at-risk communities

·         involve multi-sectors including food and agriculture, health, water, sanitation and hygiene, education, employment and social protection

·         are underpinned by multi-disciplinary and multi-stakeholder collaboration with investment from both public and private sectors

·         are served by effective accountability mechanisms with relevant indicators that can monitor progress in achieving measurable objectives

Trends in nutrition over the last 20 years or so have been positive as progress in reducing hunger has been pronounced. According to FAO, 1.9 billion more people today are able to meet their nutrition needs, at least for dietary energy, than in 1990. Over this period, 63 developing countries have reached the MDG target 1.c for halving the proportion of hungry people. If we look at the changing composition of foods available for consumption, it is apparent the quality of the average diet has also improved. People are eating better, enjoying more balanced diets and safer foods. The improvements in dietary diversity have likely reduced the numbers of people suffering one or more micronutrient deficiencies. People are living longer and healthier lives now than ever before, partly also due to improvements in water and sanitation, health services and rising incomes, largely due to globalization and urbanization.

However, despite such progress in reducing hunger and undernourishment, 805 million people - or one in 9 people - are undernourished i.e. are unable to meet their dietary energy requirements, and 2 billion people are deficient in one or more micronutrients. An estimated 161 million children under five years of age are stunted or chronically malnourished, 99 million underweight for their age and 51 million wasted or acutely malnourished, while at the same time, 500 million people are obese.

The persistent and unacceptably high level of malnutrition was a major reason for holding in November last year the Second International Conference on Nutrition (ICN2) organized jointly by FAO and  WHO. All documents are available on the ICN2 web site www.fao.org/ICN2. At the ICN2, the Rome Declaration on Nutrition and an accompanying Framework for Action were endorsed by Member countries. The following actions were taken in support of the ICN2:

International Symposium held on food and nutrition security (http://www.fao.org/ag/humannutrition/nationalpolicies/meetings/en/)

18 Expert Papers were commissioned http://www.fao.org/about/meetings/icn2/preparations/papers/en/

7 regional and sub-regional preparatory meetings held (http://www.fao.org/about/meetings/icn2/preparations/en/)

Country Nutrition Papers and Case Studies prepared http://www.fao.org/about/meetings/icn2/preparations/country-nutrition-papers/en/)

Preparatory Technical Meeting (PTM) 13-15 November 2013 (http://www.fao.org/3/a-at607e.pdf)

FAO/CABI publication on Improving Diets and Nutrition: Food-based Approaches (http://www.fao.org/3/a-i3030e.pdf)

3 online technical discussions via the FSN Forum http://www.fao.org/fsnforum/

Social protection http://www.fao.org/fsnforum/forum/discussions/social-protection-and-nutrition

Nutrition enhancing agriculture and food systems http://www.fao.org/fsnforum/forum/discussions/nutrition-enhancing-agriculture

Contribution of civil society and private sector http://www.fao.org/fsnforum/forum/discussions/CS-PS-Nutrition

2 online discussions via the FSN Forum on the Rome Declaration and one on the Framework for Action http://www.fao.org/fsnforum/forum/discussions/ICN2_revised_draft and http://www.fao.org/fsnforum/forum/discussions/ICN2-FFA

The main outcomes of the ICN2 conference:

nutrition raised higher up the international development agenda

public awareness raised of the persistent and unacceptably high levels of malnutrition in the world

FAO recognized as a principle leader in the international nutrition architecture

nutrition mainstreamed within the work of FAO – FAO’s Strategy and vision for nutrition (PC 112/2) harmonized with ICN2 outcomes

Rome Declaration on Nutrition and its companion Framework for Action unanimously adopted

Focus needs to be given to those groups who had not benefited from the development that many others had enjoyed over the last twenty years or so, including the resource poor, low income, socially excluded, economically marginalized, food insecure and nutritional vulnerable households and communities. Countries have committed to take ten steps to translate their commitments for nutrition into action:

1.      Eradicate hunger and prevent all forms of malnutrition

2.      Increase investments actions to improve diets  and nutrition

3.      Develop coherent public policies to enhance sustainable food systems

4.      Raise the profile of nutrition and align national resources accordingly

5.      Improve nutrition by strengthening human and institutional capacities

6.      Strengthen and facilitate contributions and action by all stakeholders and promote collaboration within and across countries

7.      Ensuring healthy diets throughout the life course

8.      Empower people and create an enabling environment for making informed choices about food products for healthy dietary practices

9.      Implement Rome Declaration on Nutrition through the Framework for Action

10.  Integrate the Rome Declaration into the post-2015 development agenda process

The Framework for Action provides a set of voluntary policy options and strategies for use by governments, acting in cooperation with other stakeholders as appropriate, for the implementation of the commitments of the Rome Declaration. It provides 60 policy and strategy recommendations which may be incorporated into national nutrition, health, agriculture, development and investment plans to achieve better nutrition for all, along with recommendations for ensuring greater accountability. The thematic areas for action are: 

·         an enabling environment - with multi-sector engagement

·         sustainable food systems for healthy diets - i.e. not just production

·         nutrition-enhancing investment and trade

·         nutrition education and information

·         social protection

·         strong and resilient health systems (including action on breastfeeding, wasting and stunting, childhood overweight and obesity, anaemia in women of reproductive age, and health services to improve nutrition)

·         water, sanitation and hygiene

·         food safety

·         accountability for ICN2 follow-up through enhanced monitoring mechanisms.

To follow-up on the ICN2 the UN General Assembly is being invited to endorse the Rome Declaration on Nutrition and the Framework for Action, and to consider declaring a Decade of Action on Nutrition from 2016 to 2025. A mechanism will need to be developed for monitoring progress and to improve coordination for nutrition based on existing mechanisms. As nutrition is a key element of sustainable development, efforts are underway to integrate the Framework for Action into the Post-2015 Development Agenda.

In taking action, lessons learned include:

·         focus on the most affected at-risk and vulnerable populations.

·         support community-level initiatives in particular of those groups most affected by undernutrition, for bringing interventions to scale and ensuring impact of nutrition-sensitive approaches.

·         combine chronic (stunting) and acute (wasting) malnutrition reduction strategies in order to maximise global impact. The management of acute malnutrition should be integrated as a component under the nutrition preventive strategies at country level.

·         closer involvement of civil society and community-based organizations in tackling malnutrition, who should be encouraged to participate in the decision-making processes including national planning, programming and monitoring.

·         ensure that improving diets and better nutrition are explicit objectives of country profiles and indicative programmes and are adequately funded.

·         support national and local level accountability mechanisms for assessing progress in implementing the commitments and set up transparent reporting instruments.

·         explicitly include nutrition in the post-2015 framework with specific food security and nutrition security goals and time-bound and measurable indicators.

Finally, three strategic priorities need to be kept in mind:

·         Enhance resource mobilization and political commitment to strengthen the link between food and agriculture systems and nutrition.

·         Scale up proven nutrition-sensitive food and agricultural interventions at country level

·         Increase knowledge and evidence to maximize the impact of food and agricultural systems on nutrition

Regarding community based activities, see "Community-Centred Food-Based Strategies  for Alleviating and Preventing Malnutrition". In: Impacts of Agriculture on Human Health and Nutrition, edited by Cakmak, I. and Welch, R.M., in Encyclopaedia of Life Support Systems (EOLSS), developed under the auspices of the UNESCO, EOLSS Publishers, Oxford, UK.http://www.eolss.net/outlinecomponents/impacts-agriculture-human-health-nutrition.aspx

I think that the most important aspect is how to improve lifestyle and awareness quality.  Poor people not only gets nutrition deficiency but also over nutrition in developing countries.  Obesity is not only happened in high class community but also in the low one.  Nutrition is not the expensive commodity, they can find everywhere with reasonable price.  The problem is that when they buy foods, nutrition is not the priority. Media have pushed them to buy food that they have watched in TV.  By this I mean that, people in developing countries have money to buy nutritious food, but they have no good awareness to choose the right food.  As long as we do not do tight control the food advertisements in media , whatever programs we intervene, the finals choices are the advertised food, not the nutritious one.  I just did research in My city, Bandar Lampung Indonesia about food pattern and obesity among school children.  The prevalence of the obesity was around 24%, and the obese children were not only coming from the rich family but also from the low class family.  Unfortunately, most of their parents have gone to the university.  So I think malnutrition is not about money or knowledge.  People just aware with what they everyday watch, not with what they have learned.  The lesson we can learn from my study is we have to start nutrition education since childhood, continuously and concistently.

salaam

How can we tackle nutritional problems in developing countries? this is an interesting problem. complex suggestions like those often suggested take a long time to implement. a simple and fast acting solution is needed. 

foraging is often used to compensate for a deficient diet. unfortunately many areas of the world the historic use of coal for manufacturing and home heating have contaminated the soil with a wide range of heavy metals and toxic hydrocarbons. hyperaccumulatores are a class of plants often used in Phytoremediation. many plants that are classified as edible are also hyperaccumulatores. when plants that are cross classified in this manor are foraged there is a danger of poisoning. at risk groups are those most likely forage due to lake of access to adequate diet. and those who are interested in wild edible plants who have not been informed of the danger. Gas chromatography can be taught in local colleges very quickly to develop long term science skills.  teach grade school children to take soil and water samples and use GPS to track the samples. train them to cooperate with local colleges that teach Gas chromatography. use geographic information systems to map the results. teach Foraging skills in grade school in combination with Phytoremediation. as part of the education program include warnings about Hyperaccumulators that are classified as edible plants. if the soil is clean these plants are safe to forage. if the soil is toxic Phytoremediation and posting of explanatory signs will prevent poisoning. heavy metal poisoning can reduce IQ and contribute to social instability. teach basic nutrition in grade school and college programs. these programs should include the effects of  heavy metal poisoning and what treatments are known.

https://en.wikipedia.org/wiki/Phytoremediation for the removal of

https://en.wikipedia.org/wiki/Hyperaccumulator

https://en.wikipedia.org/wiki/Foraging                                                  https://en.wikipedia.org/wiki/Geographic_information_system https://en.wikipedia.org/wiki/GPS_navigation_device                https://en.wikipedia.org/wiki/Gas_chromatography                    https://en.wikipedia.org/wiki/Lead_poisoning#Treatment

A practical approach is through schools. Provision of an affordable and healthy cooked lunch and implementing a snack (and smoking) ban on the premises. Operational in German primary and secondary education of my children.

Lack of current information with respect to nutrient intakes of the public is a major problem in tackling these issues. Nationwide community surveys should be conducted in order to find reliable information, in order to find solutions. The major obstacle is the great population sizes in many developing countries and difficulty to access some communities (e.g. Pakistan, India, Uganda, Tanzania, Bangladesh), to gather information.

Never the less; some efforts are made. Following is an example of such an effort we put in Sri Lanka.

Article Nutrition Assessment of Several Sects in the Sri Lankan Community

Provided that we have proper scientific evaluation of the significantly nutrition deficit areas and population segments, as well as the greatly deficit nutrients in regular diets; food/nutrient based dietary guidelines can be updated time by time.

to remove poverty

Nutritional problems in developing countries are the by product of corruption and lack of justice. Fair distribution of wealth among all walks of life is the first step for eliminating inequity. The government should use carefully prepared programs to help the poor to acquire working skills to make the ends meet. Analogously, by teach the poor the right skills for running their own businesses they can cope with nutritional problems.

There are many sectors (agriculture, education, trade, etc.) influencing the current nutrition situation in developing countries. To tackle the nutritional problems in developing countries will therefore require a multi-sectoral approach where all sectors concerned are guided by mutual policies and objectives without conflicts. Success stories through this approach have been reported for Nepal and Burundi, citing appropriate policies and the role of the government as most important. Therefore, governments have to take up the challenge.

here in the Pacific Islands obesity is certainly a bigger challenge than undernutrition. Here awareness building is an important strategy to mitigate this form of malnutrition.

Yes,raising awareness is one of the strategies to combat the obesity challenge; to be effective it should involve the decision makers as well.

Impliment programmes and policy to compliment the problem by bringing proffessional together.

Health promotion on a healthy diet and exercise is one of the strategies that will combat obesity and undernutrition. secondly global training of public health professionals and more research.

An interesting topic for discussion. It would be difficult to solve nutritional problem on a broad approach because communities have divergent reasons for malnutrition. A community approach involving multiple sectors from production to consumption would not only reveal the extent of the problem but also the source of the problem, and possible community based solution in precision

Investing more in Nutrition based polices in Public and private sectors. Establishment of new nutraceutical industry. Development of regulatory framework. Development of human resources in Nutrition and Dietetics field. Offering extensions services.

These are the some strategies that can be adopted to uplift nutritional status in developing countries