Please, could you share any successful strategy that have effectively reduce young children malnutrition in a rural community.

In the conceptual framework for malnutrition,there is the immediate causes of malnutrition, underlying causes and the basic causes.The nutrition programs mostly address the immediate causes and the underlying causes without considering the most important basic causes that when addressed will help curb the re-occurrence of the nutrition emergency.

There is need for a shift paradigm to sustainable livelihood approach. in this approach,programs focus on the vulnerability context of the affected population. Their  resource capabilities are assessed in terms of their capital assets and then policies, institutions and processes are lobbied  to build their capacity in their own livelihood context. With this sustainable approach I believe the outcomes for the programs can yield significant reduction on the prevalence of malnutrition in sub-Saharan Africa.

Malnutrition is a tip of an iceberg which has hygeine and sanitation aspects, limited resources and low income generation, and most crucial is the knowledge level of the community at its bottom. Hence, to overcome such challenges the government should initiate intervention and subject support  programmes in addition to ongoing  supplementary programs for the community.

These programs should involve objectives like general hygeine to avoid recurrent infections in the malnourished children in order to prevent further damage to their nutritional status, toilet facilities in the remote areas, clean drinking water, activities involving income generation to alleviate poverty and health promotion campaigning to enhance the knowledge and awareness of the community on health and nutrition aspects.

I think these strategies could be helpful in reducing malnutrition in sub-Saharan Africa.

A new aspect of possible propagation of malnutrition is Environmental Enteric Dysfunction (EDD) which means that the gut is dysfunctional and hence not able to absorb nutrients...it is leaky! Some of the EDD effects include malformed villi or disfigures stomach lining. EDD can be caused by unhealthy environments, pesticide residues from the mothers milk among many othetrs. This may explain why despite all the interventions, we still get cases of recurring MAM and SAM. Studies are currently being conducted on this aspect and one of the pointers is that some foods actually are able to reverse EDD mainly the prebiotis.

a very important question....

as others have responded, strategies for malnutrition have largely been very limited to addressing very proximal causes in a medicalised way (sometimes as limited as distribution of RUTF)  without paying any attention to root causes and engaging and empowering communities.

some work we have been doing on comprehensive strategies to address malnutrition is coming to fruition and i am happy to say that our paper on this has been accepted by the international journal for child health and nutrition. i look forward to sharing it when it is public.

we have been advocating a particular set of comprehensive strategies that also encompass the 'childcare' determinant in addition. we needed to demonstrate this and that led to a programme called Action Against Malnutrition (AAM) in tribal areas of India. pls see website phrnindia.org for details on AAM.

Food insecurity is the number one factor alongside lack of good nutritional knowledge in most African communities. Plant based diet for instance to some degree is available and affordable in most African communities and yet they don't utilize them.