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Books received

Growth monitoring and promotion in young children: Guidelines for the selection of methods and training techniques. Derrick B. Jelliff and E. F. Patrice Jelliffe. Oxford University Press, New York and Oxford. 1990. (ISBN 0-19-505623-X) 134 pages, paperback. US$18.95.

Growth monitoring has been considered the most effective means of enabling mothers and peripheral health workers to determine when breast milk is no longer sufficient as the sole source of food, when the child is not getting enough food, or if there is the presence of infectious disease or other health complications. It has been the cornerstone of the UNICEF-WHO child survival strategies. Unfortunately however, recent evaluations have revealed that it is often a meaningless ritual due primarily to poor training and supervision and the inadequacy of support services. Questions have been raised as to the cost effectiveness of the time required for growth monitoring. These guidelines indicate what is required to make growth monitoring effective and to justify its cost.

In a clear and practical manner, this slender manual describes the tools for growth monitoring and their adaptation to varying circumstances and systems. Most important are its guidance in planning and implementing training and supervision of growth monitoring programmes and their evaluation. Its seven appendices include information on how to evaluate weighing scales, how to conduct focus group interviews, and how to introduce the concept of weighing into a village, basic dietary messages, and a selective bibliography. One of the appendices describes growth monitoring problems that have been encountered in the Dominican Republic, Ecuador, Thailand, Indonesia, and India. The book will be a valuable guide for persons engaging in growth monitoring and is highly recommended.


Infant and child nutrition worldwide: Issues and perspectives. Edited by Frank Falkner. CRC Press, Boca Raton, Fla., USA, 1991. (ISBN 0-8493-8814-7) 297 pages, hardback.

This book brings the latest knowledge and insights into the needs of children during their first two years for food security, health security, and developmentally sensitive care. It is edited by a paediatrician who has worked extensively with WHO, and the authors of the twelve individual chapters are well recognized not only for their outstanding international contributions but also for their sympathy and understanding of the problems of the poor in developing countries. Topics include maternal undernutrition and reproductive performance; scientific, social, and psychological aspects of breast-feeding; the why, when, and what of weaning; infant nutrition and development; and direct intervention programmes to improve infant health and nutrition. Two chapters provide a historical perspective, and one describes the geographic distribution of malnutrition in infants and young children. This is an excellent book for students of nutrition, paediatrics, and public health. and their professors will also profit from it.

Dietary management of young children with acute diarrhoea: A manual for managers of health programmes. 2nd edition. Derrick B. Jelliffe and E. F. Patrice Jelliffe. World Health Organization, Geneva, 1991. (ISBN 92-4-154428-7) 29 pages, paperback. SwF 8, developing countries SwF 5.60.

This manual very briefly summarizes current knowledge of the relationship between diarrhoea and malnutrition and how it applies to the feeding of children with acute diarrhoea. The second chapter, on the selection of foods to be given during diarrhoea, is largely merely descriptive of traditional and current practices. However, the final chapter, on dietary management during and after diarrhoea, does strongly emphasize the need for continued feeding during the acute episode and extra food thereafter for catch-up. In between are chapters on collecting information in communities and preventing diarrhoea by good feeding practices. This is a convenient reference for managers and supervisors of programmes of nutrition and primary health care.


Micronutrients in health and in disease prevention. Edited by Adrianne Bendich and C. E. Butterworth, Jr. Marcel Dekker, New York, Basel, and Hong Kong, 1991. (ISBN 0-8247-8539-8) 430 pages, hardback. US and Canada US$125. all other countries US$143.75.

Deficiencies of the micronutrients iron, vitamin A, and iodine in developing countries are currently the subject of an intensive preventive effort by international and bilateral agencies. This book is a reminder that there are many additional micronutrients with health consequences for both industrialized and developing country populations. It analyses the role of micronutrients in only recently recognized areas such as cognitive function, susceptibility to viral infection, birth defects, immune function, some kinds of cancer, cardiovascular disease, and cataracts. The sections are organized by functions affected and not by individual nutrients. Nutrients covered include vitamins E, B6, and B12, folate, carotenoids, and polyunsaturated fatty acids.

Each of the chapters is on the frontier of nutrition knowledge, and hence many of the suggested relationships must be regarded as tentative. The demonstrated or possible beneficial effects of improving intakes of nutrients which are found to be deficient are described. However, the authors, all authorities resident in the United States, do not go beyond the available evidence and cite more than 1,600 references. Indiscriminate use of vitamin supplements is discouraged, and their potential toxicity indicated. The book contains important new information and is valuable reading for physicians and nutrition scientists.


A practical guide to the correction of iodine deficiency. John T. Dunn and Frits van der Haar. ICCIDD, WHO, UNICEF, Netherlands, 1990. (ISBN 9070785-05-6) 62 pages, paperback.

This booklet is a short, focused, non-technical, and practical introduction to the subject of iodine deficiency control. The chapters summarize the major consequences of iodine deficiency, the means for its correction, and the key elements of control programmes. It is intended only as an introduction to more technical manuals prepared by ICCIDD for those who will be responsible for the implementation of specific preventive programmes.

Copies can be obtained without charge by writing to the nearest office of the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), or the International Council for the Control of iodine Deficiency Disorders (ICCIDD).


Strategies for assessing the safety of foods produced by biotechnology. Report of a joint FAO/WHO consultation. World Health Organization, Geneva, 1991. (ISBN 92-4-156145-9) 59 pages, SwF 11/US$9.90, developing countries SwF 7.70.

This book begins with a review of current and future applications of biotechnology in food production and processing, with separate sections devoted to applications in micro-organisms, plants, and food animals. Emphasis is placed on the safety of new technologies that promise dramatic improvements in the food supply, whether through the production of nutritionally superior cereal and grain crops or the development of farm animals that are disease resistant, produce lean meat, and grow more efficiently. New techniques that can increase the efficiency and reduce the costs of the food processing industry are also assessed.

Separate chapters are devoted to the safety assessment of foods derived from micro-organisms, plants, and animals generated by biotechnology. Each chapter first identifies all the possible hazards, discusses the likelihood that such hazards will arise in practice, and describes the scientific principles and procedures needed to assure the safety of the finished food. A concluding section stresses the need for a new framework of safety assessment that relies on a characterization of food in terms of its molecular, biological, and chemical properties and uses the resulting data to determine the need for toxicity tests. The report also notes that the new techniques of molecular biology provide powerful tools not only for improving the world's food supply but also for conducting more sensitive safety assessments.


Putting people first: Sociological variables in rural development. 2nd edition. Edited by Michael M. Cernea. Oxford University Press, New York, London, 1991. (ISBN 0-19-520465-4) 575 pages, hardback.

This is the second and expanded edition of a work, first published in 1985, that has had a major influence on the programme and project thinking of the development agencies. Like the first edition, it criticizes explicitly or implicitly the neglect of social and cultural dimensions and the insensitivity to local knowledge and constraints that often characterize the projects of the development agencies. It provides many different examples of disregard for grass-root institutions and organizations and of the technocratic and economic biases that determine development planing.

This new edition highlights more explicitly the issues related to natural resources management, the environmental implications of development programmes, and the formation of human capital through promoting participation. It also describes adverse consequences of "structural adjustment," including the greater impoverishment of some marginal groups, the forced displacement and involuntary resettlement of populations, and the deterioration and dissipation of income-generating assets. It uses specific cases to illustrate how the knowledge and methods of anthropology and sociology work with regard to all aspects of development.

A chapter by Conrad Kottak, describing lessons from completed World Bank and USAID projects in which people did not come first, provides powerful arguments for insisting on a socially informed and culturally appropriate design and implementation strategy for every development project. A chapter by Robert Chambers describes some shortcut and participatory methods developed for agricultural projects, which are similar in principle to methods developed for projects in nutrition and primary health care (cf. S. C. M. Scrimshaw and E. Hurtado, "Field guide for the study of health-seeking behaviour at the household level," Food Nutr Bull 1984;6(2):27-45; and Scrimshaw and Hurtado, Rapid assessment procedures for nutrition and primary health care. anthropological approaches to improving programme effectiveness [Los Angeles, Calif, USA: UCLA Latin American Center, 1987]).

Everyone involved in the design, implementation, and evaluation of development projects should be familiar with the messages of this book and its paradigm. It will also be a valuable reference for university students in courses related in any way to intervention programmes for household and community improvement in developing countries.


Addressing malnutrition in Africa: Low-cost program possibilities for government agencies and donors. F. James Levinson. Social Dimensions of Adjustment Project, working paper no. 13. World Bank, Washington, D.C., 1991. (ISBN 0-8213-1897-7) 35 pages, paperback.

This paper presents a range of possible programme options for addressing malnutrition. Among its conclusions is that agencies or donors choosing to concentrate their nutritional improvement resources in a relatively small geographic area could employ appropriate combinations of core nutrition activities with interventions designed to address household food insecurity and preharvest hunger. An alternative to intensive and localized nutrition activities is the use of limited resources to provide financing for components of larger programmes in ways that can increase their effectiveness.


Food and nutrition policy in Mediterranean Europe: Proceedings of a WHO symposium. Edited by A. Ferro-Luzzi, E. Cialfa, and G. Leclercq. WHO Collaborating Center for Nutrition Series, no. 1. World Health Organization, Rome, 1991. 223 pages, paperback. (Request copies from the National Institute of Nutrition, Via Ardeantina 546, 00178 Rome, Italy.)

This publication outlining the basis for European food and nutrition policy and describing it for the EEC and for most individual countries on the continent also has chapters dealing with education of the public and the role of consumer associations and of various agencies of the public and private sectors. Its applicability to developing countries is limited.


Food from dryland gardens: An ecological, nutritional and social approach to small-scale household food production. David A. Cleveland and Daniela Soleri. Center for People, Food and Environment, Tucson, Ariz., USA, 1991. (ISBN 0-9627997-0-X) 387 pages, paperback.

This practical handbook with helpful line drawings by Daniela Soleri contains a wealth of practical information encouraging dryland gardens that conserve natural resources and take advantage of the biological diversity still available in traditional crops. It serves as both a beginner's guide and a reference for those with more experience.


Milk and dairy products: Properties and processing. Ionel Rosenthal. VCH Publishers, New York, 1991. (ISBN 0-89573-938-0) 217 pages, hardback.

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