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Malnutrition: What can be done? Lessons from World Bank experience. Alan Berg. Johns Hopkins University Press, Baltimore, Md., USA, 1987. 120 pages.
Action to eradicate the underlying causes of poverty are important in dealing with the problem of malnutrition. However, as Alan Berg argues, although nutrition problems are closely linked to a country's level of economic development, "nutrition improvements need not await that development." World Bank experience suggests that efficacious and affordable measures for dealing with nutritional deficiencies are at hand. Evidence is provided by analysis of four major Bank-supported projects in Brazil, Colombia, India, and Indonesia and 57 nutrition actions in other projects. For example, the Tamil Nadu Integrated Nutrition Project in India used a combination of "sensitive but practical" growth monitoring, highly selective supplementary feeding of nutritionally at-risk mothers and children, a comprehensive communications programme and rigorous management to reduce malnutrition by an estimated 50% in 9,000 villages between 1980 and 1987. Berg estimates that the project delivered about twice the benefit for half the cost of comparable programmes in Tamil Nadu. "This finding. . . suggests," he writes, "that a well-managed and targeted programme is able to reduce serious and severe malnutrition more than a less-focussed programme and at a significantly lower cost."
Malnutrition: What Can Be Done? cites similar World Bank experiences to challenge widely held assumptions about nutrition interventions. Large food programmes can be targeted in ways that push costs to much lower levels than earlier programmes. There is also evidence from a large-scale Indonesian project that nutrition education alone can do much to improve nutritional status - women's lack of schooling need not be an insurmountable obstacle. Other World Bank research has shown that vitamin and mineral deficiencies may be caused by a rapid shift from traditional, locally produced grains to polished rice and refined wheat, and that the price low-income families pay for food can be substantially reduced by increasing the efficiency of the food marketing system.
(From SCN News, 1988;1&2:37.)
Infant growth and nutrition. Proceedings of a workshop held 25-26 May 1987, Arnhem, Netherlands. Foundation for the Advancement of the Knowledge of the Nutrition of Mother and Child in Developing Countries, P.O. Box 20, 6710 BA Ede, Netherlands.
The themes of the workshop documented in this book are the continuum of maternal nutrition in pregnancy and lactation, and infant growth up to one year of age. The opening paper provides an excellent review of the current state of knowledge concerning infant feeding and highlights research needs. Other papers present research findings from Kenya, Zaire, India, Indonesia, China, the Philippines, Thailand, and the Netherlands. The topics addressed are all of current interest; they include the age to which exclusive breast-feeding is adequate, the "weanlings dilemma" of too few calories or empty calories, the role of birth weight in infant growth, energy requirements during pregnancy and lactation, weight gain and maternal fat stores in pregnancy, and the impact of the introduction of supplementary foods to the infant on breast-feeding. The book contains relevant data on maternal nutritional status and anthropometric indicators from a number of developing countries which have been scarce in earlier studies.
The group discussions and workshop summary are an informative overview of what is well established and what needs further study with reference to (1) the effect of nutrition on birth weight and lactation and (2) nutritional and environmental factors affecting infant growth and health. A rich list of topics for further research is presented for those interested in maternal nutrition and infant growth.
- Mary Ann Anderson
Nutrition and development. Edited by Margaret R. Biswas and Per Pinstrup-Andersen. Oxford University Press, Oxford, UK, and the United Nations University, Tokyo. 208 pages. Paperback, £4.95.
This book, originally published in 1985 (see the review in the Food and Nutrition Bulletin, vol. 9, no. 2, p. 73), has now been newly issued in paperback.
The problems of malnutrition in different population segments need to be addressed with effective government policies and programmes. The interrelationships between nutrition and development are complex, and decisions on development are often made without a full appreciation of their nutritional implications. Nutrition and Development reviews fundamental policy issues regarding nutrition and looks at the lessons learned from the implementation of nutrition policy throughout the world.
Appropriate use of fluorides for human health. Edited by J. J. Murray. World Health Organization, Geneva, 1986. 131 pages. SwF 22.
The purpose of this book is to help public health authorities and dental practitioners decide what methods of ensuring an optimal intake of fluoride are most appropriate to the circumstances of a particular community and to provide practical advice on those methods. This goal is important because of the relatively poor worldwide acceptance of fluoride use in public health measures to reduce dental caries despite overwhelming evidence of the safety of the recommended levels of fluoride.
The book is concerned primarily with current and careful statements about the routes for providing fluoride and the benefits from each procedure. Each section contains sufficient information to make a wise decision on the most practical procedure to use considering the geographic, cultural, and economic setting of the community. It is well-designed for its intended audience. The emphasis on the use fluoride in well-tested procedures as the best way to reduce dental caries is praiseworthy.
A farmer's primer on growing soybean on riceland and A farmer's primer on growing cowpea on riceland. R. K. Pandey. International Rice Research Institute, Manila, Philippines, and International Institute of Tropical Agriculture, Ibadan, Nigeria.
Soybeans and cowpeas are high-value, nutritious crops that have great potential to fit into the ricebased cropping systems that dominate tropical agriculture. To realize the full yield potential of soybeans and cowpeas, farmers must know how the plants grow, their critical growth stages, and how to prevent stress at each stage. Literature is available on growing the crops, especially soybeans, in temperate zones. But little has been published on the whys and hows of growing soybeans and cowpeas in the tropics.
The International Rice Research Institute (IRRI) and the International Institute of Tropical Agriculture (IITA) have published these two new books to fill that gap. Dr. Pandey, an agronomist with IRRl's Rice Farming Systems Program, wrote the highly illustrated books to help small-scale farmers in the tropics increase their productivity and income. The new primers are also intended for extension workers and students.
"Soybean is widely grown in temperate zones, but not in the tropics," Pandey explains. "But a soybean crop can generate farm income in the off-season after the rice harvest, and help break the pest and disease cycle associated with continuous rice cropping." Soybeans are also an excellent source of protein and edible oil, and a raw material for the food and livestock feed industries.
"On the other hand, cowpea has been grown in the tropics for centuries and is well adapted to tropical environmental stresses," Pandey says. "Cowpea tolerates drought and can grow on poor, even acid, soils." Improved varieties from IITA with a short or medium growth period can profitably fit into a wide range of cropping systems. Cowpeas are used as a food, fodder, or green manure crop that can be grown with minimum inputs.
"Both crops 'fix' or draw nitrogen from the atmosphere; so planting them before or after rice enriches the soil and cuts fertilizer expenses," Pandey says. "And both crops add protein to the starchy diets of subsistence farm families."
The new primers were patterned after A Farmer's Primer on Growing Rice, which is available in 33 languages and is almost certainly the most widely published agricultural text in existence. The new primers are also designed for easy and inexpensive co-publication. The text is minimal; the illustrations convey as much information as possible. IRRI has blocked the English text off from the line drawings and reprinted sets of the illustrations. Co-operators may translate and strip the text onto the artwork, then print non-English editions on local presses.
The soybean primer was released in mid-November 1987 and is already being translated into Cebuano, Hindi, and Tagalog.
The primers were made possible by a collaborative project of IRRI and IITA. The centres are "sister" institutions supported by the Consultative Group on International Agricultural Research (CGIAR), a consortium of about 50 donor countries, international and regional organizations, and private foundations that support agricultural research in developing countries.
IRRI will release a fourth similar book, A Farmer's Primer on Growing Upland Rice, in early 1988. The upland (dryland) rice primer was written by Michel Arraudeau, a French plant breeder on assignment at IRRI from the Institut de Recherches Agronomiques Tropicales et des Cultures Vivrières, and IRRI plant physiologist Dr. Benito S. Vergara, author of the original Farmer's Primer. Arraudeau has many years of experience in upland rice in Asia and Africa.
To prepare for the new primers, IRRI conducted a research project on the effectiveness of the Tagalog and Hiligaynon editions of the original primer in 1986. The transfer of rice technology information was measured among 84 small-scale farmers on the islands of Luzon and Negros in the Philippines. The findings of the study were used to tailor the three new primers for more effective use. A paper describing the research project is available from IRRI.
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The Editor
Food and Nutrition Bulletin
The United Nations University
Cambridge Project Office
Massachusetts Institute of the Technology,
E38-756
Cambridge, MA 02139, USA