NUTRITION SCENARIO IN AFRICA & LATIN AMERICA Mexico In Mexico an investigative effort aimed at improving the nutritional con

ditions of the population through application of the scientific method was adopt ed. Through this the interventions adopted were established using cross control studies. Only when the results proved to be statistically justifiable they were scaled up. Large scale surveys to determine the magnitude and distribution of ma lnutrition, and social responses for the policies and programs on malnutrition w ere conducted; functional consequences or health impact of malnutrition on popul ations in order to determine the relevance of the problems; studies about the et iology and the social and biological mechanisms of malnutrition; studies about t he design and testing of small-scale actions or interventions; efficacy studies (conducted under controlled conditions of delivery and utilization of interventi ons); and effectiveness studies or large-scale program evaluations conducted und er regular program operating conditions and including evaluations of the process and cost-effectiveness of interventions. The process ends with the design and e valuation of policies and programs in order to provide feedback for decision mak ing. (Rivera, 2009) Based on the similar surveys conducted at different points of time inter ventions like food assistance programs with proper focus on the various issues l ike focus on the poorest pockets, areas with highest prevalence of under nutriti on were riveted on. This way Mexico came up with many successful themes like dis tribution of micronutrient fortified food for the children of age group 6-59 mon ths. This led to a significant increment in the heights of the children of the i ntervention group (average increase of 29.8 cm). a similar program on anemia was initiated. The evidence presented demonstrated the usefulness of applying research results toward the design of new policies and nutrition programs in Mexico and t he very successful interjections of the same, in a short term as well as a long term basis. Niger Niger is an African country, with localized natural resources, GDP of 70 0 per capita; as per a survey done in 1992, it was nothing closer to achieving t he MDGs. Also the prevalence rates of the wasting and stunting rates also showed no significant improvement. But in the years from 1990-2006, estimated mortalit y rates among children<5years of age decreased substantially. The interventions in place for the period; integration of Vitamin A supplementation into semi-annu al or annual national vaccination programs, involvement of the various directora tes like malaria, public health and economy and finances and the Agriculture min istries for a round up development. And most important of all the aim to bring a bout behavior change in terms of Infant and young child nutrition. Studies were conducted for analyzing the prevalent practices, myths and resource determinatio n for the continuation of programs. The significance given for initiation of breast feeding within the first hour of birth led to substantial changes. The introduction of breastfeeding in the first hour increased from about 20% to about 50%. The prevalence of exclusiv e breastfeeding among all infants <6 months of age, which was almost non-existen t in 1998, increased to 14% in 2006. (Wuehler, 2011) Two national evaluations of the successful integration of VAS and malnut rition programs into other health sector programs reflect the international find ings related to the success of scaling up breastfeeding programs. The identified characteristics of these programs include: ownership and collaboration at all l evels, including politicians, implementers, communities, and recipients; flexibi lity in adapting programs and supply chains to local needs; promotion of the pro gram through a variety of communication channels; the use of very clear and memo rable messages, and effective staff training. Peru Malnutrition in Peru can be attributed to multiple causes, both direct ( including insufficient amounts and variety of food consumption) and indirect (ex

clusion from markets, food insecurity, education levels, unclean water, inadequa te sanitation, cultural preferences and ineffective governance), with resultant effects on health outcomes as well as the country s economic and social development. (Christine Aguiar, 2007) It was found in the study that, 25.4% of all children under five suffere d from stunting in Peru. Malnutrition affects adult performance as well. As peop le in Peru are not only stunted due to malnutrition and are less physically capa ble of doing some tasks, their low level of caloric and vitamin intake means tha t they are often less able to do work for longer periods of time, especially mor e strenuous tasks. Overall, physical labor in Peru is often less productive than it could potentially be if malnutrition could be curbed. There are specific programs in place handling the problems related to Ma lnutrition by the Peruvian government. The Peruvian government spends about $250 million a year on food assistance programs to vulnerable populations in the cou ntry. It uses community municipalities as the basis for providing in-kind transf ers of milk and other commodities including cereals and other milk products to h ouseholds. Priority is given to the first-tier group of households which consist of fa milies with lactating mothers and children age six or younger. Once people in th is tier have been provided for, the program distributes milk and related commodi ties to households with children from 7 to 13 years old, and people suffering wi th tuberculosis. Although it was found that, the percentage of beneficiaries of the Vaso de Leche program that is not poor or extremely poor ranges from 60 to 6 8%. Most of the resources, therefore, are going to middle income Peruvians. And hence the target population for the program was found to be misjudged and hence it did not lead in substantial changes in the indicators. The Comedores Populares or Communal Kitchens serve as a financial aid, p roviding meals at a lower cost and giving neighborhood women more time for incom e-generating activities. Organized by women s voluntary associations made up of abou t 25 women, they prepare meals for approximately 100 people in their neighborhoo d. About 10% of all meals are provided free to the extremely poor, elderly and s ick. The rest of their neighborhood clients pay a minimal fee to support the pro gram. This was similar to the program called Positive Deviance initiated in Odisha and West Bengal in India. But the issues with funding and management of funds, self -managed kitchens faced with serious problems due to the economic crisis and obs tructions from terrorism. Brazil In Brazil, it was defined that poor living conditions, including househo ld food insecurity, low parental education, lack of access to quality health car e and an unhealthy living environment are among the main determinants of stunted growth. In Brazil, three national health and nutrition surveys conducted between 1974 75 and 1996 have pointed to declining trends in child stunting prevalence. Ove r a 33-year period, we documented a steady decline in the national prevalence of stunting from 37.1% to 7.1%. Prevalence dropped from 59.0% to 11.2% in the poor est quintile and from 12.1% to 3.3% among the wealthiest quintile. The decline w as particularly steep in the last 10 years of the period (1996 to 2007), when th e gaps between poor and wealthy families with children under 5 were also reduced in terms of purchasing power; access to education, health care and water and sa nitation services; and reproductive health indicators. (Carlos Augusto Monteiro, 2011) Along with the improvement in the purchasing power the major determinant s for the improvement in the rates of under-nourished children were also; a majo r expansion of cash transfer program for poor families and maternal education. T he emphasis given by the government in improving the enrollment and the standard s of education and completion of at least primary education by all in the year 1 990. The Brazilian Unified Health System, created in 1988 by the new Brazilia n constitution after the military dictatorship, has increased access to free ser vices for the whole population. Family heath strategy, was set up for the specif ic purpose of promoting equity in access to primary health care. The strategy ha

s succeeded not only in targeting the poorest rural municipalities and periurban slums, but also in contributing to reduced child mortality. Along with these the quality of care was given utmost importance in addi tion to access to health care, environmental conditions and food security. Also the most important underlying cause was identified as diarrhea; was responsible for 17.3% of all registered infant deaths in 1985 07, but by 2003 05 (the latest period with information available) ac-counted for 4.2% of all deaths. Interventions lik e use of oral rehydration solutions and zinc powders led to the change see in th e indices. Conclusion Many such significant schemes were innovated in these small countries to combat the terror of under-nutrition and with the aim of moving a little further toward s the ultimate aim of achieving MDGs in the year 2015. There were significant im provements made by some like Brazil and Mexico, where as a few succumbed in thei r wombs due lack of managerial assistance and financial guidance. Due to lack of political will a few significant schemes like Comedores Populares in Peru and P ositive Deviance in India were befuddled. There is a need to identify the innova tive schemes in the countries and leverage them with funds if their potential in delimiting the problems with nutritional myths is attained. The action up taken, strategies outlined, and the successes notified should be m arked in for their replicablity and feasibility in various other low and middle income countries to make a dent in the indicators foregrounding the immense burd en or malnutrition.

WORKS CITED Carlos Augusto Monteiro, e. (2011). Narrowing socioeconomic inequality in child stunting: the Brazilian experience, 1974 2007. Bull World Health Organ, P305-311. Christine Aguiar, e. (2007). An Analysis of Malnutrition Programming and Policie s in Peru. University of Michigan, P 1-66. Rivera, J. A. (2009). Improving nutrition in Mexico: the use of research fordeci sion making. Nutrition Reviews Vol 67, S 62-69. Wuehler, S. E. (2011). Situational analysis of infant and young child nutrition policies and programmatic activities in Niger. Blackwell Publishing Ltd Maternal and Child Nutrition, P133-156.