4. Nutrition Education in Developing Countries: An Examination of Recent Successful Projects

Abstract

This document is the fourth chapter in a book that identifies priorities for action to enhance child growth and nutrition in developing countries. The chapter opens with a look at the five major reviews of the primarily North American literature in nutrition education. The literature suggests that nutrition education can institute change but that a strong need exists for theoretically-based research that compares the outcomes of various educational strategies. In 1985 Hornik raised important questions about using the mass media to extend coverage of nutrition education especially in areas such as breast feeding weaning and diarrhea prevention and control. This chapter uses an analytical framework to analyze five successful nutrition education projects from India (two) Indonesia the Dominican Republic and Tanzania. The results of the analysis are presented as hypotheses requiring validation. The framework looks at the following aspects of the programs: 1) model and theory (program philosophy political support and sector priorities); 2) duration; 3) context (social and economic conditions and setting); 4) needs assessment (focus and method of identification); 5) intervention (health goal purpose type and components); 6) administration and infrastructure (organization leadership and resources and coverage); 7) training and supervision (purpose and concepts method and curricula location and length reinforcement and frequency monitoring and feedback); and 8) communication and education strategy (theory base methods and dimensions content and messages channels media and materials). The analysis indicates that the traditional medical model of nutrition education is being replaced (due to its failure) by models which involve participatory intervention. The projects were not theory-based so no theory-based evaluation was possible and no model of effective education could be extrapolated. The active involvement of participants in a multichannel approach seems to be a key to successful interventions and the use of social marketing techniques is gaining widespread acceptance. Educational interventions require strong political support and an infrastructure for delivery. Implementation requires training and supervision of local educators in a decentralized organization.