Nutrition Education in Public Health Programs—What Have We Learned?

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Abstract
The importance of malnutrition as a public health menace in the under-developed countries is now recognized, but educational efforts to improve nutritional practices have proved less successful than hoped. Recently, specialists in social, cultural and educational problems have cooperated with public health and community development personnel to study ways of improving these efforts. The differences in types and location of the communities studied were not reflected in the conclusions reached. Everywhere, the cultural impedimenta of the educator and those of the peasant were frequent sources of frustration. Practices using local foods and remedies, and representing a well thought-out compromise between scientific and traditional ideas, proved acceptable even in the presence of pre-scientific beliefs. Curative procedures that showed immediate benefit were more appreciated than preventive measures, especially in maternal and child health work, but only if offered in a congenial manner and with respect for the mothers'' own ideas. Lack of unanimity among the professional "educators", public health and medical personnel, teachers etc., destroyed the effectiveness of nutrition education, while the active cooperation of the indigenous "educators", parents, curers, midwives and pharmacists increased it. The wider implications of any educational procedure must be considered at the outset, and all educational material carefully tested before general use. Nutritional improvement may have to be approached indirectly. One main essential for success is the educator''s awareness of the attitude and skills appropriate to his task. Another is a detailed knowledge of the economic, social and cultural conditions of the area for which nutrition education is planned, as these may vary from village to village. Field training in rural areas for all public health nutrition workers would increase their understanding of the complex nature of nutritional problems, of the resources at their disposal, and of the approaches likely to yield desired results. Some knowledge of the social science concepts, and of the principles of education is also necessary. How this training can be arranged needs thought. Where it has been achieved, educational efforts have proved outstandingly successful.