Community Food Actions as a Nutrition Intervention in Primary Health Care

These actions refer to a wide variety of food-related activities at the local level, either community or household, which involve and benefit the members of that community or household. The ultimate purpose of community food actions is to prevent malnutrition and contribute to good health. This is accomplished through food production activities, in the broadest sense of the term, which assist community or household members so that they may achieve and maintain good nutritional status. Most community food actions consist of the following characteristics: participation of the community in the action process, utilization of appropriate, low-cost technologies, promotion of self-reliance, and minimal use of outside inputs and resources. Community food actions share several features in common with the PHC approach, including a focus on the needs of the poor and vulnerable population, especially mothers and young children. These actions can take a number of forms, some of which have existed for centuries, such as gardening, local production of weaning foods using indigenous crops, improved food storage, processing, and preservation methods, promotion of small livestock enterprises, creation of community seed banks, extension of credit to small farmers, insect and rodent control, community irrigation or wells, availability of fuel-efficient stoves, and development of a food marketing and distribution system. In order to determine which community food actions are most appropriate for inclusion in a PHC program, several factors should be taken into consideration, including the livelihood of the target population, the locale of the target population, availability and access to resources, food production activities, food production problems, seasonality of food, food consumption habits, main health problems in the community, socioeconomic conditions in the community or household, and availability of qualified community development workers. The most appropriate food actions would be selected with maximum community involvement, based on their ability to address the food and nutritional needs of the particular community or household, as well as support the PHC system by regularly providing an adequate, nutritious food supply, particularly to the most vulnerable segments of the population. The problems that beset both the health and agriculture sectors in the developing world will only be resolved if they become the concern of the community, if priorities are set right, if a low-cost, appropriate technology is available, and if the community is prepared to share the costs and can afford it. In order to overcome or prevent major constraints, the following key issues and concerns should be addressed during the design and implementation of community food action interventions: identifying the basic problem in a given community or household situation, selecting the most appropriate community food actions, ensuring maximum community involvement, utilizing low-cost, appropriate technologies, promoting self-reliance, and providing technical extension and follow-up support.