Untangling the web of malnutrition

Carly Hayes (University of Waterloo)

Malnutrition is a problem that spans multiple sectors: social, biological, environmental, and economic, just to name a few. What we have learned from interviews with community members, photos taken by school-aged children, speaking with experts, spending time with our family partners and gathering data from ministries, is that all of the causes are inherently connected and cannot be disentangled from the complex web of malnutrition.

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This pictures show the preparation of K’ispiño.  A typical dish made with alpaca blood, moraya flour, cilantro and salt. The meal was served with potatoes and uchucuta.

Malnutrition is the state of lacking adequate access to necessary macro and micronutrients in the daily diet that are required for the biological and cellular processes our bodies use to function. But malnutrition also encompasses a number of other factors, including sanitation, education, social structures, and culture. My colleague Kennedy recently wrote an article about it, and you can access it here.

The Peruvian government has sought to remedy malnutrition in the same way that it is structured – by providing programs that are multi-sectoral and address multiple problems. Through QaliWarma, the government has endeavoured to improve school attendance rates by providing school meals. Through CunaMas, mothers receive education on early childhood stimulation to improve cognitive development. In Chispitas, targeted families receive supplementation to combat anaemia in children aged from 6 to 36 months old. And finally, in Juntos, a cash transfer program, the Peruvian government has incentivized health care access and school attendance by providing conditional cash transfers of 100 soles per month.

While the Peruvian government has been praised for commitment and multi-sectoral approach to reducing malnutrition by the World Bank, this data masks regional inequalities. Last week we had an interview with the doctor of Lares Health Center (Lares was the poorest district in Peru until 2013), a centre who is in charge of 11 different communities. Cuncani is part of these communities, which are all between 40 minutes and five hours away from Lares. What came to light through this conversation is that despite this dedication to improving overall welfare, malnutrition has gotten worse in a number of ways. The statistics from this year, that were released few days ago, indicate that 37% of the children are malnourished, 22% more than a year ago.

Why is this happening? While we are still trying to answer this question, one possible answer is that no program exists to combat malnutrition, in its multiple forms, as an end goal in itself. These programs are often coupled with goals about achieving universal education, improving healthcare access, and increasing household incomes. Without a program to address malnutrition directly, the complexity of this problem gets lost among a number of other worthwhile goals. And without a direct focus on eliminating malnutrition in the most vulnerable communities, the malnutrition web will only become more tangled.

After finishing with this research, we will continue to improve our efforts and keep working on local solutions for local problems. With our work with the Lares Health Centre, and into the future, we are hoping to reinforce monitoring and evaluation efforts in order to prove that malnutrition and poverty can only be finished when reality, culture, and complexity are taken into account. We hope that the new government of Peru knows this and will take action with this in mind.

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