oa South African Health Review - Nutrition : a Primary Health Care perspective : Primary Health Care : programme areas
Malnutrition impacts negatively on morbidity, mortality, educability and productivity. Notwithstanding the success reported in relation to the reduction of specific nutrient deficiencies such as folate and iodine, the overall nutritional status of the South African population has not improved over the last fourteen years. In reality, the double burden of disease has become more severe with the increased prevalence of micronutrient deficiencies (i.e. vitamin A and iron) together with high levels of overweight and obesity. The Integrated Nutrition Programme is located within a Primary Health Care framework, is based on internationally accepted 'best practice' and has a comprehensive set of interventions. Analyses of selected interventions suggest that implementation is sub-optimal. Inadequate human resources and lack of appropriate capacity have been identified as critical contributors to the lack of progress. Improvement in the nutrition situation will therefore require a concerted and coordinated effort to develop a range of capacities at different levels and within different cadres of health workers. These capacities and skills should not only be developed in-service, but should also be infused during training. In addition, further research into implementation is encouraged to assist in finding sustainable solutions for South African nutrition problems.
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