Evaluation Challenges with Respect to Large-Scale Nutrition Intervention Programs

摘要

Large-scale nutrition interventions are at best inefficient and difficult to evaluate. Although the goals behind larger community and nationally based nutrition interventions are often noble, the difficulties of implementing and evaluating multi-faceted programs to such large populations prove too big a burden for any organization to fulfill or government. The lack of successful evaluations in the literature speaks volumes to the inability of anyone as of yet to adequately assess the impact of these large-scale programs. However, in numerous examples, smaller-scale nutrition interventions have been proven successful. Although these small-scale interventions have largely been conducted in controlled conditions, their limited scope and specific targets make the processes of implementation and evaluation more conducive. Thus, rather than implementing large, multi-faceted nutrition interventions, a series of smaller, independently run interventions with specific aims and targets should be considered. Large-scale nutrition interventions generally consist of several major activities, identified by 1996 Nutrition Policy Discussion (Gillespie et al, 1996). These are: 1. Growth monitoring and promotion 2. Promotion of breastfeeding and appropriate complementary feeding 3. Communications for behavioral change, or CBC (nutrition education and information-education-communication, or IEC) 4. Supplementary feeding 5. Health related services 6. Micronutrient supplementation.