Discussion [on nutrition a health sector responsibility].

It becomes increasingly evident in the less developed countries how difficult it is to improve the health of the population when adequate attention is not directed to the problem of malnutrition. Without adequate nutrition particularly during early life individuals are unable to realize the maximum physical and mental potential that is written into their genes. Malnutrition weakens the organisms functioning making it susceptible to illnesses and less able to recover from them. The situations seriousness in the developing countries is compounded because the health sector has little capacity to carry out effective activities in the area of nutrition. Primary health care must be a system that attacks the origin of precarious health creating an infrastructure on which health can be based. Such a system would have little to do with medicines but would focus on nutrition and hygiene. The package of nutrition and health must be delivered in such a way that families will accept it in a progressive fashion. The package must be 50% mother and child nutrition and 50% hygiene vaccinations birth spacing and an elementary attention to fevers and diarrhea. No department other than public health should be in charge of delivering this "package of basic actions" because no other department is responsible for the "quality of life." 2 major constraints face the health authorities: the gap between what is feasible on a socioeconomic basis and what is scientifically sound; and the gap between public demand and nutritional requirements. The health sector must qualify itself to overcome these constraints. Nutritional programs organized by the health services should have the following objectives: acquainting the health team with the relationship between nutrition and disease; promoting better nutrition practice through educational and training courses for health and allied services personnel; developing an appraisal system by which nutritional programs can be effectively evaluated and revised; and stimulating and initiating innovative activities and research to solve problems of malnutrition. The sociocultural action is the only approach that deserves some optimism. The objective of nutrition education and recovery centers is to make use of the time required for the recovery of a malnourished child to educate the mothers and encourage them to pass on the information provided. Nutrition a health sector responsibility must be dealt with directly by activities affecting food and diet and indirectly by preventing and treating the diseases that arise from malnutrition or are made more severe as a consequence of malnutrition.