[Current and future status of human nutrition in the Central American isthmus]. / Estado presente y futuro de la nutrición humana en el istmo centroamericano

Of the four major nutritional problems in the Central American Isthmus, calorie and protein deficiency, endemic goiter, nutritional anemias, and vitamin A deficiency, the most devastating is the first, calorie and protein malnutrition. Our present stage of advancement requires that the nutritional problem be solved through intensive and continued governmental action that would guarantee the people of this area an adequate diet without deteriorating the environment and without depleting natural resources. This would imply a reorientation of the scientific and technological research and a new agricultural policy, together with a new model of development that would place priority on these considerations, recognizing, at the same time, their demographic predominance.

Systems analysis in nutrition and health planning: approximate model relating birth weight and age to risk of deficient growth.

This paper summarizes the initial phase of an effort to develop semiquantitative methods for nutrition and health planning. The general approach is to utilize the methods of systems analysis and operations research where appropriate, but the emphasis is on developing a simplified, approximate analysis that government planning groups could conveniently apply in evaluating various potential programs for attaining specific nutrition and health objectives, while satisfying certain constraints (e.g., budget, facilities, personnel). An essential element of the analysis is a model that provides an approximate description of malnutrition (inadequate growth, as indicated by weight for age) and mortality in terms of those variables that can be affected by intervention programs. We have concentrated initially on using the results of two INCAP longitudinal studies to develop models relating the incidence of malnutrition (second and third degree on the Gomez scale) to age and previous growth, including birth weight. The two studies cover rural Guatemalan communities with considerable variability in ethnic, socioeconomic, and ecological conditions. Because they are tentative, the resulting models are discussed only qualitatively and not quantitatively. The models may serve as baselines to estimate the consequences of potential programs aimed at different target groups, such as pregnant women and children whose weights at birth or thereafter fall below prescribed levels. The possible benefits of using models of this nature in nutrition and health planning are discussed.