Abstract
A new approach to community-based nutritional surveillance has potential for improving programmes for growth promotion by focusing on the children at greatest risk and increasing the capacity for appropriate action. First, cross-sectional surveys can help to identify where malnutrition is distributed in the community so that high-risk groups can be targeted for intensive monitoring. Second, field studies can be conducted in parallel with general implementation to help define causal factors influencing local patterns of growth faltering and guide selection of an appropriate mix of interventions and methods to suit local conditions. This information can provide a better basis for training mothers, volunteers, and service personnel.
Cultural, ecological, and economic constraints need to be identified as part of stimulating self-reliant community action. Demonstration of locally relevant and simplified procedures by a field research unit in each region should be linked with systematic extension to all parts of that region. These field research units should themselves be linked in a mutually supportive national and international network. Feedback of information from community-based surveillance can assist policy and administrative decisions for programme correction. These methods may provide our most direct means of introducing and measuring “adjustment with a human face.”