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Kendall W. King - Journal of Nutrition Education, Summer, 1971

Nutrient Deficiencies

As the food situation began to be understood in country after country, it was more or less this: there were national caloric and protein deficits of 15% to 25% and similar deficits in most of the minerals and vitamins. Under those an conditions, one has to anticipate less than normal growth rates in children, reduced efficiency of working people, and elevated incidence and severity of infections diseases; fatal malnutrition, however, should not be inevitable.

The fact that there was often in these countries a preschool child mortality rate of 50% - the greater part of which involved severe malnutrition - forced the conclusion that there was a maldistribution of food within the family so that the young child got less than he needed of the food that was available. To correct that problem, maternal education seemed to be the only practical approach.

This education would have to be different in both technique and content from any with which we had experience. The students would be mature women but, for the most part, illiterate and tradition-bound. The usual classroom situation would be foreign and uncomfortable to them. All this meant changes in teaching technique would be needed.

In addition, the mothers world be poor - very poor. Most of them would have only 10 to 15 cents per day for the food-plus-fuel expenses for each member of the family. In addition, they would have access only to primitive native markets in which there were almost never any processed foods. These factors dictated object matter for the instruction quite different from that which is customary in the wealthier nations. Child feeding systems built around meat, milk, and eggs simply could not be used on a total daily food budget of 10 cents per child. A further deterrent was the fact that college-trained teachers were not available in most such countries; where they were, the national budget could not accommodate the salaries of the numbers needed.

It was to meet just this type of circumstance that J. M. Bengoa in 1955 first suggested the Nutritional Rehabilitation Center, or Mothercraft Center as it is known in some countries. In the United States we would tend, in contemporary jargon, to call Mothercraft Centers an example of "particularly well-attuned, sociologically relevant, practical educa-tion." Several recent reviews and one book have described the effectiveness of such centers as a means of practical public health education in nutrition and related aspects of child care for a particular target population: the largely illiterate, extremely poor of the third world.

That this group of people can be usefully served indicates that contemporary efforts to bring realistic understanding of nutrition to low-income, largely minority groups in the United States can succeed if the characteristics and needs of the American groups are clearly understood, and if the educational program is adjusted to accommodate rather than fight those characteristics.

Bengoa's basic idea was to identify badly nourished preschool children, induce their mothers to bring them to a center, and have the mothers participate in the nutritional rehabilitation of their own children using only foods, equipment, and funds similar to those which were available to them in their own homes. A recent book (1) summarizes the accumulated experience with Mothercraft Centers in Brazil, Colombia, Costa Rica, Guatemala, Haiti, Peru, the Philippines, and Venezuela as of 1969, five years after the first centers were opened in 1964 in Haiti and Guatemala. In addition to these, centers have been opened in Senegal, Ghana, Ecuador, the Dominican Republic, Algeria, Nigeria, Mexico, El Salvador, and Uganda. Reviews of their operation, objectives, and effectiveness have been published by King (2), Beghin (3), Sebrell and King (4), King, et al (5), Beghin, et at (6), and Bengoa (7, 8).

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