Recognition and Management of Malnutrition

In a disaster situation, feeding program options can range from a general feeding program to therapeutic and supplemental feeding programs. It is essential to ensure an equitable and appropriate distribution of available food supplies, with special emphasis on targeting the vulnerable groups. These programs must integrate local habits and preferences to the greatest possible extent.

General feeding programs

These types of programs distribute food to all people affected by the disaster. General feeding programs can be designed as complementary (providing some food items that are limited or not available) or supplementary (giving nutritional support to vulnerable groups) nutrition.

There are two commonly used forms of ration distribution: wet rations (which can be consumed without further preparation and are distributed at a feeding center) and dry rations (which require cooking and are consumed at the place of residence). There are advantages and disadvantages to each form of ration distribution.

Wet ration distribution ensures that the target individual consumes it, allows for the delivery of complementary health care services, and eliminates safety concerns that must be considered when carrying dry rations to the homes of children and women who can be victims of violence. In addition, when the food is prepared in a community site, participants do not need any fuel supply or cooking utensils. On the other hand, wet rations are often not feasible for large populations as they are labor-intensive and expensive.

Dry ration distribution is associated with lower cost and can reach larger numbers of individuals with fewer staff resources. Programs in Africa have introduced semisolid supplemental foods called ready to use therapeutic food (RUTF) that successfully improved early childhood nutritional status in malnourished populations. In addition, the family unit is maintained in their living area with the mother or caregiver spending less time away from the children. Feeding responsibility remains within the family, so that the habits and preferences of the affected population are more likely to be ­considered.

Recent experiences with cash transfers have had positive outcomes. These are often cheaper than providing food directly and do not disrupt local food markets. Cash transfer may also be more culturally acceptable and provide for a greater variety in the diet. Most of the time the money seems to be used to purchase food for the family.