Abstract

PIP: This article describes the community-based nutrition intervention in rural southern Malawi. The program aims to reverse micronutrient deficiencies in vitamin A, iron, and zinc in a society where staple diets are plant-based and contain high levels of anti-nutrients. Anti-nutrients, such as polyphenols, dietary fiber, and phytates, inhibit absorption of iron and zinc. This population's diet was also low in dairy and meat products. The Tulimbe Nutrition Project aimed to modify and diversify diets rather than to supplement or fortify diets. This approach was more culturally acceptable and economically feasible. The approach required changing food selection patterns and methods of preparing and processing indigenous foods. The new diets aimed to enhance the availability, access, and use of micronutrient-rich foods throughout the year. The project was initiated in 1995 in two communities among 300 families with children ranging in age from 3 to 7 years. A baseline assessment with interviews and focus groups was conducted. The assessment for children included a 24-hour dietary recall, anthropometric measurement, and other clinical measurement. Anthropometric and dietary assessments were repeated at 6 and 12 months. New cultivars and technologies were introduced, such as soybeans, short-duration pigeon peas, groundnuts, sunflower seeds, and papaya seedlings. The Malawi Industrial Research and Technology Development Center built and installed solar dryers, seed oil presses, and ovens in each community. People were encouraged to include soaked and fermented maize flour and germinated cereal flours in infant and child porridges. Parents were educated about micronutrient-rich foods, meal frequencies, portion sizes, and food combinations. Information was provided through demonstrations, home visits, plays, songs, and booklets. The program evaluation is in progress.