Remembering and acting on 'Malnutrition': A Latin American Network to Foster Deep Learning on Nutrition Interventions Past and Present

This proposal will bring together a diverse group of anthropologists, historians, public health and nutrition specialists, and epidemiologists to create a research network to tackle the challenge of malnutrition in Latin America. The central objective of this network is to change the approach of future nutrition programmes by taking into account 'lost' learning on what has, or has not worked in the past; as well as taking into account what has, or has not worked, according to the perspectives of those communities most commonly targeted for nutrition interventions.

The network will be a partnership between UK research institutions and researchers, public health experts and activists in Peru, Colombia and Nicaragua and will focus on these Latin American countries. All three countries have been identified in the most recent global nutrition data as places of 'double burden', which means that there are high rates of obesity and diabetes, alongside high rates of micronutrient deficiencies such as anaemia and undernutrition.

Most troubling is that these complex and overlapping forms of malnutrition in Peru, Colombia and Nicaragua exist despite a long history of nutrition interventions in the region. It is clear that a new way of 'doing nutrition' is needed.

The members of the proposed network are particularly concerned with the multiple layers of past and present nutrition interventions experienced by communities a result of changing public health and nutrition priorities at national and global level. We want to better understand the complex factors that shape the success (or failure) of nutrition interventions through a deeper understanding of what these past and present attempts to mitigate malnutrition have looked like from the standpoint of the 'target community', and what these attempts look like when viewed through the lens of history.

We know, for example that how 'target communities' receive and react to behaviour change messages related to food preparation, breastfeeding, food production, and improved sanitation can vary widely. We also know that the question of 'poor nutrition' and how to remedy it at the local level is often part of complex politics of race, gender, ethnicity and socio-economic status.

What we do not know is how those communities most targeted for 'nutrition' change have lived these distinct cycles of intervention into their eating, parenting, cooking and agricultural practices over long periods of time; and how disconnected (or not) their experience has been from nutrition policy change at the national level. By participating in a network focusing directly on such community experience, researchers from these countries, policy makers and practitioners will increase their capacity to understand how past, present and future interventions in these areas might work as complementary layers rather than a potentially uncoordinated mess of approaches and messaging.

Our network will be grounded in a practice of 'mutual learning', which means to say that we seek a relationship of equals across the network where distinct forms of knowledge and diverse perspectives on what matters in nutrition research will be welcomed. We intend to share what we learn and expand outwards from more traditional sources of nutrition 'expertise' to include historical, political and cultural interpretations of nutrition interventions at grassroots levels, as well as through analysis of national nutrition policy-making processes.

For our methods we will use exploratory ethnographic research (participant observation in sites selected through consultation with the public health schools and local contacts); oral history methods (in-depth one-to-one interviews and group oral history interviews, or 'witness seminars'); and archives-based historical research.