COMCEC
Malnutrition in the OIC Member
Countries: A Trap for Poverty
1. CONCEPTUAL FRAMEWORK
In this section of the report is laid out the current thinking around and experiences of tackling
malnutrition internationally. In order to appreciate the current understanding, the report first
presents a short overview on the changing nature of the international agenda over time, briefly
summarises current international targets. The report then details the defining types of
malnutrition and discusses what is known about determinants of malnutrition, with a special
focus on the role of poverty.
1.1. Short History of the International View of Malnutrition
The international agenda has changed considerably over the last few decades. After years of
neglect in global policy agendas, nutrition is increasingly being recognized as a key driver of
development. There is now a stronger focus on the cognitive and economic consequences of
malnutrition, as well as a more nuanced understanding of the causes of malnutrition and the
best statistics for tracking progress than in the past.
The practice of international nutrition has gone through distinct phases of understanding and
action. The primary focus on starvation, protein, and medical models of intervention and
treatment in the 1950s and 1960s gave way to multi-sectoral planning, before the focus shifted
toward micronutrients in the 1990s and 2000s. In recent years the picture has become more
complex as more actors, with a wider recognition of the multiple issues surrounding nutrition,
have become involved (Gillespie and Harris, 2016).
The 1970s saw the focus shift away from seeing protein as the key issue in malnutrition
towards recognising the multifaceted nature of malnutrition. This led to the concept of multi­
sectoral nutrition planning, marking a reaction to largely food supply-oriented interventions
that did not address the wider, non-food drivers of malnutrition and had little impact. To
advocates of multi-sectoral planning, the challenge was not launching more and better
nutrition interventions, but rather influencing policies and programs in a broad range of
development sectors. This thinking led to the establishment of “nutrition cells,” often in the
office of a president or prime minister. A total of 26 nutrition planning entities were
established in the 1970s, supported primarily by the U.S. Agency for International
Development (USAID) and the Food and Agriculture Organization of the United Nations (FAO)
(Gillespie and Harris, 2016).
However, by the 1980s, most of these nutrition cells had been abandoned. The hard-learned
lesson here was that a multifaceted challenge like malnutrition requires action from many
sectors, but it does not necessarily require such actions to be elaborately choreographed by
any one entity. The failure of multi-sectoral planning gave rise to the era of “nutritional
isolationism” in which the pendulum swung back to nutritionists who increasingly focused on
two sets of interventions that needed little involvement from other sectors: micronutrient
supplementation and breastfeeding (Gillespie and Harris, 2016).
The start of the 1990s saw a giant step forward in the form of the UNICEF's development of a
coherent nutrition framework that provided a common language and suggested specific roles
for different actors. The 1990s was also a decade of focus on micronutrients, in particular,
vitamin A, iodine, and iron. The 1990 World Summit for Children set a goal of reducing
anaemia by one-third by the end of the decade (practitioners later concluded it could not be
achieved because of the widespread difficulty of delivering supplements as well as recipients'
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