Comment

To a large extent, the widespread applicability of the protocol manual is due to the similarities in basic food use patterning in human societies. Compared with religious practices, political arrangements, family structure, and many other areas of culture, food and diet are much more constrained. These constraints are more pronounced in small children and pregnant women, the groups most at risk for vitamin A deficiency.

The FES approach for community assessment of natural food sources of vitamin A is intended to address a specific need for new ways to understand food use and diet in areas of serious vitamin A deficiency. While we recognize the use of vitamin A supplementation, in the form of capsules and other methods for target populations, more sustained and economically sound measures should include serious attempts to improve the use of locally available vitamin A-rich food. In part, this manual is based on the faith that such approaches to malnutrition can be effective, provided that there is sufficient, carefully gathered information available about current food quality, food practices, and peoples' reasons for choosing their food consumption patterns.