|Community Assessment of Natural Food Sources of Vitamin A, Guidelines for an Ethnographic Protocol (International Nutrition Foundation for Developing Countries - INFDC, 1997, 141 pages)|
Steps in the protocol are intended to achieve the following interrelated goals within a local community food system:
1. Identify significant sources of preformed vitamin A and carotene-rich food in the context of the local food system.
2. Describe patterns of food consumption especially for vitamin A-containing food, particularly with respect to infants, young children, and women of reproductive age.
3. Identify cultural beliefs that influence food choice and consumption patterns.
4. Identify cultural, ecological and socioeconomic factors that constrain or facilitate consumption of vitamin A.
5. Describe the community explanations and understandings of vitamin A deficiency diseases and symptoms.
For each step, the manual defines research questions to be addressed, and guidance on how to collect field data on the forms which are provided. The entire protocol can be completed by a field team of three in a period of six to eight weeks.
As outlined in many policy-relevant documents, food-based interventions are best seen as one component of a multi-stranded strategy to reduce vitamin A deficiency. Together with other types of interventions (such as vitamin A supplement distribution and food fortification with vitamin A, improving consumption patterns of local food resources containing vitamin A can help reduce the burden of morbidity and mortality associated with inadequate intake of this essential nutrient. Food-based interventions are viewed as those most likely to be sustained, provided the culture and ecology of the vitamin A-containing foods are addressed in programs based in agriculture, food processing, social marketing, and public health education.
It is understood that food carries many nutrients, and that when communities are at risk for vitamin A deficiency, they may be at risk for other nutrient deficiencies as well. The scientific issues of nutrient composition of food as consumed, and of dietary evaluation of those vulnerable to vitamin A deficiency, are particularly complex for vitamin A. While some steps in the protocol can contribute to knowledge of general food use and nutrition, others are specific to issues of vitamin A in food, and the cultural context of the use of these food sources. To understand vitamin A in food as consumed in communities vulnerable to deficiency, the complex issues are broken down into component parts, and each is addressed in turnthis is a particular strength of the protocol.
The assessment will give several perspectives on dietary change, some of which will be specific to vitamin A nutrition. Understanding the elements of food availability, food choice and consumption patterns will set the stage for understanding how consumption of vitamin A-rich food can be improved. For example, steps in the protocol will help to define the food history of the area, migration patterns of the people, where and how food items no longer used to a great extent can still be harvested, and ability to access food available in markets. This information together with cultural food beliefs and practices is especially important in programs based in agriculture, public health, social marketing, and nutrition education.