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close this bookCulture, Environment, and Food to Prevent Vitamin A Deficiency (International Nutrition Foundation for Developing Countries - INFDC, 1997, 208 pages)
close this folderPart II. Creating the protocol
close this folder3. Theory and process: The methods
View the document(introductory text...)
View the documentThe International Union of Nutritional Sciences, committee on nutrition and anthropology
View the documentTheory of the methodological approach
View the documentOverview of methods of data-collection described in the protocol manual
View the documentTesting the protocol
View the documentComment

Theory of the methodological approach

Positive dietary change is a gradual process initiated by education, food availability, and choice, and has been given low priority in most vitamin A intervention programs (Darnton-Hill, 1988; IVACG, 1989; Kuhnlein and Receveur, 1996). However, food-based programs for the prevention of vitamin A deficiency are recognized as essential components of the mix of interventions that will prevent mortality and morbidity related to the deficiency of this vitamin (Underwood, 1994). Effective positive dietary change that will prevent vitamin A deficiency requires identifying and quantifying natural food sources rich in vitamin A and provitamin A, in conjunction with foods rich in nutrients that impact on vitamin A uptake and bioavailability (Mejia, 1986). Ecological, cultural, and economic factors that influence food availability, cost, and consumption patterns, as well as attitudes and beliefs about food and feeding behaviors need to be defined and incorporated into programs, as these are often the underlying causes of the deficiency (Devadas, 1987; Kuhnlein, 1992).

It becomes increasingly clear that community data must be used to create locally effective programs for the prevention of vitamin A deficiency and improved health that will be sustainable for the long term. Such data include the availability of food; economic value of food; consumption patterns; values of and attitudes and beliefs toward food; feeding behaviors; and existing vitamin A deficiency (Kuhnlein and Nieves, 1992). Protocols are needed to assist community health, agriculture, education, and nutrition personnel and program planners in obtaining critical information for program planning and development aimed at the elimination of vitamin A deficiency as a public health problem.

Research methods grounded in nutrition and anthropology can be used to devise the needed protocols. As described in Chapter 1, the focused ethnographic study (FES) methodology has been developed and used to address the necessary community data in a series of predetermined questions, the answers to which will assist intervention planning. Similar to manuals developed in rapid assessment procedures (RAP) and other guidelines for ethnographic data-gathering, the manual for community assessment of vitamin A includes techniques used to gather both qualitative and quantitative information. The interviewing methods, including the use of in-depth interviewing, cognitive mapping techniques, and structured observation, are drawn from standard research procedures in the social sciences. Tools incorporated from nutrition research techniques include food frequency, 24-hour recall, market surveys, and food system data compilations. In common with other RAP approaches, but departing from the usual approaches in non-applied qualitative research, the manual sets forth very specific steps for data-collection to be followed by the field team. The provision of forms for data-recording, and instructions for data analysis, are further means of facilitating the goal of producing a programmatically useful report in a timely fashion.