Many programs designed to improve food security include adult women of reproductive age, who may not be pregnant or lactating. Managers of these programs recognize that the nutritional benefits are not necessarily direct, and it is not easy to measure or attribute any change in nutritional status to the intervention. Such projects, which invariably strive to empower women, include income-generation or credit schemes, home gardening and agriculture, improved technologies, and adult literacy, alone or in combination.
Health-based interventions, such as family planning and longer birth spacing, are assumed to have a more direct effect on women's nutritional status, but the inputs and outcomes rarely, if ever, include issues related to improving the nutritional status of women. However, the potential is there to change this.
The role of iron/folic acid supplements remains equivocal, except where severe deficiency exists. Insufficient data are available to justify the provision of free multiple micronutrient supplements through the public health system, although there is some rationale to improve micronutrient status before these women become pregnant so that they are in the best nutritional state possible. The demand side issues for supplementation need to be addressed concurrently; otherwise, it is unlikely that these programs can be successful.
In urban areas, adult women of reproductive age may be reached through the workplace, social/community groups, religious centers, etc., where the possibility exists of getting institutional support for health-related activities that include nutrition. Similar groups could be used in rural areas where they exist, and activities that support or strengthen group 'cohesion' should be seen as a component of an addon nutrition/health activity. As with the other groups of the life cycle framework, it is important to put nutrition in the context of perceived priorities.
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