Malnutrition in food-surplus areas: experience from nutritional surveillance for decentralized planning in Haiti.

In Haiti, a novel approach to nutritional surveillance was developed on the basis of a low-cost, simple-to-repeat set of household surveys in all nine administrative departments using sentinel community sites. This system allows each department to independently conduct follow-up surveys as needed. The results of the first round of surveys conducted in 1995 show lower malnutrition rates in typical food-deficient departments and high levels of malnutrition in several food-surplus areas. Further analyses underscore the importance of variables related to child-care practices and of care-enabling factors such as household food security, health environment, and caregivers' time and education. These findings challenge the traditional thinking among a majority of Haitian policy makers who look at the malnutrition problem solely from the perspective of local food production.