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    To look for solutions, and especially to sustainable solutions to the problem of PEM, or to favor good growth, survival and development, it is useful to examine the causes of PEM beyond the immediate causes which are related to the synergy between poor diet and disease.

    Poor diet and disease actually result from underlying causes related to insufficient access to food by families or households, inadequate caring practices provided to vulnerable members of the household, generally mothers and young children, and inadequate access to health services and to a healthy environment (e.g. clean water). It is necessary to identifiy in a specific situation what are the major constraints to providing adequate access to food, to health services and to care. These can be influenced to a certain extent by education but they fundamentally result from how ressources are used in society and who controls them; this in turn results from the political and ideological superstructure that is prevalent.

    framework adapted from UNICEF, 1990: Strategy for improved nutrition of children and women in developing countries.

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