Objectives of the Review
Among the most difficult problems confronting the world community throughout the history of mankind has been the problem of food shortage and diet deficits. However, there seems to be little dispute that remarkable increases in food production have been achieved in providing for the nutritional needs of all human beings over the past decades by both developing and developed countries. Yet the number of hungry people has increased due to rapid population growth and more importantly, the lack of effective food distribution and political will to solve the problem.
Never before have food chains and food webs been more vulnerable to disruption. Human beings have unrelentingly manipulated the eco-system of this biosphere for short-run benefit without thinking about the long term adverse impact. Utilization of food to sustain life is the end point of the complex and interlocking processes of transferring energy from the sun, through food production, distribution, household food entitlement, and individual consumption, to cells in the body. There are threats along the way i.e. ecological degradation (greenhouse effect, acid rain, drought etc); inefficient distribution or unequal access to foods due to adverse economic and political situation; ignorance, lack of education or nutritionally adverse food taboos or habits; and diseases and illnesses that have harmful effects on ingestion, absorption and utilization of food inside the human body. In response to these threats, human beings have attempted to improve the production process by means of science and technology, the distribution process by social and economic systems, consumption by modifying culture and food habits, and diseases through medical and health care. However, interventions are usually confined within disciplinary boundaries and are not always concerned with the improvement of the community being targeted. For example, economists usually deal with it by lifting people above the poverty line or dealing with equity questions of income distribution, since the problem is related mainly to low income class and an increased purchasing power will command a fairer share of food. But these do not necessarily guarantee good nutrition or food intake, especially without a proper nutrition education. Agricultural research and recent advances in biotechnology have increased crop and animal yields dramatically, but applications of these technologies lag far behind in reality.
Thailand experienced one of the highest economic growth rates in the world in the late 1980's, and concurrently made significant progress in improving the social welfare conditions of its people. At the same time Thailand also achieved a dramatic reduction of malnutrition in pre-school children. But considering that Thailand is a food surplus country with a good economic development record, malnutrition in considerable magnitude still exists amongst the population. There is still plenty of room for improvement. There also seems to be a policy vacuum whereby changes in problems and situations in the long-run are not addressed. Experience has shown that ample food production in itself is not enough to cope with the mounting challenge of feeding people. Other elements, both economic and social, can also indirectly influence nutritional status. Agriculture production, food prices, purchasing power, marketing systems and food habits are examples of important socio-economic factors1. Millions of people lack the income or purchasing power with which to command their fair share of food, due to economic and political factors. Government policies, like the premium on export rice in the past, would reward the urban population or better-off classes who had more political voice, by depressing domestic prices at the expense of the less-politicized poor who engaged in rice farming. However, even sizeable improvements in household income do not always lead to improved nutrition, because additional funds may be spent on prestige foods of lower nutritional value or on consumer goods. These rapid changes in dietary, food acquisition and food expenditure patterns have created concern among scholars and policy makers alike. In the rural areas, because of the pressure on land and its resources due to population growth and rapid rural development, household food acquisition and food security rely more on market systems rather than domestic cultivation and a partial hunting and gathering way of life. These rather primitive food entitlements, although leading to food variety and nutritional balance, suffer from intermittent periods of scarcity. In some cases, development in terms of electrification, communication and transportation is also conducive to poor nutrition especially among the poor and under-educated. Commercial bombardments and the invasion of processed food in rural areas may result in an adverse situation when people sell more nutritious food in favour of buying less nutritious but more prestigious food. In the urban areas, there is an accelerated shift from home-based food preparation to processed or pre-cooked food. National and international agribusiness are also clearly visible in the present and will certainly claim an increasing share in people's daily life. Consumer behaviour, as never before, is being modified by intensive advertising and quite often by unfounded claims for the health benefits of special foods. Some hazardous food habits that may lead to parasitic infestation and other medical problems have also been quite difficult to modify. In these circumstances, although nutrition education may contribute to improve food choice and the better utilization of available food supplies, it needs good communication strategies to change people's values and perceptions.
1. Rabidhadana A. The Role of Social Science in Nutrition Research. A paper presented at the Workshop on Integrated of Food Crops, Fisheries and Nutrition Research in Northeast Thailand. Khon Kaen, December 7-9, 1988.
As a result of the ACC/SCN-organized workshop on "Managing Successful Nutrition Programmes" at the 14th IUNS Congress in Seoul in 1989, it was decided, following a proposal by UNICEF, to conduct a series of studies on country-wide actions aimed at improving nutrition. These case studies could be presented at the 1993 IUNS Congress in Australia.
Thus, the overall objective of this country review is to describe the food and nutrition situation and its trends, and the large-scale nutrition relevant actions, that were formulated and implemented in the 1980s. The goal is to draw important conclusions as to which programmes are effective in combatting and preventing malnutrition, why, and how they are best managed. The scope goes beyond "nutrition" programmes per se. In addition to the analysis of changes in nutritional status, the study shall investigate the scope of indirect actions and trends in socio-economic factors (agriculture, food, industry, education and health) that have a bearing on the nutritional status of the population. The review aims to draw important policy conclusions on what actions worked/or did not work in the context of Thailand.
