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June 1974 (Volume 52)
Quarterly Article
James E. Austin
F. James Levinson
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In operational terms, effective nutrition services can increase health worker credibility with mothers and increase their receptivity toward family planning. Among other synergistic program relationships, high IUD removal rates are related to nutritional anemia in women which could be corrected by nutritional supplementation. Finally, operating efficiencies might be attainable in some instances through the use of common personnel and facilities. Integration, although desirable in many cases, faces several barriers: attempts to maintain separate programs in order to preserve independent institutional prestige and power; unequal priority assignment to the different programs; the lack of integrated approaches by international funding agencies. Additional information would be useful on attitudes in the parental procreation decision-making process, managerial requisites of integrated delivery systems, biological and physiological linkages between fertility and nutrition, and impact assessment of integrated programs. Two of the most critical problems facing low-income countries today are wide-spread malnutrition and burgeoning populations. Programs have been mounted to attack both of these interrelated problems, but little has been done to coordinate and integrate these efforts. In many situations there appears to be strong rationale for such integration. Both are new programs trying to establish their places on the national development agenda. Population control is more readily justified by economic criteria while nutrition is more socially and politically acceptable. Their fusion can achieve a mutually reinforcing complementarity. There also exists a series of relationships (with varying degrees of evidential strength) among fertility, family size, and malnutrition: smaller families result in better nutrition which reduces malnutrition-related mortality, thus improving child survival probabilities and, in turn, enhancing family-planning motivation.
Author(s): James E. Austin; F. James Levinson
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Volume 52, Issue 2 (pages 169–184) Published in 1974