in the United States (at institutions that emphasize 

 applied sociology, anthropology, psychology, etc. , and 

 also provide training in nutrition) and in developing 

 countries. More specific actions by the United States 

 could include: (1) funding and institution-building 

 for such training for domestic and foreign students in 

 both the United states and developing countries; (2) 

 appropriate support for existing international 

 institutions involved in nutrition research and field 

 training; and (3) recognition that social and 

 behavioral scientists are essential rather than 

 peripheral members of international health, nutrition, 

 and population program teams. 



Modern marketing techniques could be adapted to 

 nutrition education to stimulate dietary changes by 

 individuals and families; for example, finding 

 culturally acceptable terms to "advertise" the value of 

 an available high protein food and explaining how to 

 prepare it could increase its use. 



5. Infrastructure for Primary Health Care Services, 



Including Maternal-Child Health and Family Planning 



Adequate health care is especially important for 

 the "poorest billion" of the world's population, 

 particularly the mothers and children among them. 

 Primary care should be simple and easily accessible, 

 and much of it can be administered by community health 

 workers with extremely limited training. 



The basic health services package includes: 

 maternal and child health care, immunizations, direct 

 nutritional supplementation, family planning supplies 

 and services, environmental sanitation, primary 

 treatment of acute illnesses and accidents, and the 

 educational components of all of these. Recent 

 experience in family planning and other health care 

 programs with rural, village-based service delivery, 

 using members of the local community as health workers, 

 has been extremely promising in bringing services to 

 those most in need. 



A major reason for the inadequacy of such services 

 in many developing countries is an inadequate health 

 care system or infrastructure, which includes the 

 personnel who work within it, physical facilities, the 

 arrangement and logistical support systems, and the 

 health care methodology and technology that flow 

 through it. Among the deficiencies found in many 

 developing countries are: 



Services simply do not reach or are inaccessible to 

 a large proportion of the population in need, 

 perhaps as many as 80 to 8 5 percent. 



96 



