Public nutrition from an approach to a discipline: Concern's nutrition case studies in complex emergencies

The Public Nutrition approach, like that of Public Health, is context speci fic. It places an emphasis on populations rather than individuals and is in ter-disciplinary in nature. Both approaches seek to understand the complex aetiology of a clinical outcome such as malnutrition within the widest poss ible framework Public Nutrition uses the UNICEF conceptual framework and ad apts and expands it. The authors of this article argue - through the examin ation of a number of case studies taken from the work of Concern Worldwide (hereafter referred to as Concern) in southern Sudan, Rwanda, Angola, Tanza nia and DRC - that there are two critical constituents of the Public Nutrit ion approach. These are: a contextual analysis (including the use of survei llance information for programme design and advocacy) and community involve ment at all stages of the project cycle. Some of the key obstacles to the a doption of the Public Nutrition approach are identified by illustrating two practical programme settings. For the Public Nutrition approach to be more widely used, the authors recommend a number of key strategies including th e further dissemination of case studies and the clarification of the scope and boundaries of the approach. These strategies will enable Public Nutriti on to evolve both as a practical programme framework as well as an academic discipline.