by Pattanee Winichagoon

1. Advocacy of malnutrition as a developmental problem associated with social disparity and must be addressed beyond health sector. Improving people’s nutrition is a country investment. Critical mass led by prime-movers resulted in the adoption of nutrition explicitly included in the 5-y national development plan. Inadequate inter- & intra-sectoral coordination was the major hurdle in the early implementation, due to rigidity in the government infrastructure and resource allocation for implementing integrated program. Integrating nutrition into broader national social and health development, spearheaded by the Poverty Alleviation Plan (1982-1986) facilitated the scale-up of nutrition program. Organizational reform allowed for harmonization and complementarity of the top-down macro policy and micro level bottom-up planning. Village health volunteers were trained and became key community mobilizers. For nutrition, volunteers were responsible for carrying out growth monitoring and promotion, using simple and appropriate technology. Marked improvement in child undernutrition was observable within about 5 years of this national effort. Nutrition component was then integrated into the basic minimum needs approach in the broadened development framework of ‘quality of life’. Sustainability of nutrition improvement can be appreciated and withstand the impact of recent Asian economic crisis. Scaling-up integrated community based nutrition program in Thailand