I) What is the problem?
Adequate nutrition is the intake and utilization of enough energy and nutrients, together with disease control, to maintain well-being, health and productivity. “Malnutrition” includes generalized malnutrition—manifesting itself as stunting, underweight and wasting in individuals—and deficiencies of micronutrients such as vitamin A, iron, iodine, zinc and folic acid.

About half of all child deaths in developing countries are associated with
malnutrition. Improving nutritional status would not only eliminate deaths due to
malnutrition, but would also avert a significant proportion of deaths due to diarrhea,
measles, pneumonia, and other common childhood diseases. Yet, the routine use of
nutrition interventions in health programs remains low.

Health services in many countries are not adequate to deliver high-quality nutrition
interventions. Moreover, successful community-based pilot programs in nutrition have been difficult to scale up and sustain. Many programs do not give sufficient attention to constraints—such as heavy workloads for mothers—and misconceptions—such as colostrom being bad for newborns, or water healthier than exclusive breastfeeding—that can prevent caregivers from feeding their children appropriate and nutritious complementary foods.

     II) What are the evidence-based interventions?
Essential Nutrition Actions (ENA) is a strategy or approach to expand the coverage of six affordable and proven nutrition interventions through actions at health facilities, in communities, and through communications channels. ENA is a series of healthy behaviors for mothers that were defined as a package by the USAID/BASICS project for their relationship with morbidity and mortality. These behaviors can be changed through cost-effective public health programs, and their progress measured.

These six interventions are:

- Immediate and exclusive breastfeeding for six months
- Appropriate complementary feeding from the age of six months through two years, with continued breastfeeding
- Nutritional care of sick children, including feeding during illness
- Recuperative feeding
- Care of severely malnourished children
- Adequate intake of vitamin A, iron, and iodine