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Research Papers
Community nutrition
Internally displaced persons (IDP) are defined as persons who flee their place of residence due to armed conflict, situations of generalised violence, violation of human rights or natural or human-made disasters, without crossing a recognised international border(1). Studies that have focused on displaced persons suggest that IDP continue to experience undernutrition with insufficient macronutrient and micronutrient intake(2). Poor nutritional status was first correlated with increased mortality rates in the 1980s, most notable in Africa where displaced populations with the highest mortality rates also had the highest prevalence of acute undernutrition(3). Although these associations were not definitively causative, it is extremely likely that the inadequate food aid supplies of this period were contributing to malnutrition, ill-health and mortality rates(4). Quantity of food aid has since been increased from the 'survival' rations (5021-7531 kJ (1200-1800 kcal)/person per d) of the late 1980s to a single minimum target of 8786 kJ (2100 kcal)/person per d for government and non-government organisations globally(4). Although changes in nutrition practices may have led to a decline in malnutrition rates observed over time, the impact of undernutrition continues(5). This may be a result of the synergism between undernutrition and mortality rates due to acute and chronic disease, which still explains a significant portion of excess mortality among IDP(5,6).
Food security is an evolving, composite concept which is said to exist 'when all people, at all times, have physical and economic access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life'(7). Three distinct aspects are critical to the attainment of food security: availability, access and utilisation of food(8). Food insecurity not only contributes to undernutrition across all ages, but is also a determinant of morbidity among IDP(9). IDP with insufficient food security are more likely to report symptoms of post-traumatic stress disorder, depression and anxiety(10,11). In the absence of a reliable...