Health systems place too much emphasis on curative, rather than preventive, care and underserve the poor. Many of the urban poor have limited access to sanitation and sewage services and so live in squalid environmental conditions. Urban residents have little information about measures they can take to improve their health and nutrition. The author suggests that achieving nutritional security in urban areas will require strengthening local capabilities and optimizing the use of resources available in households, communities, and institutions. By paying special attention to the interactions of malnutrition with health, and to the region s new emphasis on involving the private sector and the community in providing for public welfare, this paper points the way to an effective response to urban-based threats to food and nutrition security.
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