Essays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 480 p.): 37. B. Sustainable Development beyond Ethical Pronouncements: the Role of Civil Society and Networking: The background:

Essays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 480 p.)

(introduction...)

About the Author

1. The Causes of Hunger and Malnutrition: Macro and Micro Determinants

(introduction...)

Macro and micro causes of malnutrition

Diagnosing the causes of hunger and malnutrition

Proposing solutions

The role of ideology (4)(5)

A critical look at nutrition planning

Working with the community

References

2. Technical, Ethical and Ideological Responsibilities in Nutrition

(introduction...)

Introduction

Science: Its political, ideological and ethical implications

The scientist as a promoter of status quo or social change

Economic power, political power and poverty

Where do liberal food and nutrition workers stand?

A critical look at our profession and ourselves

The future challenge

References

3. De-Westernizing Health Planning and Health Care Delivery: A Political Perspective1

(introduction...)

Understanding the roots of the problem: Western medicine and its hierarchy:

The participation issue:

Decentralization

Steps towards de-westernization:

Notes

References

4. Book Review: Susan George. A Fate Worse Than Debt: A radical new analysis of the Third World debt crisis (Or, the world financial crisis and the poor)

5. Viewpoint - Ethics, Ideology and Nutrition

(introduction...)

Ethos

Ideology

Liberals

Radicals

Political naivete?

Social consciousness

What can I do?

Tool

Establish links

References:

6. Ethics And Ideology in the Battle Against Malnutrition

(introduction...)

How is our ethos formed?

How is ideology formed?

Liberals and radicals - a typology

How relevant is our work?

Are we politically naif?

Are we afraid of speaking-up in political terms?

Nutritionists in the third world

A new direction? - Some possible conclusions

An attempt to know who we are

References

7. The Challenge of Feeding the People: Chile under Allende and Tanzania under Nyerere

(introduction...)

Abstract

The conceptualization of malnutrition as a problem and its effects on nutrition policy formulation: A review of the literature

The challenge of feeding the people: How it has been addressed

Nutrition intervention in Chile and Tanzania: Two perspectives of a shared commitment

Tanzania and Chile: A review in perspective

References

8. The Role of Health and Nutrition in Development (Le Rôle de la Santé et de la Nutrition dans le Développement - El Papel de la Salud Y la Nutrición en El Desarrollo)

Abstract - Résumé - Resumen

The role of health and nutrition in development

Capacity of the current system to alleviate hunger and malnutrition.

9. Multidisciplinarity, Paradigms and Ideology in Development Work

(introduction...)

Setting the focus:

An attempt to define the concepts:

A development paradigm?

Multidisciplinarity:

The role of conceptual frameworks:

Ideology:

Ethos and norms:

Conflicts in the terminology?:

Subjectivity of the sciences:

The social and the classical sciences in development work:

Science and its environment - The real world around us:

Does a universality and pluralism of theories exist that makes multidisciplinary work realistic?:

Transcending narrow paradigms:

Crisis - The battle of the paradigms:

The dilemmas in choosing a new paradigm:

Who are the real innovators?:

Tackling the basic causes of maldevelopment:

A critical look at what we do:

The limits of traditional development project evaluation:

“We should” - Our inherent obligations and the challenges ahead:

Conclusions:

Acknowledgements:

References:

10. Survey on Attitudes to Nutrition Planning

11. “Household Purchasing-Power Deficit” - A More Operational Indicator to Express Malnutrition

(introduction...)

The indicator

Uses and potential abuses of the proposed indicator

Income generation

Income redistribution

Food consumption subsidies - Rationing system

Conclusions

References

12. Foreign Aid and its Role in Maintaining the Exploitation of the Agricultural Sector: Evidence from a Case Study in Africa

(introduction...)

Evidence of the exploitation: A preamble and five exhibits

Sources, uses, and sectoral distribution of foreign aid: A preamble and four exhibits

Putting it all together: A final balance sheet

Postscript

References

13. Low School Performance: Malnutrition or Cultural Deprivation?

14. Hunger and Malnutrition: Outlook for Changes in the Third World*

15. Viewpoint: Nutrition Planning - What Relevance to Hunger?

(introduction...)

The general issues

North-South conflict

The response of the rich

Aid and funding agencies

The international bureaucracy

The basic questions

The planners and the people

Research

A third world perspective

16. Rosalia

17. The Political Economy of Ill Health and Malnutrition

(introduction...)

The situation: The macro and micro levels.

The actors : institutions, social groups and individuals

The methods and solutions:

Epilog:

References

18. Commentary - The Markets of Hunger: Questioning Food Aid (Non-Emergency/Long-Term)

(introduction...)

Introduction

The politics of food aid: in the donor countries - in the recipient countries

Not just any kind of aid

Concluding remarks

References

19. Activism to Face World Hunger: Exploring New Needed Commitments

(introduction...)

The problem(s) of hunger and its (their) solutions

Looking at ourselves and the other actors in the battle against hunger and malnutrition. (individuals, institutions and social groups)

Organizing ourselves and others

Keeping our eyes open and constantly learning more about the issues at stake

Speaking up!

20. The Child Survival Revolution: A Critique - or Health Still Only for Some by the Year 2000?

(introduction...)

Abstract

Background

The key questions

Do people really have choices?

A critical look at GOBI and the Child Survival Revolution

The efficacy of GOBI

The implementation of GOBI

References

21. Development Nemesis

(introduction...)

Part One: Development and today's reality

Abstract

Introduction:

Section I. Western development: Past and present

(introduction...)

1.1. A critique of outdated development theories and praxis

1.2. Third World development as seen by the North

1.3. The oversold technological approach in Western development

Section II. Myth and reality in development ideology, paradigms and models

2.1. Ideology and development models

2.2. Paradigms and new theories

2.3. The irrelevance of current development studies

2.4. The myth of objectivity and of apoliticism

2.5. The issue of social power

Epilogue:

Part Two: The actors and the future of development - The era of empowerment

Abstract

Introduction

Section III : The actors in today's development drama (Or rather farce?)

3.1. From liberals to progressives: a typology of modern-day secular missionaries in development work.

3.2. What liberals need to - the normative dimension

Section IV: The non-actors in today's development

4.1. Issues on participation:

4.2. Participation: the future

Section V: Development: The future

(introduction...)

5.1. What is needed to overcome stale third world development policies: A fresh (or not so fresh...) set of prescriptions.

Epilogue:

Biographical note

22. Looking Beyond the Doable: Resolutions for a New Development Decade

23. Egos/ Alter Egos of the Main Actors in Development Projects:

(introduction...)

Why projects don't work

The ''expert'':

The consultancy's management:

The donor agency officer:

The civil servant:

24. Positive Deviance in Child Nutrition: a Discussion

(introduction...)

Positive deviance in context. Positive Deviance: The difference between coping and adapting

Positive Deviance in situations of failure to thrive as opposed to situations of hunger and malnutrition

Positive Deviance and Poverty

Gaining weight by behaving in a positively deviant manner

What is behind positive deviant attitudes?

Conclusion

References

25. The Project Approach in Development Assistance

26. Triage Management in Third World Health Ministries

27. On Behalf of the African Child: Challenges and Windows of Opportunity for the Donor Community.*

(introduction...)

THE NINE PANELS

PANEL No. 1: The empowerment factor

PANEL No. 2: A national commitment to health and nutrition: Does everything start with a sound causal analysis?

PANEL No. 3 : Breaking out of the poverty cycle

PANEL No. 4 : An enhanced role for the caring of children

PANEL No. 5 : The right to know

PANEL No. 6 : The population/PHC/nutrition link

PANEL No. 7 : Never be sorry to be too late

PANEL No. 8 : Pressures imposed to address the economy: Do the people matter?

PANEL No. 9 : Other factors to reckon with in the 90s

28. The Household Entitlements Revolution or a Women-Centered Approach to Family Security

29. Brave New World: A Political Pendulum in Search of its Balance

30. Malnutrition and Income: Are We Being Misled? (A Dissenting View with a Confusing Literature)

(introduction...)

The issue of malnutrition and income as presented in the literature:

The thesis: (A counter-argument)

What to do then?:

References

31. A Path for the 1990s?: Government-Donor Partnership to Finance PHC in the Third World

32. Downsizing the Civil Service in Developing Countries: The Golden Handshake Option Revisited.

(introduction...)

Introduction: Setting the empirical and conceptual scene:

Why downsize?:

Why a golden handshake?:

Possible new approaches and their limitations: How much to downsize?: Determining the magnitude of the downsizing

How to downsize?: To set preconditions or not to set

What to do with the wages saved from downsizing?

The Kenya example

The golden handshake: A grant or a loan to departing civil servants?

To give incentives or to dismiss

Other implementation issues: Alternatives on how to set up the payment system for the golden handshake:

How to redeploy public servants to the private sector?

Conclusions:

References:

33. The World Declaration on Nutrition and the 1992 International Conference on Nutrition (ICN) Plan of Action: The Cutting Edge of Conventional Thinking.*

(introduction...)

Do international conferences solve world problems?

Do international declarations change the course of history?

Do international conferences overlap in their purposes?

Do international conferences bring out the best in the process of their preparation?

Where are we left after ICN?

34. Income Generation Activities for Women, the Ninth Essential Element of Primary Health Care? An Idea Whose Time has Come!

35. Some Reflections on ACC/SCN's 'How Nutrition Improves'

36. Nutritional Goals for the Mid-Nineties: A Call for Advocacy and Action

37. A. The Emerging Sustainable Development Paradigm: A Global Forum on the Cutting Edge of Progressive Thinking

(introduction...)

A development paradigm in need of replacement:

Windows of opportunity to take advantage of: (Normative aspects)

The three pillars of an emerging sustainable development paradigm:

Getting from the old to the new paradigm: The time for consolidating a transition is now!

Reevaluating the major development objectives in the late-nineties: Should social gains justify economic sacrifice?

References:

37. B. Sustainable Development beyond Ethical Pronouncements: the Role of Civil Society and Networking

(introduction...)

The context:

The background:

What commitments are needed beyond ethics?: From the normative to the operational in sustainable development

The primarily ethics-led process to sustainable development

The primarily politically-led process to sustainable development

Networking

Leadership

References

38. Foreign Aid: Giving Conditionalities a Good Name or Conditionalities: the Launching of a South-South Counter-Offensive

39. The Community Development Dilemma: when are Service Delivery, Capacity Building, Advocacy and Social Mobilisation really Empowering?

(introduction...)

Service delivery:

Capacity building:

Advocacy:

Social mobilisation:

40. Development in the Mid 1990s: Reflections of an Old Socialist

41. Book Review: Questioning the solution -The politics of primary health care and child survival with an in-depth critique of oral rehydration therapy

42. Equity In Health and Nutrition and the Globalization of the World's Economy

43. A. Different Challenges in Combating Micronutrient Deficiencies and Combating Protein Energy Malnutrition, or the Gap Between Nutrition Engineers and Nutrition Activists

43. B. Micronutrient Deficiencies and Protein-Energy Malnutrition

44. Northern-Led Development: is it Selling Technical Fixes to Solve the Problems of Ill-Health and Malnutrition?

(introduction...)

The foreign aid scenario under a technical fix approach

Endnote:

45. Actions and Activism in Fostering Genuine Grassroots Participation in Health and Nutrition

46. Health, Nutrition and Sustainable Development.

(introduction...)

The need for a more critical and visionary attitude

Endnote:

Postscript:

References:

47. New Perspectives, Old Risks: our Need to Change and to Reconceptualize or Reemphasizing the Need to Tackle the Causes of Poverty in the Battle against Ill-Health and Malnutrition

48. Health Sector Reform Measures: Are they Working?... And where do we go from here?

49. On Development, the Real World, Power Games and the Ugly Faces of Greed (Food for thought about a state of mind).

50. So What... in Search of the 'Big Picture' in Development (Food for a depressive thought)

51. Can Significantly Greater Equity be Achieved through Targeting?: An Essay on Poverty, Equity and Targeting in Health and Nutrition. (*) (Food for a targetter's thought)

(introduction...)

Poverty, equity and social justice:

Equity and health for all:

Equity, structural adjustment and safety nets for the poor:

Who are the poor and how do we find them?:

Equity and the public/private allocation of resources:

Avenues and dead-end streets to equity:

Equity and targetry: (**)

Equity and participation:

Equity and prepayment schemes:

Equity and social security:

Where to go from here?

52. Globalization, or the Fable of the Mongoose and the Snake (Fableous food for thought)

(introduction...)

Globalization and its negative consequences:

A dearth of workable solutions?

The Equity/Equality approach:

The Human Rights approach:

Bolder steps are needed:

Three caveats:

In closing:

References:

53. Elements for a Nutrition Activism Course and Curriculum*

54. The Role of Human Rights in Politicizing Development Ethics, Development Assistance and Development Praxis

55. A Letter to the Student Erica who is Planning to Specialize in International Nutrition

56. Food for a Capitalist thought - Book Review - The Lugano Report: On Preserving Capitalism in the Twenty-First Century

57. Food for Finding where Your Thoughts Are - Variations on a Theme by the Chilean Writer Isabel Allende

58. Remembering

59. Letter to The Lancet - Draft 2 IMCI: An Initiative in Need of a New Name, a Greater Community-Centered Focus, and a Grassroots Mandate

60. Food for Planning the Right Human Thoughts - Human Rights Based Planning: The New Approach

61. Food for an Ombudsman's Thought - On Health Sector Reform, Health and Poverty and Other Herbs

62. What does the New UN Human Rights Approach Bring to the Struggle of the Poor?

(introduction...)

We live in a new age of rights

The Challenge: what changes?

The Human Rights approach: Some Iron Laws

The participation factor in Human Rights

The use of indicators in Human Rights work

The World Bank, or a position full of contradictions on how to look at the Human Rights approach

Human Rights from the United Nations’ and the NGOs’ perspective

Writing Human Rights into law

Training in Human Rights

Some conclusions

63. Food for a Poor Thought on Health and Poverty - Health a Precious Asset, But Not ‘A New and Potentially Powerful Exit Route from Poverty’

64. Food for a Poor Thought on Attacking Poverty - The WB’s World Development Report 2000/2001 or the Trivialization of the Concept of “Empowerment”

65. Human Rights or the Importance of Being Earnest: A Personal Account

66. AID and Reform in Africa: Lessons from Ten Case Studies, Final Report

67. Food for Thought About a State of Mind (2) - On Morality, Freedom, Choices, Justice and the Need for People’s Power

68. Thinking Loud - On Statistics*

69. A Reader in Human Rights (1) - The Short Papers Here Collected are Part of an Ongoing Series the Author Irregularly Submits to About a Half Dozen E-Mail List Servers

HRR24 - Food for NGOs Thoughts

HRR25 - Food for Donors Thoughts

HRR26 - Caveat Emptor

HRR27 - Development and Rights: The Undeniable Nexus

HRR28 - On the Role of the State, the UN and Civil Society

HRR29 - On Vulnerability, Access and Discrimination*

HRR30 - Potpurri

70. Aiming at the Target: What’s Left for the Devil to Advocate?

(introduction...)

The big hype:

The outcome-process riddle:

Being realistic:

On convergence:

The Human Rights twist:

The equity factor:

On accusations of dependency and top-down implementation:

Donors (and we ourselves) touch some projects more than others:

The poverty alleviation connection:

The background:

At the closing of the decade, the issue of power (mostly the lack of it to enact sustainable development changes) is still very much at the center of the development challenge. The issue remains largely unresolved or -looking at it from the opposite perspective, is actually very much resolved- but against the very odds of sustainable development.

The remaining challenge is thus to break with the old development paradigm and to come up with what will need to be done, especially during the transition to a new sustainable development paradigm based on the new emerging development ethics. Promoting and encouraging the growth of budding civil society organizations with a genuine popular mandate and leadership, and encouraging them to network and coalesce into movements with growing social and political power, are at the center of this challenge (and seems to be the only way out).

In this context, the voices of the new development ethics proponents are being heard ever louder:

Ethics is no longer to be seen as ancillary to development, but 'development owes it to itself to be inherently ethical'. The new ethics calls for working with the poor as protagonists and not merely as recipients of goods and services. It calls for giving a more holistic meaning to development; for safeguarding fundamental human needs; for people planning with autonomy, and in doing so, for politicizing people's actions towards development. (Carmen, 1994)

This is a good start. But the question that hits us in the face is how to go from the normative or prescriptive in such pronouncements to the operational and pragmatic.