|Essays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 480 p.)|
|15. Viewpoint: Nutrition Planning - What Relevance to Hunger?|
· Is nutrition planning in the context of the underdeveloped countries a utopia, a possibility, or a reality?
Two factors are important in trying to answer these questions. The first is the degree of commitment of a given third world government to finding a solution to the problems of malnutrition in its country. This may be difficult to determine, given the frequency with which governments pay lip service to their commitment which in the end turns out not to be genuine. The implementation of agreed strategies too often becomes tangled up due to rigidities in the bureaucratic structure which the governments are not willing to bypass through new regulations.
Evaluation of the programmes funded by international donor agencies should be built-in to grants with a clear bilateral understanding that a lack of progress in programme implementation and achievement of previously agreed intermediate goals would necessitate a closure of the programme. This may sound dictatorial and unfeasible, but, again, time and money are too precious to continue playing nutrition or development games that lead nowhere in terms of real improvements for the target population, because of a lack of a true commitment.
The second aspect has to do with how the underdeveloped countries perceive nutrition planning. Do they really see nutrition planning as a comprehensive package that will provide alternative answers to a number of problems often not directly related to the nutrition issue, but certainly affecting it indirectly? Do the international agencies see it this way themselves? If so, there is a vast field here for advocacy by the international donor agencies.
Linking both the above aspects is the problem of what the countries do with the people they have sent for special training in nutrition planning. We should explore this issue more closely each time we accept a candidate for training and, as I said before, give support to our graduates when they return home, to make sure they can apply their newly acquired knowledge in a productive way. Too many of our graduates lie fallow back in their countries, and its partly our fault. Finally, do we need a threshold number of trained nutrition planners coming from the various different professional backgrounds in order to begin some national activities in nutrition planning? This question has been raised before. Do we need a minimum number of trained personnel to make a real impact? If we think the answer is yes then we should move away from international nutrition planning workshops and concentrate exclusively in in-country training.
· Is nutrition planning going to solve the world's malnutrition problems?
I am the first to accept that my views in this article are extremely polemic and often only sketchy. My personal opinion, after having ruminated over these problems, is that we have enough evidence and experience, so far, to be able to predict that if we ritualize nutrition planning as a technique only, we have a good chance not to solve the problems implicit in the question above, with all the ramifications that this may bring, including for world peace.
Since the final consideration will continue to be a question of Weltanschaung, of ideology, in terms of equal rights and opportunities for people in the world, it will partly depend on what position we, who are involved in the matter, will lake in the near future. If we do not move towards genuine changes, changes are going to come in spite of us, the question is how and when. History may give us the answer.
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I would like to thank the many friends with whom I have discussed these ideas, especially during the US AID sponsored Berkeley Food and Nutrition Planning Symposium in late March 1977. Their criticism and some of their ideas were incorporated into the final version of this article.