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close this bookEssays on Food, Hunger, Nutrition, Primary Health Care and Development (AVIVA, 480 p.)
View the document(introduction...)
View the documentAbout the Author
Open this folder and view contents1. The Causes of Hunger and Malnutrition: Macro and Micro Determinants
Open this folder and view contents2. Technical, Ethical and Ideological Responsibilities in Nutrition
Open this folder and view contents3. De-Westernizing Health Planning and Health Care Delivery: A Political Perspective1
View the document4. 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)
Open this folder and view contents5. Viewpoint - Ethics, Ideology and Nutrition
Open this folder and view contents6. Ethics And Ideology in the Battle Against Malnutrition
Open this folder and view contents7. The Challenge of Feeding the People: Chile under Allende and Tanzania under Nyerere
Open this folder and view contents8. 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)
Open this folder and view contents9. Multidisciplinarity, Paradigms and Ideology in Development Work
View the document10. Survey on Attitudes to Nutrition Planning
Open this folder and view contents11. “Household Purchasing-Power Deficit” - A More Operational Indicator to Express Malnutrition
Open this folder and view contents12. Foreign Aid and its Role in Maintaining the Exploitation of the Agricultural Sector: Evidence from a Case Study in Africa
View the document13. Low School Performance: Malnutrition or Cultural Deprivation?
View the document14. Hunger and Malnutrition: Outlook for Changes in the Third World*
Open this folder and view contents15. Viewpoint: Nutrition Planning - What Relevance to Hunger?
View the document16. Rosalia
Open this folder and view contents17. The Political Economy of Ill Health and Malnutrition
Open this folder and view contents18. Commentary - The Markets of Hunger: Questioning Food Aid (Non-Emergency/Long-Term)
Open this folder and view contents19. Activism to Face World Hunger: Exploring New Needed Commitments
Open this folder and view contents20. The Child Survival Revolution: A Critique - or Health Still Only for Some by the Year 2000?
Open this folder and view contents21. Development Nemesis
View the document22. Looking Beyond the Doable: Resolutions for a New Development Decade
Open this folder and view contents23. Egos/ Alter Egos of the Main Actors in Development Projects:
Open this folder and view contents24. Positive Deviance in Child Nutrition: a Discussion
View the document25. The Project Approach in Development Assistance
View the document26. Triage Management in Third World Health Ministries
Open this folder and view contents27. On Behalf of the African Child: Challenges and Windows of Opportunity for the Donor Community.*
View the document28. The Household Entitlements Revolution or a Women-Centered Approach to Family Security
View the document29. Brave New World: A Political Pendulum in Search of its Balance
Open this folder and view contents30. Malnutrition and Income: Are We Being Misled? (A Dissenting View with a Confusing Literature)
View the document31. A Path for the 1990s?: Government-Donor Partnership to Finance PHC in the Third World
Open this folder and view contents32. Downsizing the Civil Service in Developing Countries: The Golden Handshake Option Revisited.
Open this folder and view contents33. The World Declaration on Nutrition and the 1992 International Conference on Nutrition (ICN) Plan of Action: The Cutting Edge of Conventional Thinking.*
View the document34. Income Generation Activities for Women, the Ninth Essential Element of Primary Health Care? An Idea Whose Time has Come!
View the document35. Some Reflections on ACC/SCN's 'How Nutrition Improves'
View the document36. Nutritional Goals for the Mid-Nineties: A Call for Advocacy and Action
Open this folder and view contents37. A. The Emerging Sustainable Development Paradigm: A Global Forum on the Cutting Edge of Progressive Thinking
Open this folder and view contents37. B. Sustainable Development beyond Ethical Pronouncements: the Role of Civil Society and Networking
View the document38. Foreign Aid: Giving Conditionalities a Good Name or Conditionalities: the Launching of a South-South Counter-Offensive
Open this folder and view contents39. The Community Development Dilemma: when are Service Delivery, Capacity Building, Advocacy and Social Mobilisation really Empowering?
View the document40. Development in the Mid 1990s: Reflections of an Old Socialist
View the document41. Book Review: Questioning the solution -The politics of primary health care and child survival with an in-depth critique of oral rehydration therapy
View the document42. Equity In Health and Nutrition and the Globalization of the World's Economy
View the document43. A. Different Challenges in Combating Micronutrient Deficiencies and Combating Protein Energy Malnutrition, or the Gap Between Nutrition Engineers and Nutrition Activists
View the document43. B. Micronutrient Deficiencies and Protein-Energy Malnutrition
Open this folder and view contents44. Northern-Led Development: is it Selling Technical Fixes to Solve the Problems of Ill-Health and Malnutrition?
View the document45. Actions and Activism in Fostering Genuine Grassroots Participation in Health and Nutrition
Open this folder and view contents46. Health, Nutrition and Sustainable Development.
View the document47. 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
View the document48. Health Sector Reform Measures: Are they Working?... And where do we go from here?
View the document49. On Development, the Real World, Power Games and the Ugly Faces of Greed (Food for thought about a state of mind).
View the document50. So What... in Search of the 'Big Picture' in Development (Food for a depressive thought)
Open this folder and view contents51. 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)
Open this folder and view contents52. Globalization, or the Fable of the Mongoose and the Snake (Fableous food for thought)
View the document53. Elements for a Nutrition Activism Course and Curriculum*
View the document54. The Role of Human Rights in Politicizing Development Ethics, Development Assistance and Development Praxis
View the document55. A Letter to the Student Erica who is Planning to Specialize in International Nutrition
View the document56. Food for a Capitalist thought - Book Review - The Lugano Report: On Preserving Capitalism in the Twenty-First Century
View the document57. Food for Finding where Your Thoughts Are - Variations on a Theme by the Chilean Writer Isabel Allende
View the document58. Remembering
View the document59. Letter to The Lancet - Draft 2 IMCI: An Initiative in Need of a New Name, a Greater Community-Centered Focus, and a Grassroots Mandate
View the document60. Food for Planning the Right Human Thoughts - Human Rights Based Planning: The New Approach
View the document61. Food for an Ombudsman's Thought - On Health Sector Reform, Health and Poverty and Other Herbs
Open this folder and view contents62. What does the New UN Human Rights Approach Bring to the Struggle of the Poor?
View the document63. Food for a Poor Thought on Health and Poverty - Health a Precious Asset, But Not ‘A New and Potentially Powerful Exit Route from Poverty’
View the document64. Food for a Poor Thought on Attacking Poverty - The WB’s World Development Report 2000/2001 or the Trivialization of the Concept of “Empowerment”
View the document65. Human Rights or the Importance of Being Earnest: A Personal Account
View the document66. AID and Reform in Africa: Lessons from Ten Case Studies, Final Report
View the document67. Food for Thought About a State of Mind (2) - On Morality, Freedom, Choices, Justice and the Need for People’s Power
View the document68. Thinking Loud - On Statistics*
Open this folder and view contents69. 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
Open this folder and view contents70. Aiming at the Target: What’s Left for the Devil to Advocate?

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

1. All agencies of the UN regularly prepare long term plans of action for approval by their respective boards. To arrive at them, these agencies go through detailed situation analyses that identify the most important causes of the problems each specialized agency deals with. As part of the latest UN reform process, the Secretary General of the United Nations has recently mandated that, starting in the year 2000, all agencies of the UN have to change the format of their upcoming plans and switch to what has been called Human Rights based plans of action. (1) Despite a rich literature on and a growing understanding of Human Rights in general, the Secretary General gave few explanations of what exactly this new approach to UN planning would entail.

2. UNICEF has taken a lead in defining in a bit more detail what Human Rights Based Planning means and entails for them. (2) What follows is a bare bones explanation of what this new concept is all about:

3. All actions in development projects/programs have to be based on a solid situation analysis. The latter has to be based on an Assessment and an Analysis of the existing situation that will then lead to decisions being made for Action; this has been called a triple A (AAA) process. But the assessment and the analysis cannot be done in a vacuum --without previously having worked on a Conceptual Framework of the causes of the problems that are to be solved. This means that one has to have an in depth understanding of how those problems come about --what their determinants are-- before one can decide what the best options are to do something about them. In other words, "One finds what one looks for" (...based on a conceptual framework). (3)

4. In the case of advocating for better children’s health and nutrition, the first concept that has to be agreed upon is that poor children’s excess mortality, excess ill-health and malnutrition are actually Outcomes in the conceptual framework. The three are determined by a series of Immediate Causes that include inadequate food intake and high prevalence of preventable diseases. The latter two, are themselves the result of yet another level of causality, Underlying Causes, that include household food and fuel insecurity, inadequate maternal and child care, low water and sanitation levels and inadequate access to (or utilization of) health care services, particularly by the poor. This whole pyramid of causes has at its base a series of Basic Causes represented by limited access to education (particularly for girls) and insufficient community control (power) over the resources (human, financial/material and organizational) poor people need to solve their problems at each causal level. (3)

5. The essence of a good situation analysis, then, is to carry out a Causal Analysis based on a pre-existing Conceptual Framework and to base all decisions for action to be taken on this analysis. Therefore, appropriate interventions for the main causes at each causal level have to be found. Addressing each cause is necessary, but not sufficient to change the outcome (i.e. ill-health, malnutrition and excess deaths). Communities need to act at all levels of determinants at the same time. This is why so many “selective PHC interventions” have failed in the past.

6. The above, basically summarizes what professionals in the field were expected to be doing up to now when trying to solve poor children’s health and nutrition problems. But the upcoming Human Rights Based Approach to Planning brings with it a new perspective to our work.

7. The essence of the Human Rights based approach is that it tells us that, additionally, we now need to carry out what is called a Capacity Analysis (or accountability analysis). (2)

What is a Capacity Analysis?

8. To analyze any Human Rights situation it is essential to identify two main groups of actors: Claim Holders and Duty Bearers. (4)

9. Claim Holders are the groups whose universally recognized entitlements are or are not being catered for by the societies they live in, and whose rights are thus being upheld or violated.

10. Duty Bearers are those individuals or institutions that are supposed to uphold the specific right related to each entitlement.

11. For example, in the case of a child as a claim holder, the first-line duty bearer is the mother; next are the father and other family members. But --forming a veritable pattern-- there also are duty bearers for children's rights further up the ladder: community leaders, district and provincial authorities, national and international leaders and institutions. (2)

12. To recap, the end result of a good causal/situation analysis is a list of locally specific immediate, underlying and basic causes that determine the problems being addressed. The participatory AAA process that identifies all those causes then also comes up with the suggested solutions for each cause identified.

13. It is here --when potential solutions have been collectively identified-- where Capacity Analysis comes in.

14. Capacity Analysis takes what is being proposed to be done for each determinant at each causal level and looks at what is already being done or not being done (and why) for that problem. It then looks at who should be doing something about it [individual and/or institution(s) who is (are) the corresponding duty bearer(s)] and attaches the name of that (those) person(s) or institution(s) to each proposed solution. This results in a list of the most crucial persons/institutions that have to be approached to push them to get the proposed solution(s) for each cause implemented. Note that, often, a particular duty bearer cannot meet her/his obligations because some of her/his rights are being violated by a duty bearer higher up (parents without resources to pay school fees cannot be blamed...). (2)

15. In a very simplified way, the end result of a good Capacity Analysis is a four or five columns table:

· the first column lists the causes listed from immediate to basic;

· the second column lists the respective right(s) being violated, for which group of claim holders (for example, children) for each cause (e.g. the right to food, the right to healthcare, etc);

· the third column identifies the gaps between what is being done and what still needs to be done (i.e. the actions needed --and one action may push duty bearers to finally carry out several previously neglected duties);

· the fourth column --to be realistic-- identifies the most critical respective duty bearer(s) by name (individuals and/or institutions responsible, often at more than one level);

· a fifth column may be added to specify who is going to approach those duty bearers and by when.

16. This table thus becomes an action plan to get the various Human Rights deemed to be violated redressed for each specific group of claim holders.

17. What this new Human Rights Approach to Planning does, then, is to couple the causal and the capacity analyses. At first glance, this may not mean much to readers being introduced to this new concept. But it is a powerful combination.

18. The coupling not only identifies what needs to be done, and at what level, but it also targets the person or institution that has to be lobbied/pressured, because they are legally responsible to do something about it under the Covenants of International Human Rights officially signed and ratified by almost all countries in the world.

19. The Human Rights approach, therefore, gives advocates of children’s welfare new powers: When appropriate, as advocates we can now approach duty bearers as ‘guilty of not doing what they are legally (and not only ethically) supposed to do’. The Human Rights covenants currently in force are very explicit about this. (5) We just have not sufficiently used this added power in our work so far.

20. Duty bearers have to be approached using the Human Rights violation justification, and have to be made accountable to comply! (6, 7) Alleging a “lack of resources” is not a good enough justification by duty bearers not to uphold the rights being violated. They have to convincingly demonstrate to us that resources available (even if meager) are not being used for other less essential functions. (7)

21. If we all do follow this new approach, we may set a growing precedent that will further the cause of those claim holders (children, for example) whose basic human rights are being violated worldwide.

22. Issues are a bit more intricate than here reflected, but this is a good introduction.

Claudio Schuftan, Hanoi
aviva@netnam.vn

References:

(1) Annan, K., UN Secretary-General Reform Program, UN, N.Y., 1997.

(2) Jonsson, U., An approach to Human Rights based programming in (UNICEF ESARO), SCN News No. 20, July 2000, pp. 6-6, ACC/SCN, Geneva, and UNICEF ESARO, Human Rights-based planning guidelines, mimeo, Nairobi, Jan. 2000.

(3) UNICEF, Nutrition Policy, UNICEF N.Y., 1990.

(4) Jonsson, U., Nutrition and the Convention of the Rights of the Child, Food Policy, 21:1, 1996, pp. 41-55

(5) Convention on the Rights of the Child, UN, N.Y., 1989.

(6) Dandan, V.B., Monitoring, supervision and dialogue in the Human Rights system, SCN News, No. 18, July 1999, pp. 34-38.

(7) UNHCR, Committee on Economic, Social and Cultural Rights, 20th session, Agenda item 7, Geneva, 26/4 to 14/5, 1999 (as quoted in SCN News No. 18, July 1999, pp. 41-45).