|SCN News, Number 10 (ACC/SCN, 1993, 52 p.)|
including reviews of:
Nutrition for Developing Countries
Poverty, Household Food Security and Nutrition in Rural Pakistan
The Challenge of Famine. Recent Experience, Lessons Learned
The Political Economy of Food and Nutrition Policies Toward Comprehensive Programs to Reduce Vitamin A Deficiency
plus new section containing selected announcements of new publications
"Nutrition for Developing Countries"
(1992) by Felicity Savage King and Ann Burgess. Oxford University Press. 480 pages.
This book is essential for anybody working in nutrition in developing countries, especially at community level. Moreover, at the special ELBS edition price of £3.95 (about $6.50) it should be on the bookshelf in any office or health centre dealing with nutrition. Not only is it practically the only book of its kind, but it is a sound and reasonably up-to-date basic text on nutrition. While it focuses primarily on Africa, much of the basic biology in it is applicable globally - on the other hand, versions adapted to other parts of the world would indeed be useful. The book could also be a work of reference for those concerned with planning programmes in nutrition; it is however not addressed to those with this responsibility, and does not spend much time on this topic.
As the publishers say: "Nutrition for Developing Countries is both a textbook of nutrition - covering the essential facts about nutrients, nutrient needs, foods, and meals - and at the same time a practical guide for nutrition workers - be they health workers, agricultural workers, home economists, or school teachers, or their trainers. It explains in clear simple language, and practical detail, how nutrition workers can help families with nutrition problems, how to treat malnourished children, and how to work with families and communities. This information is not easily available elsewhere, and no other manual covers the subject so comprehensively. The manual is liberally illustrated, with many new drawings, as well as some from the previous edition of the book."
What do you think about the "Three Food Groups"?
Source: "Nutrition for Developing Countries", p.73
The illustrations and clear text, and considerable new thinking - see figure about three food groups below - make the book readable and pleasant to use. The conclusions drawn about what to do about problems usefully addresses the issue: so what should we advise people to do differently? - but does not go into much detail concerning how to communicate such information. Occasionally, there is perhaps some wishful thinking if not set in the context of real constraints - for example while it's true that appropriate technology projects can develop ways to reduce women's workloads, and hence their energy needs, setting up for example childcare centres can be easier said than done. There is a need for a sequel to this book, which goes into more detail about "how to", built on the "what" that this book describes so well.
Oxford University Press supplies bookshops in many parts of the world, and can also provide copies by mail, so in case of difficulty contact Oxford University Press, Saxon Way West, Corby, Northants, NN18 9ES, or by fax: 44-536-746337.
"Poverty, Household Food Security and Nutrition in Rural Pakistan"
(1993) by Harold Alderman and Marito Garcia. IFPRI Research Report No. 96, IFPRI, Washington, D.C. 108 pages.
Designing government policies to reduce poverty and to improve household food security and nutrition is one of the most important challenges facing developing country policy makers. The successful design of such policies depends in large measure on understanding how households acquire and spend incomes, use savings to protect consumption, and cope with economic crises such as poor harvests. This research addresses such concerns by analyzing detailed three-year panel data (1986-89) for 800 households from five rural districts in rural Pakistan.
The study finds that incomes of the 800 households fluctuated considerably over the three years, largely as a result of bad weather, illness, and changes in remittances from abroad. Calorie intakes, however, did not fluctuate, not even seasonally. Savings, including storage of grains, helped to compensate for reduced production and higher food prices. Households apparently were able to save or borrow enough from family networks to even out fluctuations in income.
Diversification of income sources also played a role in reducing income fluctuations. Although all of the survey households were rural, their income sources were not strictly agricultural. Crop earnings represented less than 45 percent of all earnings, while non-farm wages and earnings accounted for 41 percent of all incomes.
These findings suggest that rural development is not synonymous with agricultural development, and that efforts to reduce rural poverty require more attention to the non-farm sector.
By South Asian standards, the calorie supply of the survey households was relatively high: 2,400 calories per person per day. However, 40 percent of the children under five years of age were underweight. The study finds that converting income into calories and calories into physical growth is hampered by the negative effects of childhood disease and infection.
To stem the spread of infectious diseases, critical community services - such as primary health-care services, sanitation and village water supply - are needed. Public health programs that reduce illness, such as immunization or those encouraging prenatal care, are also important. However, mere physical presence of such services is not enough: quality of services is equally crucial.
A key finding is that education - particularly female education - is strongly correlated with better nutrition in children. In fact, the impact of education is much stronger than that of increasing incomes. Educating women to at least the primary level is nearly three times more effective in improving the nutritional status of children than increasing household incomes by 10 percent.
To obtain a copy of the above publication please contact: International Food Policy Research Institute, 1200 Seventeenth Street, N.W., Washington, D.C. 20036-3006, USA. Tel: (202) 862 5600 Fax: (202) 467 4439.
Richard H Adams, IFPRI
"List of Free Materials in Reproductive Health"
List of FREE MATERIALS in Reproductive Health 1993 Supplement
(1993) INTRAH. Supplement to the 5th Edition of the List of Free Materials in Family Planning and Maternal and Child Health. 90 pages.
Details of where to obtain over 200 free materials containing information on issues to do with Reproductive Health are listed in this 1993 supplement to the 5th edition of the INTRAH List of Free Materials in Family Planning and Maternal and Child Health.
Materials are listed under nine headings: Family Planning; Maternal and Child Health; Primary Health Care; AIDS; Population; Development; Environment and Development; Women and Development; and Information Sources. Each listed item is accompanied by a brief description of its content, the language(s) it is published in, and a contact address.
As stated in the introduction to this supplement, all listed materials are available either "free of charge to anyone who requests them, or free only to organizations or persons in developing countries. Any restrictions concerning availability are included in the description for each item".
This publication is an INTRAH Training Information Packet (TIP). According to INTRAH, "the aim of this TIP is to inform health care professionals, particularly in developing countries, of the large number and variety of materials available free of charge from organizations around the world."
Whilst INTRAH is unable to distribute the materials contained in the list itself, the list usefully contains an example of the type of letter that could be used to request an item from the address given with it.
For further information and to obtain a copy of the publication please contact Penelope Maglaque, Librarian, Program for International Training in Health (INTRAH), The University of North Carolina at Chapel Hill, School of Medicine, 208 North Columbia Street, CB#8100, Chapel Hill, North Carolina 27514, USA.
"The Challenge of Famine. Recent Experience, Lessons Learned."
(1993) Edited by John Osgood Field. Kumarian Press, Connecticut, USA. 282 pages.
This book is a compilation of some of the papers presented at the "Workshop on Famine and Famine Policy" which was held at Tufts University (USA) from 1986 to 1989.
It begins with a description of famine, then goes on to describe the history of particular famines in Africa in the 1980s, highlighting both the effective and non-effective responses of the international community.
With this historical perspective, the book then goes on to discuss the positive role of development in reducing vulnerability to famine and finishes with some ways to improve both the early detection of famine and the response of the international community to famine.
The strength of this book lies in its historical approach. The use of recent cases of famine and responses to famine gives a framework necessary to interpret the assessments of famine situations and suggestions for improvement in early famine detection and rapid response which is the main message of the book.
To obtain a copy of this book, please contact Kumarian Press, Inc. 630 Oakwood Ave., Suite 119, West Hartford, CT 06110-1529, USA. Tel: 203 953 0214 Fax: 203 953 8579.
"The Political Economy of Food and Nutrition Policies"
(1993) edited by Per Pinstrup-Andersen. Published for the International Food Policy Research Institute by Johns Hopkins University Press. 278 pages.
One of the apparent strengths of the neoclassical paradigm has been its simplicity (abstracting from the rest of the world in order to explain a particular economic phenomenon). This strength, however, has proven to be a weakness at times. For example, focusing on the public sector as a single entity and ignoring the interaction among individuals who collude to form different interest groups has resulted in the formulation of the wrong strategies and/or the unsuccessful implementation of the right programs. The Political Economy of Food and Nutrition Policies edited by Per Pinstrup-Andersen aims to provide a structured documentation and analysis of political economy aspects of food and nutrition policies and how these may be considered in future policy design and execution. As stressed by Field in one of the essays in the book: "No one is against good nutrition, and no one favours malnutrition". However, the inability of various countries to ameliorate food insecurity and poor nutrition indicates that the problem is more complex, often involving decision makers who tend to have conflicting interests.
Parts One and Two of the book deal with these different sets of decision makers: Part One analyzes political economy aspects at the national level - discussing conceptual issues and empirical evidence based on case studies from Sri Lanka, Colombia, the United States, and Nicaragua.
Part Two focuses on political economy matters at the local and household level - emphasizing the need for policymakers to familiarize themselves with: (1) the local power structure in order to effectively influence it; and (2) the needs and various constraints faced by their intended recipients.
Part Three analyzes the extent to which public investment in improved nutrition can be justified by its impact on labour productivity. Part Four examines research needs and implications for incorporating and reconciling economic and political considerations in nutrition strategy formulation and management.
Part Five cites the book's main conclusions, one of which is the need for more and better information about a number of issues (e.g. the costs of alternative programs and policies to intended recipients, as well as to other key interest groups in society; macro and micro level constraints faced by different players) in order to effectively assist policymakers.
This book is a thorough, well-written, primarily qualitative study of various political economy issues in nutrition research, policy design and implementation. The challenge, however, comes in formulating an appropriate and fairly generalizable model that will incorporate its various suggestions. Theoretically, perhaps, one can resort to game theory (the identification of different key players and the creation of policies that would yield acceptable payoffs to all of them). Realistically, however, one may be confronted with an asymmetry of information problem since not everyone has an incentive to reveal one's true preferences (e.g. politicians often say what is deemed to be "politically correct" but they may pursue their own interests while the poor and powerless may be worried about the repercussions of expressing their discontent openly). Unfortunately, actions of agents are not costlessly observable. As stressed in the book, however, weighing the potential costs and benefits of various policies to different economic agents, as well as being able to predict their reactions is essential in ensuring successful nutrition policies. Thus, research/analytical methodologies are needed that are neither too costly nor time-consuming and yet informative and dynamic enough to predict how people will react based on various policy stimuli.
Christine L. Pena, IFPRI
"Toward Comprehensive Programs to Reduce Vitamin A Deficiency."
(1993) Report of the XV International Vitamin A Consultative Group Meeting, Arusha, Tanzania, 8-12 March 1993. 161 pages.
This report provides a valuable summary of current research findings and important policy and programme issues for those involved in combating vitamin A deficiency. The report is divided into two main parts - an overview followed by the full abstracts from all the papers submitted. The overview focuses on what it takes to turn a project into a programme, and draws on experience from Tanzania, India, Brazil, and The Philippines, as well as international experience. Operational programmatic issues are also explored, including the synergism between the community and health providers and the means of integrating vitamin A activities within primary health care systems, immunization and growth monitoring. Dietary diversification strategies are considered along with the types of communication strategies that have potential.
Additional sections cover methodologic issues in assessing vitamin A status, including clinical and histological methods of assessment, biochemical methods and the means of assessing dietary vitamin A intake. The findings of recent community trials of the relationship between vitamin A status and childhood morbidity and mortality, and a comprehensive meta-analysis are described. Recent possibilities that exploit the complementarity between vitamin A deficiency control and the control of other micronutrient deficiencies such as iron and iodine are also considered.
The overview section also includes reports from UN agencies and several NGOs on their commitments for the virtual elimination of vitamin A deficiency by the year 2000. The final section comprises 72 pages of abstracts that cover the whole spectrum of recent work on vitamin A control problems, from status assessment of populations to evaluation of programmes.
The report is thus an essential compendium of information on vitamin A deficiency control for individuals and institutions, from grassroots to international level. Comprehensive programmes clearly need to be in place and working effectively for the goal of virtual elimination of the problem to be realistically achieved six years from now.
For further information and to obtain a copy of the publication please contact: Laurie Lindsay Aomari, IVACG Secretariat, The Nutrition Foundation, Inc., 1126 Sixteenth Street, N.W., Washington, D.C. 20036, USA. Tel: (202) 659 9024 Fax: (202) 659 3617
Troubleshooting flow chart
Extracted from "UN Special"
In this section we include selected publishers' announcements of new publications; these are not independent reviews, but are included to draw attention to new relevant material.
"Real Markets: Social and Political Issues of Food Policy Reform"
(1993) UNRISD, the European Association of Development Research and Training Institutes (EADI), and Frank Cass and Company. Edited by Cynthia Hewitt de Alcantara. 131 pages.
If development policy in the 1980s was consistently shaped by an appeal to market principles, rather narrowly defined, the process of reform in the 1990s already shows signs of increasing concern with market practice - with what a growing number of people are calling the political economy of "real markets". This collection of essays on specific exchange environments in developing countries contributes valuable new material for rethinking experiments in market reform, from the bottom up, and shows why standard policy prescriptions are likely to have surprising consequences in different social settings.
Case studies in Africa, Asia and Latin America illustrate the enormous variety of "real" market settings in which food policy reform has been attempted, from the relatively incipient and partial market structures of eastern Zaire to the highly elaborate and monopolistic systems of Bangladesh and India. Authors trace the structure of social relations underlying different kinds of rural markets and explore the impact of market reforms on economic producers and consumers. At the same time, they highlight the dilemmas of food policy reform and provide case studies of how official marketing policy is challenged and moulded by the reactions of rural people to rapidly changing circumstances.
This volume lays the groundwork for a new effort to temper general calls for "market reform" with a deeper understanding of how market economies work. It is relevant not only for readers in developing countries and the industrialized West, but also for reformers in Eastern Europe and the ex-Soviet Union, where prevailing visions of the market may often be stylized and formalistic. The book should also contribute to bridging the gap between economists and other social scientists, as they deal with the "real world" of food markets in the 1990s.
Real Markets: Social and Political Issues of Food Policy Reform can be ordered from: Frank Cass and Company Ltd, Gainsborough House, 11 Gainsborough Rd, London E11 1RS, United Kingdom; or Frank Cass, c/o International Specialized Book Services, 5804 NE Hassalo St., Portland, Oregon 97213-3644, USA.
(Source: United Nations Research Institute for Social Development (UNRISD) Press Release, October 1993)
"A Manual for the Use of Focus Groups"
(1993) by Susan Dawson, Lenore Manderson and Veronica L Tallo.
This manual is a step-by-step practical guide for the use of focus groups, a research approach that has proved to be extremely useful in a wide variety of settings for providing, rapidly and economically, information on the range of opinions, knowledge, beliefs and practices of a population. It was written to help researchers in the social and health sciences use focus groups to learn more about social and cultural issues influencing health behaviour and the prevention and control of disease. Focus groups are organized interview sessions with specific goals, structures, time-frames, and procedures and have become recognized by the scientific community as a valuable tool for gaining information for a variety of purposes. Even those familiar with focus group research will find that it provides new insights and examples that may be adapted to different research questions and teaching contexts.
This book may be ordered from the International Nutrition Foundation (INFDC), Charles St. Sta., Box 500, Boston, MA 02114-0500, USA. Price: Industrialized country citizens and staff from international organizations - US$ 10 plus $2 postage and handling (add $0.50 for each additional copy). Developing country citizens -US$ 5 plus $3 postage and handling (surface) per book, $4 air mail.
(Source: UNU Food and Nutrition Programme for Human and Social Development Communication, 2 November 1993)
"Iron EDTA for Food Fortification"
(1993) International Nutritional Anaemia Consultative Group.
The International Nutritional Anaemia Consultative Group (INACG) has released a new publication on a novel iron compound that will help developing countries combat iron deficiency anaemia, the world's most common nutritional deficiency, affecting one out of every six people. The new monograph, entitled, Iron EDTA for Food Fortification, was produced by INACG will the support and encouragement of the US Agency for International Development (USAID), which has for many years been a leader in addressing the problem of iron deficiency anaemia.
People in developing countries now stand to benefit from an exciting iron fortification compound that can easily be added to their diets. A compound called iron EDTA (sodium iron ethylenediaminetetraacetic acid) was provisionally approved this year by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) for food fortification programs and is the subject of a just-released publication designed to help developing countries use it.
Iron EDTA for Food Fortification provides governments, industry, donor agencies, nongovernmental organizations, and research institutions with the scientific and technical information on the safety and efficacy needed to establish iron EDTA food fortification programs. It was prepared by a distinguished group of experts under the auspices of INACG.
Iron EDTA "represents a major addition to the iron arsenal because this unique iron compound can be used in diets where conventional food iron compounds cannot - high cereal or legume diets," said Richard Seifman, director of the Office of Nutrition at USAID. Iron EDTA makes iron available for absorption from cereals and legumes, which form the basis of diets in many developing countries. It does so without altering the taste, smell, or colour of the fortified foods. (For many years USAID has been involved in supporting and encouraging interest in iron EDTA.)
Widespread fortification of cereals and legumes with iron EDTA could greatly reduce iron deficiency during early childhood, thus preventing permanent impairment of mental and motor development. Also standing to benefit are pregnant women. These vulnerable groups are particularly prone to iron deficiency anaemia and its consequences, such as greater risk of infection, premature delivery, increased maternal deaths, and low birth-weight babies. Not to mention the adverse effects on school achievement and worker productivity.
The economic and social impact of this preventable condition is enormous. Substantially reducing iron deficiency in women and children by the year 2000 is a goal adopted at the World Summit for Children in 1990, and the 1992 International Conference on Nutrition.
Iron EDTA can make a difference.
Single copies of Iron EDTA for Food Fortification are available free of charge to appropriate developing country professionals, and for US$3.50 for those in developed countries. Copies can be obtained from the INACG Secretariat, The Nutrition Foundation, Inc. 1126 Sixteenth Street, N.W., Washington, D.C. 20036, USA. The International Nutritional Anaemia Consultative Group was established in 1977 to guide international activities aimed at reducing iron deficiency anaemia in the world. INACG receives support through a cooperative agreement between The Nutrition Foundation, Inc. and the Office of Nutrition, Bureau for Research and Development, US Agency for International Development.
(Source: INACG Press Release, October 1993).
"A Brief Guide to Current Methods of Assessing Vitamin A Status"
(1993) International Vitamin A Consultative Group.
A Brief Guide to Current Methods of Assessing Vitamin A Status is the newest in a series of monographs published by the International Vitamin A Consultative Group (IVACG). This book is an introduction to various current dietary, physiological, biochemical, histological, and clinical procedures for the assessment of vitamin A deficiency. Investigators and program planners will find the text helpful in selecting assessment methodologies best suited to their specific situations and available resources.
Each chapter includes a brief description of a procedure, a discussion of its advantages and limitations, information about interpretation of the data obtained from the method, and an example of its application. Key recent references for each procedure aid the reader in gathering more detailed information. An IVACG task force of scientists from several nations contributed to the development of this new monograph. Dr Barbara A Underwood and Dr James A Olson served as the book's editors.
Single copies of this and other IVACG publications are available free of charge to representatives in developing countries and for US$3.50 to those in other nations. Order copies from: IVACG Secretariat, The Nutrition Foundation, Inc., 1126 Sixteenth Street, N.W., Washington, D.C. 20036, USA.
A cooperative agreement between The Nutrition Foundation and the Office of Nutrition, Bureau for Research and Development, US Agency for International Development provided major support for this publication. The International Vitamin A Consultative Group was established in 1975 to guide international activities for reducing vitamin A deficiency in the world.
(Source: IVACG Press Release, undated)
"Effective Nutrition Communication for Behaviour Change"
Report of the Sixth International Nutrition Planners Forum. In Spanish and French. (1993)
As community-based nutrition interventions become more and more prevalent, learning the mechanisms of effective communication in promoting behaviour change has become a critical step in planning successful programmes. No longer the sole domain of professional nutritionists, nutrition interventions now require the collaboration of communications specialists, policy makers, and the health-care community. Effective Nutrition Communication for Behaviour Change provides the key principles necessary for successful planning of collaborative interventions. The International Nutrition Planners Forum (INPF) is pleased to announce the release of this report in Spanish and French.
This report summarizes the Sixth International Conference of the INPF held 4-6 September 1991 in Paris, France. Participants from 18 developing countries were organized into country teams comprising a technical nutrition specialist, a nutrition practitioner responsible for nutrition education programmes, and a media specialist. Each country team presented a case study of a nutrition communication programme from their country. The report provides a synthesis of the discussions generated at the conference and the content of the case studies. The conference provided a unique hands-on learning experience, offering participants the opportunity to incorporate what they learned from the presentations into plans for new communication projects for their countries.
Also available from the INPF Secretariat is Crucial Elements of Successful Community Nutrition Programmes, the report of the Fifth International INPF Conference, held in 1989 in Seoul, Korea. This report is also available in Spanish and French.
INPF is an informal organization of technical experts and professionals from developing countries with expertise and responsibility for nutrition and related policy and programmes. It was established in 1981 through the initiative of the US Agency for International Development to provide better opportunities and channels of discussion among developing country nutrition professionals.
Copies of both reports may be ordered from: INPF Secretariat, The Nutrition Foundation, Inc., 1126 Sixteenth Street, NW, Suite 700, Washington, D.C, USA.
(Source: INPF Press Release, undated)
ADMINISTRATIVE COMMITTEE ON COORDINATION - SUBCOMMITTEE ON NUTRITION (ACC/SCN)
The ACC/SCN is the focal point for harmonizing the policies and activities in nutrition of the United Nations system. The Administrative Committee on Coordination (ACC), which is comprised of the heads of the UN Agencies, recommended the establishment of the Sub-Committee on Nutrition in 1977, following the World Food Conference (with particular reference to Resolution V on food and nutrition). This was approved by the Economic and Social Council of the UN (ECOSOC). The role of the SCN is to serve as a coordinating mechanism, for exchange of information and technical guidance, and to act dynamically to help the UN respond to nutritional problems.
The UN members of the SCN are FAO, IAEA, IFAD, ILO, UN, UNDP, UNEP, UNESCO, UNFPA, UNHCR, UNICEF, UNRISD, UNU, WFP, WHO and the World Bank. From the outset, representatives of bilateral donor agencies have participated actively in SCN activities. The SCN is assisted by the Advisory Group on Nutrition (AGN), with six to eight experienced individuals drawn from relevant disciplines and with wide geographical representation.
The Secretariat is hosted by WHO in Geneva.
The SCN undertakes a range of activities to meet its mandate. Annual meetings have representation from the concerned UN Agencies, from 10 to 20 donor agencies, the AGN, as well as invitees on specific topics; these meetings begin with symposia on subjects of current importance for policy. The SCN brings certain such matters to the attention of the ACC. The SCN sponsors working groups on inter-sectoral and sector-specific topics.
The SCN compiles and disseminates information on nutrition, reflecting the shared views of the agencies concerned. Regular reports on the world nutrition situation are issued, and flows of external resources to address nutrition problems are assessed. State-of-the-Art papers are produced to summarize current knowledge on selected topics. SCN News is normally published twice a year. As decided by the Sub-Committee, initiatives are taken to promote coordinated activities - inter-agency programmes, meetings, publications - aimed at reducing malnutrition, primarily in developing countries.
Illustration by Plantu published in Le Monde and reproduced as a greeting card for Action Internationale Centre la Faim (AICF) to help in its fight against hunger. Present in 19 countries, AICF works mainly in the areas of nutrition, water supply, medical service and agriculture, to come to the aid of victims of war, famine and natural disasters. Donations may be sent to: AICF, 9 rue Dareau, 75014 Paris, France. Tel: (1) 45 65 40 40 Fax: (1) 45 65 92 50 / CCP 2820 W Paris.
Printed by The Lavenham Press Ltd., Lavenham, Suffolk, England.