Nutrition Policy Implementation: Issues and Experience

534 Pages·1982·5.753 MB·English

by  Fernando E. Viteri (auth.), Nevin S. Scrimshaw, Mitchel B. Wallerstein (eds.)

Nutrition Policy
Implementation
Issues and Experience
Nutrition Policy
Implementation
Issues and Experience
Edited by
NEVIN S. SCRIMSHAW
Institute Professor, Massachusetts Institute of Technology
Director, MIT/Harvard International Food and Nutrition Program
Senior Adviser, World Hunger Program, United Nations University
and
MITCHEL B. WALLERSTEIN
Associate Director, MIT/Harvard International Food and Nutrition Program
Lecturer, Departments of Political Science and Nutrition
Massachusetts Institute of Technology
Sponsored by the United Nations University, Tokyo, Japan
PLENUM PRESS. NEW YORK AND LONDON
Library of Congress Cataloging in Publication Data
Main entry under title:
Nutrition policy implementation.
Includes bibliographical references and index.
1. Nutrition policy. I. Scrimshaw, Nevin S. II. Wallerstein, Mitchel B.
TX359.N8861982 363.8'56 82-9137
ISBN-13: 978-1-4684-4093-5 e-ISBN-13: 978-1-4684-4091-1
DOl: 10.1007/978-1-4684-4091-1
©1982 Plenum Press, New York
Softcover reprint ofthe hardcover 1 st edition 1982
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
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Preface
The MIT International Nutrition Planning Program (INP) was initiated
in the fall of 1972 with a grant from the Rockefeller Foundation, later
supplemented by funds from USAID under the 2110 Program. Con
ceived as a multidisciplinary undertaking, the INP was a joint effort of
the Department of Nutrition and Food Science and the Center for Inter
national Studies at MIT that also included representatives of the Depart
ments of Economics, Political Science, Urban Studies, Humanities
(Anthropology), and Civil Engineering. It has been successful in attract
ing graduate students and conducting research on various international
food and nutrition problems, including the design of intervention pro
grams.
A condition of the original grant from the Rockefeller Foundation
was the organization of a meeting to summarize and evaluate the prog
ress of the program. It was ultimately decided that the best approach
would be a workshop that would attempt to assess what had been
learned about the implementation of food and nutrition policies since
the start of the INP. Out of concern for food and nutrition policy issues,
the World Hunger Programme of The United Nations University (UNU)
and the Ford Foundation also agreed to cosponsor the workshop.
The interest of the UNU stemmed from an expert group meeting in
1975 that identified research and training in food and nutrition policy
and planning as a major subprogram priority. In 1977 the UNU signed
an agreement of association with a consortium consisting of the MIT -INP
and the Center for International Health of the Harvard School of Public
Health, with the resulting program to be known as the International
Food and Nutrition Program (IFNP). At the time of the workshop, a total
of 20 UNU Fellows, drawn from all parts of the world, had participated
in the IFNP advanced study program, taking advantage of the resources
of both institutions. The workshop itself drew upon faculty and staff
v
vi PREFACE
members at MIT and Harvard, as well as individuals from instituions
both within and outside the United States to discuss, in various cate
gories, the implementation of nutrition policies.
Because the conference marked the end of the first phase of the pro
gram at MIT, the moment was considered particularly auspicious for
merging the UNU-sponsored IFNP and the MIT-sponsored programs,
both to avoid confusion and duplication of effort and to indicate that
concern with planning activities and field studies necessarily involves
policy analysis across a broad range of disciplines. From the beginning,
the INP approach has been multidisciplinary, and the involvement of
the Harvard School of Public Health brought into the program yet
another group of disciplines. Students entering the program through
either Harvard or MIT may take part in courses in both institutions
through cross-registration and participate in a weekly Food Policy Sem
inar:~ It is intended that the present volume will be a reference source on
the kinds of food and nutrition issues that occupy IFNP students and
staff.
The IFNP has benefited greatly from the participation in this work
shop of individuals from other institutions in the United States and
abroad. This has been possible through the support of the Rockefeller
and Ford Foundations and The United Nations University World Hun
ger Programme. Thanks are extended to these institutions for making
this volume possible.
NEVIN S. SCRIMSHAW
MITCHEL B. WALLERSTEIN
Contents
Introduction .................... . xiii
I • THE RATIONALE FOR INVESTMENT IN
NUTRITION .............................. . 1
1 • Nutrition and Work Performance .................. . 3
F. E. VITERI
Comment ....................................... . 15
HARRY L. JACOBS
Discussion ..................................... . 19
2 • The Impact of Malnutrition on Behavior ...... . 21
JOSEF BROZEK
Comment .......................... . 37
ERNESTO POLLITT
Discussion ...................................... . 39
3 • Malnutrition and Infection. . . . . . . . . . . . . . . . . . . . . . . . . 41
R. K. CHANDRA
Comment........................................ 53
GERALD KEUSCH
Discussion ...................................... . 57
II • FOOD FORTIFICATION. .. . .. ... . ........ .... . . .. . 59
4 • Food Fortification. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
STANLEY N. GERSHOFF
Comment .................................. . 73
F. E. VITERI
vii
viii CONTENTS
5 • The Program of Fortification of Sugar with Vitamin A
in Guatemala: Some Factors Bearing on Its
Implementation and Maintenance . . . . . . . . . 75
GUILLERMO ARROYAVE
6 • Prevention of Iron Deficiency ..................... . 89
MIGUEL LAYRISSE
Discussion ...................................... . 97
III • SUPPLEMENTARY FEEDING AND FORMULATED
FOODS..................................... 99
7 • Programs of Supplemental Feeding and Weaning Food
Development................................ 101
NEVIN S. SCRIMSHAW
Comment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
ALBERTO CARVALHO DA SILVA
8 • Food Aid for Supplementary Feeding: A Case Study
from Egypt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
STEPHEN R. ALLEN AND ANDREW J. KOVAL
9 • The Nutri-Pak: Experience with an Indigenous
Supplementary Feeding Intervention in the
Philippines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
GEORGE H. ROPES
10 • Supplementary Nutrition: A Case Study from India. . . 141
BADRI T ANDON
11 • Supplementary Feeding and Formulated Foods: Some
Comments ....................................... 151
RICARDO BRESSANI
Comment ....................................... . 161
GRETCHEN BERGGREN
Comment ....................................... . 163
HOSSEIN GHASSEMI
Discussion ...................................... . 167
CONTENTS ix
IV • INTEGRATED, MULTI SECTORAL VILLAGE-LEVEL
INTERVENTIONS. ... . .. . . ... .. . .. . . . . . . . . 171
12 • Integrated Multisectoral Interventions at the Village
Level. . . . . . . . . . . . . . . . . . . . . . . . . 173
BRUCE F. JOHNSTON
13 • Development from Below: Transformation of Village
Based Nutrition Projects to a National Family
Nutrition Program in Indonesia ..... . 209
JON E. ROHDE AND LUKAS HENDRATA
14 • Integrated Multisectoral Nutrition Intervention at the
Community Level: The Colombian Experience ... 231
LUIS FAJARDO
Comment .... 243
RICARDO L. SANCHEZ
15 • Interface Problems between Nutrition Policy and Its
Implementation: The Philippine Case Study 247
R. FLORENTINO, C. ADORNA, AND F. SOLON
Comment 269
VVARRENBERGGREN
Comment ..................... . 271
JOHN O. FIELD
Discussion ..... 275
V • SMALL-FARM AGRICULTURAL SYSTEMS. . . . 277
16 • Some Issues in Expanding Small-Farm Agricultural
Production . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
SOLON BARRACLOUGH
17 • A Regional Approach to Agricultural Development
and Its Potential Insights for Nutrition Planning 289
DONALD R. FIESTER
18 • Nigeria's Experience with Programs Aimed at
Expanding Small-Farm Agricultural Production 307
BEDE N. OKIGBO
x CONTENTS
Comment ..................................... . 325
MICHAEL LIPTON
Discussion ...................................... . 331
VI • POST-HARVEST FOOD CONSERVATION........... 335
19 • Post-harvest Food Losses in Developing Countries: A
Survey. . . . . . . . . . .. . . .. . . . . ... . .. ... ... . . .. . .... . . 337
E. R. P ARISER
20 • Who Is the Loser in Post-harvest Losses? ............ . 373
HANS GUGGENHEIM
21 • Problems in the Post-harvest Processing of Rice in
Southeast Asian Countries ... . . . . . . . . . . . . . . . . . . . . . . 385
Y ASUMASA KOGA
Comment ....................................... . 419
H. A. B. P ARPIA
Comment ....................................... . 421
PIERRE SPITZ
Comment ................. . 423
HANS GUGGENHEIM
Comment ................. . 425
MICHAEL LIPTON
Comment ....................................... . 429
RICARDO BRESSANI
Discussion 433
VII • FOOD PRICE CONTROLS AND CONSUMER
SUBSIDIES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
22 • Food Prices as a Nutrition Policy Instrument. . . . . . . . . 437
C. PETER TIMMER
23 • Consumer Food Price Subsidies in Pakistan . . . . . . . . . . 453
BEATRICE LORGE ROGERS
24 • Food Subsidies in Egypt 473
LANCE TAYLOR
CONTENTS xi
25 • Strategies and Mechanisms for Urban and Rural
Subsidization: The Case of CONASUPO . . . . . . . . . . . . . . . . 481
JAMES E. AUSTIN
Comment ....................................... . 499
ALBERTO CARVALHO DA SILVA
Comment ................... . 507
JAMES GAVAN
Discussion ...................................... . 509
VIII • NUTRITION POLICY IMPLEMENTATION... . . . ... . 513
Final Discussion ................................. . 515
Summary Comments ..... . 521
SOL H. CHAFKIN
CONCLUDING AFTERTHOUGHTS ........................ . 527
ALAN BERG ...................................... . 527
MERRILL S. READ .................................. . 528
BADRI N. TANDON ................................ . 530
MICHAEL LIPTON .................................. . 532
MITCHEL B. WALLERSTEIN AND NEVIN S. SCRIMSHAW ..... 535
Participants .............................................. . 539
Index ................................................... . 543