Joy J L, Payne P R
Food Nutr (Roma). 1975;1(4):2-17.
We have argued that development strategies aimed at the reduction of all forms of deprivation, according to an explict statement of values and priorities, are necessary for the integration of nutrition planning into overall national development planning. We do not regard this as likely to lead to the neglect of the key issues of investment and production. Instead, we argue that consideration of investment and production strategies should be explicitly directed to their purpose, the reduction of deprivation, rather than, as in the past, treated as the necessary means to that purpose. Thus investment and production strategies would be aimed directly at relieving deprivation including, especially, nutritional deprivation, and their impact in this respect will need to be explicitly predicted and evaluated. We have argued that problems and potentials differ greatly at the area level and that planning must be an iterative process in which national and area-level strategies and programmes are brought to consistency through successive cycles of adjustment and reappraisal. A major role in planning, especially in detailed design and implementation, is assigned to area level. Planning must proceed from an identification of the deprivations under attack to the identification of intervention measures. Elsewhere we have argued the case for the 'functional classification" of malnutrition and the use of "typical profiles" in the understanding of "the ecology and etiology of malnutition". Where planning accepts the need for an integrated approach to the attack on all forms of deprivation, these analyses of nutritional deprivation would from part of a more comprehensive analysis of general deprivation. The existence of "functional classification" and "typical profiles" analysis with respect to malnutrition would provide an excellent base from which a more comprehensive view might be developed. The factors affecting the evolution of nutritional - and other - deprivation problems need to be understood in order that we can identify points in the system where intervention may control theri emergence. In any situation there will be alternative intervention points bearing either directly on the alleviation of symptoms (malnutrition) or, more or less indirectly, on the control of its causes. In general, mixed strategies will be called for. At this stage in our understanding no generalizations are possible about the nature of strategy choices. Our choice of intervention measures must be based upon an understanding of the overall system as it generates malnutrition, and of which forces exert the most powerful effects. One important element of this analysis will be an understanding of the behaviour of the malnourished. However, conventional planning approaches, in which ministries and departments concern themselves only with problems and measures which conform to the definition of their own spheres of responsibility, have failed to define these choices effectively...
我们认为,根据明确的价值观和优先事项声明,旨在减少所有形式贫困的发展战略对于将营养规划纳入国家总体发展规划是必要的。我们不认为这会导致忽视投资和生产的关键问题。相反,我们认为对投资和生产战略的考虑应明确指向其目的,即减少贫困,而不是像过去那样,将其视为实现该目的的必要手段。因此,投资和生产战略将直接旨在缓解贫困,包括特别是营养贫困,并且需要明确预测和评估它们在这方面的影响。我们认为,地区层面的问题和潜力差异很大,规划必须是一个反复的过程,通过连续的调整和重新评估周期,使国家和地区层面的战略及计划保持一致。规划中,特别是在详细设计和实施方面,地区层面将发挥主要作用。规划必须从确定所针对的贫困状况出发,进而确定干预措施。我们在其他地方论证了营养不良的“功能分类”以及在理解“营养不良的生态和病因”时使用“典型特征”的理由。当规划认可需要采取综合方法来应对所有形式的贫困时,这些对营养贫困的分析将成为对总体贫困进行更全面分析的一部分。关于营养不良的“功能分类”和“典型特征”分析的存在,将为形成更全面的观点提供一个极好的基础。需要了解影响营养及其他贫困问题演变的因素,以便我们能够确定系统中可以通过干预来控制这些问题出现的点。在任何情况下,都会有直接针对缓解症状(营养不良)或或多或少间接针对控制其成因的替代干预点。一般来说,需要采用混合战略。在我们目前的理解阶段,对于战略选择的性质无法进行概括。我们对干预措施的选择必须基于对产生营养不良的整个系统的理解,以及哪些力量产生了最强大的影响。这一分析的一个重要要素将是对营养不良者行为的理解。然而,传统的规划方法,即各部委和部门只关注符合其自身责任范围定义的问题和措施,未能有效地界定这些选择……