Nutritional well-being is fundamental to achievement of the full social, mental and physical potential of individuals and populations. When people are healthy and well nourished, they have the energy, creativity and security to live their daily lives with dignity and to contribute actively to their families, their communities and their countries.
Not everyone has access to the food they need to be well nourished, and this has led to large-scale hunger and malnutrition in the world. The significant improvements over the last 30 years in food supplies, nutrition, health and access to basic social services have, unfortunately, not benefited everyone equally. Approximately 800 million people today are chronically undernourished and unable to obtain sufficient food to meet even minimum energy needs. Many others are only marginally better off and constantly face the threat of food insecurity and malnutrition. According to recent FAO figures, 208 million people in India are undernourished, 140 million in China, 186 million in sub-Saharan Africa, 167 million in the rest of Asia and the Pacific, 55 million in Latin America and the Caribbean, and 36 million in the Near East and North Africa. Worldwide, approximately 200 million children under five years of age are stunted (of low height-for-age), and more than 160 million are severely underweight.
Malnutrition takes a heavy toll on nations, affecting the growth, health, productivity and quality of life of their peoples. Without adequate nutrition, children cannot grow and develop their potential to the fullest, and adults will experience great difficulty in maintaining or expanding theirs. Poor nutrition and health can result in productivity and economic losses, as adults afflicted by nutritional and related disorders are unable to work; education losses, as children are too weakened or sickly to attend school or learn properly; health care costs for caring for those suffering from nutrition-related illnesses; and costs to society for caring for those who are disabled along with, in certain circumstances, their families.
Hunger, malnutriton and their devastating consequences can be dramatically reduced through well-conceived policies and carefully developed and implemented programmes. Achieving and maintaining optimal nutritional conditions in a population requires concerted efforts, careful planning and proper management of resources. A key element for success is to design food and nutrition programmes that are efficient and effective in reaching the most needy or at-risk population groups. To achieve this, a number of basic questions need to be answered:
These questions clearly relate to the targeting of food and nutrition policies and programmes, which is the topic of this publication. The targeting of programmes intended to improve nutrition can be a highly effective means of ensuring that precious resources are allocated to those most in need. The design of targeting procedures is a necessary step in the development of targeted policies and programmes. The question is not only when to target, but how and whom to target. A rationale for the need to target has to be developed first, because targeting involves costs. Decisions concerning how to target a programme and whom to target are usually not easy. Criteria must be established to identify and select the target population, the specific causes for the food and nutrition problems in the target population have to be identified, and the resource constraints have to be properly assessed. Similarly, to ensure maximum effectiveness, the operational design of targeted programmes needs both to include clear and verifiable objectives and goals and to lay out steps related to programme implementation, monitoring and evaluation, as well as criteria for the phasing out of the programme.
This publication is intended for all those who need to make decisions about incorporating targeting into food and nutrition programmes. It is meant to serve as an introduction, from the nutrition perspective, to the basic issues, considerations and methods of targeting. More a reference guide than a step-by-step manual, it provides a general introduction to the use, benefits and costs of targeting (Chapter 1); a description of the six primary targeting schemes and the major advantages and disadvantages of each (Chapter 2); a discussion of the main issues in the planning and design of a targeting scheme, including assessing costs and resources and selecting targeting criteria and indicators (Chapter 3); information on monitoring and evaluating the effectiveness of targeting in order to maximize programme impact (Chapter 4); a description of the types of targeted programmes most commonly used to improve nutrition, highlighting special concerns for each of these programmes (Chapter 5); and conclusions and suggestions for broad areas for action that will help to improve the targeting effectiveness of food and nutrition programmes (Chapter 6). Case studies providing actual examples of various targeted food and nutrition programmes that have been implemented around the world are provided in the Annex.
Valeria Menza
Nutrition Officer
Food and Nutrition Division