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Targeting for Nutrition Improvement

A well-selected and implemented targeting method will maximize the social returns from a food and nutrition programme by excluding non-needy individuals, while minimizing the cost by including only the most needy.

What is targeting?

Targeting is a method by which goods and/or services are delivered to a group of individuals or households that have specific characteristics. Thus, in programmes that aim to produce nutrition improvements, targeting means limiting the intervention to the selected groups that are deemed most in need of those improvements (such as children under five years of age, or pregnant and lactating mothers).

The process of targeting requires many stages of decision-making during the design and implementation of an effective food and nutrition activity. Each stage involves separate information gathering and analysis of the food and nutrition situation, the benefits to the population in terms of nutritional well-being, and the financial costs associated with programming and implementation. All of the following stages are necessary for a well-designed and well-targeted activity:

  1. assessment of the extent and magnitude of the food and nutrition problems, and analysis of their causes in the general population;
  2. identification of the population groups most at risk;
  3. prioritization according to the severity of the problems, the population groups affected and/or the availability of resources;
  4. planning and development of the programme;
  5. implementation of the programme;
  6. monitoring of the programme's effectiveness in reaching the target population, in order to decide on corrective measures to improve targeting effectiveness and programme efficiency;
  7. evaluation of the programme's impact on the target population;
  8. phasing out of the programme when its objectives and goals have been reached (or when the programme's budget is terminated).

Targeting means including some people as beneficiaries and excluding others. Programme targeting may not always be possible for political or social reasons: for example, in some Latin American countries (Costa Rica, Brazil), all schoolchildren have the right to school feeding, regardless of whether they are at risk of undernutrition or not. In most settings, it is important that the targeting rationale and criteria for programme eligibility are well understood, not only by programme administrators and staff, but also by the whole population - both target and non-target groups. This strongly argues for full and effective participation by both groups in all phases of the process outlined above.

What are the benefits of targeting ?

As the targeting of programmes involves additional costs, it is important to be fully aware of the benefits of targeting. A well-selected and implemented targeting method will maximize the social returns from a food and nutrition programme by excluding non-needy individuals, while minimizing the cost by only including the most needy. In instances where current spending on nutrition-related activities only partially covers those people in immediate need, targeting can ensure optimal impact by directing limited resources to those at greatest risk. Where current spending on nutrition-related activities covers many beneficiaries who are not in need of assistance, improved targeting can lead to substantial reductions in public expenditures on programmes, without necessarily reducing their impact on those most in need.

In order to understand the overall impact of a nutrition activity on the target population, it is necessary to consider the direct and indirect nutritional, social and economic benefits. Potential negative effects on the target population, or on others, may also result from a programme, and these also need to be accounted for.


A well-targeted programme can potentially deliver nutritional benefits in a more cost-effective way than an identical programme that is poorly targeted. For example, directing supplementary food rations to children who are malnourished will be more cost-effective than providing supplementary feeding to all the children who attend health services. Either more or better food supplements can be provided to malnourished children within the same programme budget, or programme budgets can be reduced. Similarly, in many societies, targeting income-generating programmes to women is more likely to improve the food consumption levels of children than not targeting those activities according to gender.


Improved nutrition has far-reaching social benefits - in terms of better health, improved learning abilities, greater physical capacities and higher productivity - that extend well into the future. As a way of increasing income-earning capacity, household food security or nutrition programmes with well-defined objectives have direct benefits in terms of reduced poverty levels, declining malnutrition rates and other similar results. For example, the distribution of food stamps in programmes that target needy women and children through maternal and child health (MCH) services will have direct benefits by increasing the access to food of the recipients and can be used as an incentive to increase their attendance at MCH centres. School feeding programmes usually increase school attendance. This may be particularly important in societies where the school attendance of girls is relatively low, because it motivates parents to send girls to schools. An educated woman will naturally contribute more to the development of her society and girls' education may increase the efficiency of other social programmes, such as family planning programmes.

The social impact of food security and nutrition activities may be particularly difficult to measure since it relates to effects such as the psychological cost of hunger, the implications of malnutrition on the mental development of children, the value of lost income as a result of lower productivity and risk-minimization (coping) strategies, the costs of additional health care, and a wide range of other factors. Most of these effects and costs are measured in different ways and not all of them can be expressed easily in monetary terms. Nonetheless, they can have important consequences in terms of the overall impact on sustainable human development, and therefore must be considered when assessing different intervention and targeting options.

In addition, direct benefits from targeting programmes are usually accompanied by indirect benefits that extend beyond the intended programme objectives. Programme participants often change their habits or behaviour as a result of the introduction of a new programme and the exposure to new knowledge and methods. Of course, programmes can also introduce new constraints for the target group. For example, the provision of credit to women for income-generating activities may necessitate a reallocation of time spent on other tasks, such as child care, with negative social and nutritional consequences. A targeting method that alters the distribution of goods and services is also likely to alter the broader pattern of incentives that influence the behaviour of participants. Understanding the likely behavioural responses of beneficiaries to a targeted intervention is important for improving the effectiveness of the targeting method and for increasing the overall social impact of the intervention.


The potential financial savings from targeting can be substantial, and have to be weighed against the additional programme costs that result from targeting (see The cost of targeting). Identification of needy groups in the population provides the targeted programme administrators with a number of cost-saving options through:

A review of nutrition programmes in 19 Latin American countries found that more than 20 percent of the population - or approximately 83 million people out of an estimated 414 million in the study countries - receive some level of benefits through nutrition-related programmes. However, in these same countries, the estimated total number of malnourished children is about 10 million. Overall, with improved targeting of benefits to the most needy, it would be possible to more than double the per capita expenditures of these programmes and cover almost five times the present number of malnourished children in the region, without increasing total programme expenditures. In countries where current spending on nutrition-related activities only partially covers children in immediate need, targeting can ensure optimal impact by directing limited resources only to the most needy. In countries where such activities cover many times as many beneficiaries as there are malnourished children, improved targeting could lead to substantial reductions in public expenditures on nutrition-related programmes without seriously undermining their impact on the most needy.

Potential negative effects of targeted programmes

Programmes that are targeted may have unintended negative consequences, either because of the programme design itself or because the targeting mechanisms fail. For example, the distribution of cash transfers in areas where market food supply is unresponsive to changes in demand, may lead to higher food prices, with significant negative implications for the purchasing power of the poor who are not benefiting from the cash transfer, and reduced real income improvements for the poor who do receive a cash transfer. Where an activity is targeted by region, population movements may result as people relocate in search of public support, placing additional pressures on the social infrastructure, services and environment in those areas.

Poorly targeted emergency food aid may lead to the sale of rations by non-needy recipients (this also occurs when rations contain foods that are not acceptable to the local population). This will decrease local market food prices and will be a disincentive to local producers in the affected areas, resulting in the continuance of food shortages and food aid dependence. In the health sector, poorly targeted public expenditures may reduce the incentives for private sector investment in areas that would otherwise have adequate levels of demand for private sector services. Other, less obvious, negative effects include the potential loss of self-esteem attached to participation in programmes targeted to deprived groups, as well as the loss of privacy through providing personal information for programme screening.

It should also be noted that targeting may have negative consequences for special interest groups. For example, it may reduce the political power base for politicians, particularly when the non-needy who are excluded are the politically most active. Targeting at the community level may increase the social pressure put on community leaders by excluded groups who want to be included among programme participants.

In the Sudan, in both the food aid assistance emergency relief programme and the school feeding programme, wheat was introduced to replace the locally consumed sorghum. This led to a new food habit of consuming wheat in the form of bread; the demand was further increased by a high urbanization rate. Local production could not meet the newly created demand for wheat, and consequently the country had to depend on imported wheat. In addition, local farmers were unable to sell their sorghum crops at reasonable prices.

In Somalia, the distribution of food supplements through the MCH services was used as an incentive for mothers to attend those services. Yet, owing to the lack of adequate supervision and trained staff, food distribution was not integrated with other routine MCH services such as growth monitoring and nutrition education because staff were fully occupied with the food distribution and could not provide other services at the same time. In practice, the health centre was operating as a food-distribution centre where, in many instances, women came only to receive food rations.

The cost of targeting

Every targeting method involves some information and administrative costs, which are incurred during the establishment of targeting criteria and the determination and monitoring of programme participants' eligibility. Different targeting methods involve different costs, and these costs must be added to the other programme costs in order to assess the net economic gain from targeting, and to compare the gains from alternative targeting schemes.

Information costs include initial costs for information gathering, information processing and analysis, as well as information verification to ensure its accuracy. Continuous eligibility screening and monitoring make these costs recurrent, and occupy programme staff time. Additional administrative costs are incurred by continuous monitoring by programme supervisors to ensure that programme staff correctly and consistently apply the eligibility criterion or criteria.

Information costs fall into two basic groups:

It should be pointed out that different targeting schemes have different time and, sometimes, other costs for the programme participants who are to gain access to programme benefits. For example, if programme eligibility is established through a means test, candidates for participation incur costs associated with travelling to a programme facility, obtaining and submitting documentation and/or submitting to an interview. Participation in the programme's data- and information-gathering activities also involves time costs for participants.

As the cost of gathering initial data can be quite high in terms of both time and physical resources, whenever possible the required information should be obtained from existing studies and data sets. In addition, if original studies are required, they should be designed to link with the other information-gathering activities that are necessary for the overall programme design, such as preliminary problem assessments, needs assessments and baseline evaluation surveys.

When the programme administration is located near the intended target population, the cost of collecting information for targeting will be reduced. Clinic-based nutritional screening is an example of a fairly low-cost targeting method, since the required information is relatively focused, staff are already on the premises to provide a range of other services and, typically, potential beneficiaries present themselves at the facility, reducing staff transportation costs for data collection. In contrast, the relief activities of non-governmental organizations (NGOs) or UN agencies, particularly those working outside their usual programme areas, can have fairly high targeting costs associated with the time and logistics efforts required to gather the necessary information, such as information to identify the affected individuals, information on the nature of local vulnerability, information for selecting appropriate targeting criteria, and information for screening purposes. More specific costs associated with different targeting schemes are discussed in Chapter 2.

In order to provide a better understanding of the presentations and discussions contained in the following chapters, a number of frequently used terms associated with programme targeting are briefly defined in the Box on the following page.

In addition to the explicit costs associated with a particular targeting method, some implicit costs, which are critical to ensuring good coverage and programme success, may be incurred. These implicit targeting costs may include the cost of expanding the infrastructure of a service delivery system to ensure greater access for the target population.

For example, in the Bangladesh food-for-education activity, the participation (coverage) of school-age girls was expanded by increasing the size of the food ration provided, so that it sufficiently compensated the girls' families for the opportunity costs of time spent at school. Although not necessarily regarded as such, these larger rations could be considered an important element of the programme's targeting mechanism.



A method of delivering goods and/or services to a select group of individuals or households, rather than to every individual or household in the population.

Target population

Those individuals or households intended to receive goods, services or benefits under a particular programme or activity.

Participant/beneficiary population

Those individuals or households who actually receive goods, services or benefits under a particular programme or activity.


The identification and inclusion of eligible individuals or households for programme participation, and the exclusion of the non-eligible.

Target indicator

A direct measure of a particular characteristic of the target population that is used to identify members of the target group.

Proxy indicator

An alternative or substitute indicator that is closely associated with a target indicator, and that can also be applied to identify members of a target population.

Benchmark indicator

A key indicator that is directly related to the stated targeting objectives, and that is used to monitor the implementation of the targeting scheme.

Coverage or participation rate

The percentage of the target population that is actually included among the beneficiaries of a programme or activity.


The proportion of the target group that is excluded from participation in the activity.


The proportion of the beneficiary population that does not belong to the intended target group. Leakage can also refer to the proportion of total benefits that accrue to individuals or households who are not included in the target group.

Errors of exclusion

The number of individuals or households who are eligible for participation but do not participate.

Errors of inclusion

The number of individuals or households who are not eligible to participate but who do participate.

Targeting efficiency

The ratio of included target population to the total target population minus the ratio of the included non-target population to the total population included (+1 = perfect targeting; -1 = targeting that is completely wrong; 0 = random programme participation).

Food insecurity

Inadequately low intake levels of nutritious and safe food. It can be a transitory, seasonal or chronic condition.


The presence of factors that place individuals or households at risk of becoming temporarily or permanently food-insecure or malnourished.

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