I am concerned that the approach discussed here does not give sufficient attention to what people at the community level could do for themselves. More attention should be given to what higher level agencies could do to facilitate those local initiatives. As Florence Egal put it, “Given the mandate of both FAO and WHO, the focus on national policies is logical. But unless we include explicitly the sub-national level we will not be in a position to address sustainably all forms of malnutrition.”
Top-down approaches tend to weaken and disempower those working at ground level. This is not a matter of simply favoring bottom-up approaches over top-down approaches. It is about figuring out how to work out an appropriate “division of labor” between agencies at different levels. Based on the principle of subsidiarity, higher level agencies should not do and decide things that ought to be done and decided at lower levels.
There is a need for discussion about how to work out the division of labor. Agencies at the higher levels should shift from designing interventions based solely on their understandings of both the problems and solutions, and move more toward facilitating analyses and action by those at lower levels. These should be partnership arrangements, with learning going on at all levels.