The third potential cause of malnutrition is people’s preferences between food and non-food items, and within food between food of different nutritive quality.
For reason such as eating habits, imitation of others,cultural tradition or ignorance people may have insufficient appreciation of nutrition. For example,they may fail to recognize the effects of malnutrition on their enjoyment of other gooda, and on their productivity.Similarly, they may fail to recognize the importance of proper nutrition to pregnant and lactating mothers and preschool children. If this is the case, the policy implication is a nutrition education campaign. There may also be a need for targeted short-team sudsidies or school feeding programs to induce a chang in eating habits.
Thus while subscribing to the view that people know what is good for them, the economist acknowledges the need for nutritionintervention to fill one or more of four gaps. Firstly the time gap between the implementation of delvelopment programs and the actual solution of poverty problem resulting in a distinct increase in people’s income or knowledge increases and the time when they can alter their eating habits accordingly. And finally, the private-social gap between what is preceived to be good for the individual person or household and what is good for the society at large.
The first three gaps are temporary and therefore the economist would support nutrition intervention only as a stopgap measure for a specified period of time. The fourth gap is of a longer term nature. It requires further elaboration. We need to ask the question: under what conditionsis there a discrepancy between the value or cost of nutrotion to individuals and the value of nutrition to society as a whole? First, when a substantial part of the medical cost of malnutrition-related illnesses is born by the pubic sector through pubic health services. Second,when malnutrition affect the economic and intellectual advancement of the nation by impairing work productivity and intellectual development, in ways not captured by the individual economic calculs.Third, When one individual’s nutrition decisions have spillover effects on other individuals as it is the case when malnutrition facilitates the outbreak of epidemics or spread of infectious diseases.
Nutrition intervention, whether of a short or long-term nature, involves expenditure of scarce by the social investment criteria, as are all other pubic investments .These criteria differ from those used in selecting private investments in that they measure the social rather than private costs and benefits, including spillover effects and distributional considerations. I would like to emphasize that only those nutrition intervention projects with a social return, or benefit-cost ratio above the cut-off point of pubic investments should be undertaken.
In all this,one should be extremely careful to include all the costs and benefits,some of which may not be easily quantifiable and measurable.For example, a school chldren feeding program which purports to improve children’s nutritional status thereby increasing their productivity and working lifespan would be socially beneficial if the discounted present value of the incremental life-time earnings of these children exceed the cost of the project.A shortfall of economic brnrfit does not necessarily discard the project if additional non-economic non-quantifiable benefits such as improvement in the quality of life can be documented.
On the other hand, not all projects with excess benefits over costs can be undertaken in the face of limited government budget. It is, therefore, important to rank projects in terma of their social benefit-cost ratio and to monitor their cost-effectiveness once implemented.In nutrition project,impact evaluation is important to comepare with and without the project situations rather than before and after, because of the possible impact of other concurrent projects or of the mere passage of time.In addition,one needs to bo aware of some unintended effects and induced food substitution. For example, non-targeted food subsidies often benefit more the rich rather than the poor. School feeding programs may replace children’s meal at home.
The economist sees a spectrum of altermative policy instruments and programs for attaining any given objective such as alleviation of malnutrition and recommends that the most cost-effective instrument or combination of instruments be used unless there are compelling reasons to do otherwise.
Moreover, the economist, unlike the nutrition specialist,is likely to look beyond the confines of nutrition programs for possible policy instrument for attaining nutritional objectives. He certainly will not ignore the fact that, wheather intended or not, agricultural and macroeconomic policies often have significant impact on nutrition though their effect on crop producetion, incomes and food price.Agriculture policies such as the rice export premium, fertillizer subsidies and irrigation infrastructure have nutritional status of people at subsistence levels of income.
Similarly, fiscal and monetary policies which alter wages,interest,foreign exchange and the general price level are not nutrition-neutral.They may in fact cancel the effect of nutrition intervention programs. This suggests another poteneial use of nutrition programs as corrective meansures of the adverse effects on nutrition of macroeconomic policies serving broader national interests.
That was briefly my view on nutrition problems as an economist.Some of the ideas may sound somewhat abstract and highly theoretical. Well,my belief is that we do need sound theories to guide our actions.
