[Identifying barriers to food and nutrition policies in Colombia: a study using the Delphi method].
OBJECTIVE
To identify the most important barriers to the development and progress of Colombia's National Food and Nutrition Plan (NFNP) (which was enacted in 1996), from the viewpoint of food and nutrition plan planners, implementers, and academicians.


METHODS
The research was carried out in two stages. The first stage consisted of a pilot study in 1998 based on individual interviews with 35 key informants with knowledge of nutrition policies in Colombia, in order to identify possible groups of experts with experience in the development of the NFNP and also to confirm the relevance and feasibility of the research. The second stage consisted of a study using the Delphi method with 77 experts who identified the principal barriers that the NFNP was facing. In a second step in the Delphi process, 58 of the experts took the 10 barriers that had been mentioned most frequently in the first step and then ranked those barriers, using a point scale from 1 to 10. In order to analyze the individual responses overall and by the three groups (planners, implementers, and academicians), we calculated the mean, the median, and the standard deviation of the scores, and we then ranked the barriers according to their median point scores. When median values were the same, we then utilized the higher mean or the smaller standard deviation. We had meetings to discuss those results with the participating experts in order to assess the soundness of our interpretations, to explore the usefulness of the study, and to formulate recommendations.


RESULTS
The five most important barriers identified were: (1) the poor linkage between the NFNP and other social and economic policies, and the lack of consistency with agriculture and foreign policies; (2) the lack of coordination between different sectors and administrative organizations in Colombia; (3) administrative corruption, which was made worse by violence and the lack of security; (4) inequity in the distribution of resources; and (5) the lack of continuity in the commitment by the different sectors that are involved. The experts who attended the sessions where the results were discussed said that their opinions had been interpreted correctly, and they also suggested possible ways to apply the study results and thus improve the operations of the NFNP.


CONCLUSIONS
Food and nutrition policies in Colombia have faced various obstacles, both from outside sources and from within the policies themselves, which can limit their usefulness to society. There is need to create a coordinating body for the NFNP.
del Rocío Ortiz
María
M
Departamento de Alimentación y Nutrición, Facultad de Nutrición y Dietética, Universidad del Atlántico, Barranquilla, Colombia.
Alvarez-Dardet
Carlos
C
Ruiz
María Teresa
MT
Gascón
Encarna
E
D003105:Colombia; D003697:Delphi Technique; D006801:Humans; D018673:Nutrition Policy; D010865:Pilot Projects