title: Interactions with the recipient community in targeted food and nutrition programs.
abstract: This article explores the relation between targeted nutrition and food assistance programs and the recipient communities. The author begins by suggesting that the renewed current emphasis on targeting has resulted from the high cost of universal entitlements in poor countries and from the need to increase the food security and resilience of the poor in these countries. They stress the fundamental human right of communities to have involvement in all steps of program targeting as elemental to good democratic governance. Next, the article reviews the issues surrounding different levels of community involvement in the components of program targeting, namely needs assessment, definition and implementation of eligibility criteria, delivery of services and benefits, and monitoring and evaluation of results. Four types of targeting eligibility are described: self-targeting, means tested, categorical, and community based. It is noted that the type and the level of engagement of programs with communities depends on whose concept of community welfare is being pursued (the development summit's or the community's), and on how broadly nutrition improvement is defined. Examples are used to illustrate the potentially severe consequences of ignoring community governance and social structures in the targeting of programs. A framework is then presented with important variables to consider when planning a targeted program: state governance contexts, the nature of the local community's institutions of governance, the ratio of the need to the available benefit, and the stability of the context. Finally, the article presents recommendations for filling in the large research gaps on this topic.
authors.affiliation: United States Agency for International Development, Washington, DC 20002, USA. TMarchione@usaid.gov
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Marchione
mesh_terms: D003153:Community Health Services / Q000458:organization & administration*; D006801:Humans; D007373:Interinstitutional Relations; D020380:Needs Assessment; D009747:Nutritional Physiological Phenomena; D018579:Patient Selection; D014481:United States