Food, Health, and Population: Policy Analysis and Development Priorities in Low-Income Countries

Johnston, B.F. & Clark, W.C. (1979). Food, Health, and Population: Policy Analysis and Development Priorities in Low-Income Countries. IIASA Working Paper. IIASA, Laxenburg, Austria: WP-79-052

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Abstract

This paper presents a policy analysis of rural development strategies in low-income countries.

Governments, development agencies, and scholars are now giving increased attention to structuring and supplementing growth strategies to reduce the most serious deprivations of poverty. The objectives of such strategies are inevitably multiple and conflicting, with any given allocation of development resources incurring a high opportunity cost in terms of activities foregone. Furthermore, the inherent complexities of the issues involved have led to great uncertainty and disagreement regarding the choice of development strategies that are likely to be most effective. Too often, this disagreement has prohibited emergence of even the minimal consensus required for effective action.

No research, however good, will eliminate the uncertainties of development. No models, however comprehensive, will reveal "optimal" strategies for development in the real world. We argue that a systematic analysis of the major components and interactions of a rural development strategy can nonetheless facilitate the ongoing process of development policy design, implementation, and improvement.

The major focus of our analysis is policy-feasibility, not optimality. We seek to define the constraints that determine the rural development objectives that are in fact obtainable with existing resources and organizational skills. We particularly emphasize the dominant constraints imposed by the structural and demographic characteristics of the low-income countries, showing that the concentration of population and poverty in rural areas will continue to be a distinguishing feature of these countries into the next century. Equally important are the interactions of malnutrition, infection, and unregulated fertility which continue to inflict high mortality and morbidity rates on infants and small children, despite the overall improvements in mortality rates and longevity of recent decades. We also analyze the relationships among various socioeconomic factors, fertility rates, and population growth, and explore their implications for the design of feasible development policies. The lack of consensus required for effective action is especially evident in the case of nutrition-related aspects of development programs. We therefore devote special attention to the interrelationships among food intake, nutrition, and health.

In our view, the essential problem is to strike a suitable balance between production-oriented and consumption-oriented (i.e., redistribution and service) activities in development strategies. Toward this end, we analyze the complementary as well as the competitive relationships between such activities. Based on this analysis, we propose a two-pronged approach emphasizing a broad-based strategy for agricultural development, and an integrated approach to nutrition, health, and family planning services which focuses on inexpensive preventive and promotive activities. We stress the need to focus the debate on these issues through a typology that recognizes the constraints and characteristics of the low-income countries. Finally, we argue that any development strategy is necessarily an experiment. It is essential that we learn how to learn from such experiences and from this how to contribute more effectively to a continuing process of adaptive policy design, implementation, and re-design.

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