SCN News No 34 - UNSCN

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28 FEATURES www.unsystem.org/scn The Peoples Health Movement: The People’s Health Movement (PHM) is a network of health activists established in 2000, initially to revitalize the principles of the Alma-Ata Declaration on Health for All and primary health care (International Conference on Primary Health Care, 1978). PHM now has a presence in around 80 countries, and has become actively engaged with WHO as both critic and supporter. PHM’s activities include a campaign to strengthen the right to health and facilitating the process of generating Global Health Watch, an alternative report on global health (Lee 2007). Training and Capacity Development With the move towards decentralised health systems, many health and nutrition workers, particularly at district level and below, now require, in addition to clinical skills, substantial public health skills in planning, advocacy, programme design, programme implementation and monitoring and evaluation, all of which are fundamental to the successful implementation of programmes. Since such skills are often in short supply, this poses a considerable challenge to training institutions and organizations. Failure to respond to this challenge of reorientation, training and support, contributes to a lack of capacity to implement policies and plans at local level “Human resources are often the greatest threat to the success of reforms” as a lack of development and training lead to low levels of staff morale, low productivity, high turnover and a drain of human resources into the private sector and other countries (Martinez and Martineau 1998). Successful nutrition programmes have invariably been found to have high levels of community participation (Shrimpton 1995). The greatest challenge is linking community-based programmes with service delivery mechanisms; thus forging partnerships for improved maternal and child nutrition (Tontisirin and Gillespie Box 4 FoodFirst Information and Action Network (FIAN) Over the last 20 years FIAN has supported the struggle of social groups and communities who have had their right to food (RtF) violated. FIAN has intervened in more than 400 cases, in 60 countries. In this process FIAN has worked closely with the victims of violations themselves or with CSOs and social movements closely related to them. Cases are only taken up when victim groups contact FIAN – directly or through partner organizations - requesting support (Windfuhr 2007). Most of the above cases are related to hunger and malnutrition of peasants, smallholder farmers, indigenous peoples, and rural workers. Most are related to land grabbing by local large farmers, and many to displacement from traditional land by “development projects”, usually controlled by large corporate interests, with the support of national governments and international finance institutions. More recently cases of urban hunger and malnutrition and malfunction of public food programmes have been documented. FIAN’s case work has influenced different dimensions of peoples´ struggle against hunger and malnutrition. Firstly, it has strengthened the capacity of local civil society and social movements to struggle for their rights at the national level, in face of local and national governments, and to be protected from actions of local or international economic interests that undermine people’s ability to feed themselves. More recently it has strengthened the capacity of civil society to negotiate adequate public policies that promote the RtF. Secondly, it has participated in standard setting for the RtF at the intergovernmental level. In 1997, FIAN, with other organizations, drafted an International Code of Conduct on the RtF, endorsed by 800 civil society organization and social movements (FIAN 1997). This code formed the basis for General Comment 12, of the UN Committee on Economic, Social and Cultural Rights in 1999, which clarifies governments’ obligations in relation to the International Covenant on ESCR (CESCR 1999). Finally, the World Food Summit follow-up, influenced by civil society pressure, coordinated by FIAN, led to the elaboration and approval of the Guidelines on the promotion of the Right to Food by the State members of FAO, in 2004 (FAO 2004b). FIAN sees the Guidelines as a potent tool to hold Governments accountable to their obligation to respect, protect, promote and provide the RtF. To support that struggle, FIAN continues to document violations and lobby governments. FIAN is presently developing tools to support civil society in introducing the RtF into national and international policies, including capacity building and monitoring tools that can be used to pressure governments to adopt coherent policies at local and national level and provide reports to the international monitoring bodies (FIAN 2007a-c). SCN NEWS # 34 back to contents
www.unsystem.org/scn FEATURES 29 1999). However, creating the capacity required to facilitate and arrange community extension (WHO/BASICS/UNICEF 1999), is a serious challenge for district level health service managers in the context of SSA today. Conclusion Capacity development, however, involves not only training to improve knowledge and skills; it also requires that those concerned accept responsibility, have the authority and have access to and control over resources necessary to perform the tasks. Thus, capacity development in the areas of public health and nutrition entails a number of linked actions, including, but not limited to, (more appropriate) training in research and programme development, as well as in policy-related research and advocacy – particularly regarding the basic causes of poor nutrition. These are the challenges that civil society must rise to if the unconscionable gap between knowledge and its implementation and the unacceptable situation of child hunger and undernutrition are to be successfully tackled. References Allain A (2005) Fighting an Old Battle in a New World: How IBFAN Monitors the Baby Food Market. Dag Hammarkskjold Foundation:Uppsala, Sweden. Ashworth A, Chopra M, McCoy D, Sanders D, Jackson D et al. (2004) Effectiveness of the WHO guidelines for management of severe malnutrition in rural South African hospitals: Impact on case fatality and the influence of operational factors. Lancet 363: 1110–15. Atarah L (2005) Playing Chicken: Ghana vs the IMF. Corporate Watch:Oakland (CA). Bassett M Bijlmakers L and Sanders D (2000) Experiencing Structural Adjustment in Urban and Rural Households of Zimbabwe. In Turshen M (ed.) African Women's Health. World Press, Inc:Africa. 167-191. Bijlmakers LA, Bassett M and Sanders D (1998) Socioeconomic Stress, Health and Child Nutritional Status in Zimbabwe at a Time of Economic Structural Adjustment - A three year longitudinal study. Nordiska Afrikainstitutet:Uppsala. Breman A and Shelton C (2001) Structural adjustment and health: A literature review of the debate, its role players and the presented empirical evidence. WHO Commission on Macroeconomics and Health Working Paper WG 6:6. WHO:Geneva. Brock K and McGee R (2004) Mapping Trade Policy: Understanding the Challenges of Civil Society Participation. IDS Working Paper No. 225. Institute for Development Studies:Brighton, UK. Cannon G (2004) Why the Bush administration and the global sugar industry are determined to demolish the 2004 WHO global strategy on diet, physical activity and health. Public Health Nutrition 7:369-80. CESCR (1999) General Comment 12. The right to adequate food (Art.11). UN Doc. E/C.12/1999/5. Committee on Economic, Social and Cultural Rights:Geneva. Chopra M and Sanders D (2000) Asking “how?” rather than “what, why, where, and who?” BMJ 321: 832. de Zoysa I, Habicht JP, Pelto GH and Martines J (1998) Research steps in the development and evaluation of public health interventions. Bull World Health Organ 76:127–133. Chopra M (2002) Globalization and food: implications for the promotion of "healthy" diets. Globalization, Diets and Noncommunicable Diseases. World Health Organization:Geneva. FAO (2004a) Globalization of food systems in developing countries: impact on food security and nutrition. Food and Agriculture Organization of the United Nations, Rome. FAO (2004b) Voluntary Guidelines to support the progressive realization of the right to adequate food in the context of national food security. Adopted by the 127th Session of the FAO Council, November 2004. FIAN (2007a) How to use the voluntary guidelines on the right to food: a manual for social movements, community based organizations and non governmental organizations. Document 49. FIAN:Heidelberg. FIAN (2007b) The voluntary guidelines on the right to food as a human rights based monitoring tool. Document 50. FIAN:Heidelberg. FIAN (2007c) Parallel reporting before the UN CESCR: writing a parallel report on the situation of the right to adequate food in cooperation with FIAN International. Document 52. FIAN:Heidelberg. FIAN, WANAHR, Institute Jacques Maritain (1997) International Code of Conduct on the Right to Food – draft. FIAN:Heidelberg. back to contents SCN NEWS # 34
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