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      Identificación de barreras a las políticas de nutrición y alimentación en Colombia: estudio por el método Delfos Translated title: Identifying barriers to food and nutrition policies in Colombia: a study using the Delphi method

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          Abstract

          OBJETIVOS: Identificar las barreras más importantes al desarrollo del Plan Nacional de Alimentación y Nutrición de Colombia (PNAN), tanto desde el punto de vista de sus planificadores y ejecutores, como de los académicos. MÉTODOS: Se realizó una investigación en dos partes: un estudio piloto basado en entrevistas individuales a 35 informadores clave con conocimiento de las políticas de nutrición en Colombia para identificar los posibles grupos de expertos con experiencia en el desarrollo del PNAN y verificar la pertinencia y factibilidad de la investigación; y un estudio por el método Delfos con la participación de 77 expertos que identificaron las principales barreras al PNAN. Posteriormente, en una segunda etapa del Delfos, 58 de los expertos ordenaron según su importancia las 10 barreras más frecuentemente mencionadas durante la primera etapa, aplicando una puntuación de 1 a 10. Para analizar las respuestas individuales globalmente y por grupos (planeadores y ejecutores del PNAN y académicos) se calcularon la media, la mediana y la desviación estándar de las puntuaciones y se ordenaron las barreras identificadas según los valores de las medianas de las puntuaciones. Cuando los valores de las medianas eran iguales se recurría a la media mayor o a la menor desviación estándar. Los resultados fueron discutidos con los expertos participantes para valorar la fiabilidad de las interpretaciones, explorar la utilidad del estudio y formular recomendaciones. RESULTADOS: Las cinco barreras más importantes fueron: 1) la desarticulación del PNAN del resto de las políticas sociales y económicas y su falta de correspondencia con las políticas agraria y exterior; 2) la falta de coordinación entre diferentes sectores e instancias de la administración colombiana; 3) la corrupción administrativa, agravada por la violencia y la inseguridad; 4) la falta de equidad en la distribución de los recursos; y 5) la falta de continuidad de los compromisos de los diferentes sectores involucrados. En la sesión en que se discutieron los resultados, los expertos asistentes consideraron correcta la interpretación de sus opiniones y valoraron posibles estrategias para mejorar el funcionamiento del PNAN en el país. CONCLUSIONES: El desarrollo y la implementación de las políticas de alimentación y nutrición en Colombia han encontrado barreras, tanto externas como dentro de las propias políticas, que pueden limitar su utilidad social. Se propone crear una entidad coordinadora del PNAN en Colombia.

          Translated abstract

          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.

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          Most cited references29

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            40 years ago, activities in international health were the domain of WHO, governments (based on bilateral agreements), and non-governmental organisations. This has changed. Today, new players (such as the World Bank and, increasingly, the World Trade Organisation) have an influence on international health. As globalisation of trade and markets takes hold, new coalitions and alliances are forming to examine and deal with the direct and indirect consequences on health. This paper examines the changing context of cooperation in international health, and voices concerns about rising potential inequalities in health, both within and between countries. The question of how such changes will affect the actions of organisations working in international health is also addressed.
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              Altruismo, mercado y poder. El Banco Mundial y la lucha contra la pobreza

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                Author and article information

                Journal
                rpsp
                Revista Panamericana de Salud Pública
                Rev Panam Salud Publica
                Organización Panamericana de la Salud (Washington, Washington, United States )
                1020-4989
                1680-5348
                September 2003
                : 14
                : 3
                : 186-192
                Affiliations
                [01] orgnameUniversidad del Atlántico orgdiv1Facultad de Nutrición y Dietética orgdiv2Departamento de Alimentación y Nutrición
                [02] orgnameUniversidad de Alicante orgdiv1Departamento de Salud Pública
                Article
                S1020-49892003000800005 S1020-4989(03)01400305
                10.1590/S1020-49892003000800005
                14653905
                62d5028e-9ce1-4a8d-92f6-af0c4d779d18

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 19 July 2002
                : 13 May 2003
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 7
                Product

                SciELO Public Health

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos

                Colombia,Programas y políticas de nutrición y alimentación

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