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Plan of action for the eradication of harmful traditional practices affecting the health of women and children in Africa.
[Unpublished] 1987. 14 p.The traditional and harmful practices such as early marriage and pregnancy, female circumcision, nutritional taboos, inadequate child spacing, and unprotected delivery continue to be the reality for women in many African nations. These harmful traditional practices frequently result in permanent physical, psychological, and emotional changes for women, at times even death, yet little progress has been realized in abolishing these practices. At the Regional Seminar of the Inter-African Committee on Traditional Practices Affecting the Health of Women and Children in Africa, held in Ethiopia during April 1987, guidelines were drawn by which national governments and local bodies along with international and regional organizations might take action to protect women from these unnecessary hazardous traditional practices. These guidelines constitute this "Plan of Action for the Eradication of Harmful Traditional Practices Affecting the Health of Women and Children in Africa." The plan should be implemented within a decade. These guidelines include both shortterm and longterm strategies. Actions to be taken in terms of the organizational machinery are outlined, covering both the national and regional levels and including special support and the use of the mass media. Guidelines are included for action to be taken in regard to childhood marriage and early pregnancy. These cover the areas of education -- both formal and nonformal -- measures to improve socioeconomic status and health, and enacting laws against childhood marriage and rape. In the area of female circumcision, the short term goal is to create awareness of the adverse medical, psychological, social and economic implications of female circumcision. The time frame for this goal is 24 months. The longterm goal is to eradicate female circumcision by 2000 and to restore dignity and respect to women and to raise their status in society. Also outlined are actions to be taken in terms of food prohibitions which affect mostly women and children, child spacing and delivery practices, and legislative and administrative measures. Women in the African region have a critical role to play both in the development of their countries and in the solution of problems arising from the practice of harmful traditions.
Health and health services in Judaea, Samaria and Gaza 1983-1984: a report by the Ministry of Health of Israel to the Thirty-Seventh world Health Assembly, Geneva, May 1984.
Jerusalem, Israel, Ministry of Health, 1984 Mar. 195 p.Health conditions and health services in Judea, Samaria, and Gaza during the 1967-83 period are discussed. Health-related activities and changes in the social and economic environment are assessed and their impact on health is evaluated. Specific activities performed during the current year are outlined. The following are specific facets of the health care system that are the focus of many current projects in these districts; the development of a comprehensive network of primary care programs and centers for preventive and curative services has been given high priority and is continuing; renovation and expansion of hospital facilities, along with improved staffing, equipment, and supplies for basic and specialty health services increase local capabilities for increasingly sophisticated health care, and consequently there is a decreasing need to send patients requiring specialized care to supraregional referral hospitals, except for highly specialized services; inadequacies in the preexisting reporting system have necessitated a continuting process of development for the gathering and publication of general and specific statistical and demographic data; stress has been placed on provision of safe drinking water, development of sewage and solid waste collection and disposal systems, as well as food control and other environmental sanitation activities; major progress has been made in the establishment of a funding system that elicits the participation and financial support of the health care consumer through volunary health insurance, covering large proportions of the population in the few years since its inception; the continuing building room in residential housing along with the continuous development of essential community sanitation infrastructure services are important factors in improved living and health conditions for the people; and the health system's growth must continue to be accompanied by planning, evaluation, and research atall levels. Specific topics covered include: demography and vital statistics; socioeconomic conditions; morbidity and mortality; hospital services; maternal and child health; nutrition; health education; expanded program immunization; environmental health; mental health; problems of special groups; health insurance; community and voluntary agency participation; international agencies; manpower and training; and planning and evaluation. Over the past 17 years, Judea, Samaria, and Gaza have been areas of rapid population growth and atthe same time of rapid socioeconomic development. In addition there have been basic changes in the social and health environment. As measured by socioeconomic indicators, much progress has been achieved for and by the people. As measured by health status evaluation indicators, the people benefit from an incresing quantity and quality of primary care and specialty services. The expansion of the public health infrastructure, combined with growing access to and utilization of personal preventive services, has been a key contributor to this process.
In: Programmes to promote breastfeeding, edited by Derrick B. Jelliffe and E.F. Patrice Jelliffe. Oxford, England, Oxford University Press, 1988. 86-93.The Nursing Mothers' Association was formed in Sweden in the early 1970s, and the group worked to gain access to mass media to influence attitudes through articles and interviews in which they demanded support and encouragement for breastfeeding. A large number of research reports also emerged in the 1970s, demonstrating the benefits and superiority of breastfeeding and breast milk. Further, the active support from international organizations such as WHO and UNICEF was of considerable value as was the controversy leading to the formulation of the Code of Marketing of Breast-milk Substitutes, which helped to focus the interest of the mass media on the issue. Sweden's Board of Health and Welfare appointed an expert group to propose a plan of action, and the group edited a comprehensive textbook on breastfeeding and breast milk to be used as a national guide. The Nursing Mothers' Association developed to a national organization with representatives visiting maternity units and offering to provide advice by telephone after the mother's discharge. 10 years after the rediscovery of breastfeeding there are several hundred thousand mothers with considerable breastfeeding experience. On a limited scale, Sweden has returned to earlier days when young women learned from older and more knowledgeable women. A wealth of personal experience has been gathered and is being conveyed to others in an informal person-to-person manner. Sweden's baby-food industry has adjusted well to the new situation and has accepted a considerable reduction in sales of breast milk substitutes and has complied with the Code. The dramatic increase in breastfeeding in almost all industrialized nations, including Sweden, suggests a strong movement and that breastfeeding is here to stay.
POPULI. 1988; 15(4):50-2.Participants in the 1988 Oslo Conference on Sustainable Development explored ways the United Nations system can promote sustainable development by enhancing global economic growth and social development. The deterioration of the environment, and the attendant problems of poverty and resource depletion, demand international cooperation and a new ethic based on equity, human solidarity, and accountability. Priority issues identified by conference participants included the following: developing human resources and fully integrated population policies; protecting the atmosphere and the global climate, ocean, and water resources; halting desertification and countering deforestation; controlling dissemination of dangerous wastes and aiming at the elimination of such toxins; increasing technology cooperation; controlling soil erosion and the loss of species; and securing economic growth, social justice, and a more equitable distribution of income and resources within and among countries as means for alleviating poverty. It was emphasized that poverty alleviation and environmental preservation can be made cost-effective components of development plans and programs and should not be considered as barriers to economic growth.
Bangkok, Thailand, United Nations Economic and Social Commission for Asia and the Pacific, 1988. v, 133 p. (ESCAP Library Bibliographical Series No. D. 11)This 486-item bibliography is compiled from materials selected from the computerized ESCAP Bibliographic Information System data base. The bibliography includes monographs, documents, and serial articles received in the ESCAP Library and the libraries of some other UN agencies during 1987. Contents are arranged under 7 broad subjects widely used among rural development staff and researchers: agriculture; application of science and technology; health and social services; human resources development and institutions; industrial development; physical infrastructure, natural resources and environment; and policies and planning. Author, title, and geographic area indexes appear after the bibliography.
POSTGRADUATE MEDICAL JOURNAL. 1986; 62(724):93-6.Breastfeeding has been on the decline in the 3rd world for the past 20 years or so. Modernization has been blamed, yet in the industrialized nations of Sweden, Britain, and the US, women play significant roles in the labor force, are active in professional and public life, and in most Western nations the educated women and those from the professional and upper classes are most likely to breastfeed their babies. Regarding milk substitutes, many products unacceptable in the Western market are on sale in developing nations. In the absence of strong governmental controls, consumer pressure, and professional vigilance, bottle feeding is taken lightly with disasterous consequences. 3 main dangers have been identified: those arising from the nonavailability of protective substances of breast milk to the infant; those arising from the contamination of the feed in a highly polluted environment of poverty and ignorance of simple principles of hygiene; and those arising from overdilution of feeds on the account of the costs of the baby foods. Market forces and competition led the manufacturers of baby foods to stake their claims to the markets of the 3rd world, and almost all of them adopted undesirable promotional methods. The ensuing uproar led to an International Code of Ethics being adopted at the 33rd world Health Assembly under the auspices of the World Health Organization. Although the matter should have rested there, some manufacturers developed their own codes and have persuaded governments to adopt alternative codes. The present situation with regard to infant feeding in the 33rd world should be considered in the context of the international developments identified and also in light of several social and demographic processes. At the current rates of growth in population up to 80% of humanity will be living in the 3rd world by the end of the 20th century. The 2nd demographic phenomenon of social and political significance is the unprecedented increase in the growth of the urban population with national health and social services failing to respond adequately to the challenge of this growth. In many developing countries national planners and economists are beginning to look upon human milk as an important national resource, and the need for a network of services to ensure the nutrition and health of pregnant and lactating women is obvious and is recognized internationally. With regard to the question of adequacy of breast milk, there are many gaps in knowledge. Each community needs to be studied separately, and those involved in scientific research in 1 environment should resist the temptation of extrapolating the results to communities and societies with a different set of circumstances.
Washington, D.C, Pan American Health Organization, 1983. x, 145 p. (Scientific Publication No. 435)This document, prepared by the Pan American Health Organization (PAHO), reviews health in the Americas in the period 1905-47, provides a more detailed assessment of progress in the health sector during the 1970s, and then outlines prospects for the period 1980-2000 in terms of meeting the goal of health for all by the year 2000. The main feature of this goal is its comprehensiveness. Health is no longer viewed as a matter of disease, but as a social outcome of national development. Attainment of this goal demands far-reaching socioeconomic changes, as well as revision of the concepts underlying national health systems. It seems likely that the coming period in Latin America and the Caribbean will be characterized by intense urban concentration and rapid industrialization, with a trend toward increasing heterogeneity. If current development trends continue, the gap in living standards between urban and rural areas will widen due to sharp differences in productivity. Regionally based development planning could raise living standards and reduce inequalities. In the type of development expected, the role of social services is essential. It will be necessary to determine whether the objective is to provide the poor with access to services that are to be available to all or to provide special services for target groups. The primary health care strategy must be applicable to the entire population, not just a limited program to meet the minimal needs of the extreme poor. Pressing issues regarding health services in the next 2 decades include how to extend their coverage, increase and strengthen their operating capacity, improve their planning and evaluation, increase their efficiency, and improve their information systems. Governments and ministries must be part of effective infrastructures in which finance, intersectoral linkages, community participation, and intercountry and hemispheric cooperation have adequate roles. One of PAHO's key activities must be systematic monitoring and evaluation of strategies and plans of action for attaining health for all.
World plan of action for the implementation of the objectives of the International Women's Year: a summarized version.
New York, New York, United Nations, 1976. 43 p.This booklet's objective is to bring the World Plan of Action for the Implementation of the Objectives of the International Women's Year to a wide audience. The 1st section focuses on national action -- overall national policy, national machinery and national legislation, funding, and minimum objectives to be realized by 1980. The 2nd section covers specific areas for national action: international cooperation and the strengthening of international peace; political participation; education and training; employment and related economic roles; health and nutrition; the family in modern society; population; housing and related facilities; and other social questions. The subsequent 4 sections deal with the following: research, data collection and analysis; mass media; international and regional action; and review and appraisal. A major focus of the Plan is to provide guidelines for national action for the 10-year period up to 1985 which the Generaly Assembly, at its 30th session, proclaimed as the Decade for Women: Equality, Development and Peace. Its recommendations are addressed primarily to governments and to all public and private institutions, political parties, employers, trade unions, nongovernmental organizations, women's and youth groups and all other groups, and the mass communication media. Governments are urged to establish short, medium, and longterm targets and objectives to implement the Plan. The following are among the objectives envisaged as a minimum to be achieved by 1980: literacy and civic education should be significantly increased, especially among rural women; coeducational, technical, and vocational training should be available in both industrial and rural areas; equal access at every level of education, including compulsory primary school education, should be ensured; employment opportunities should be increased, unemployment reduced, and discriminatory employment conditions should be eliminated; infrastructural services should be established and increased, where necessary, in both rural and urban areas; legislation should be introduced, where necessary, to ensure women of voting and electoral rights, equal legal capacity, and equal employment opportunities and conditions; there should be more women in policymaking positions locally, nationally, and internationally; more comprehensive measures for health education, sanitation, nutrition, family education, family planning, and other welfare services should be provided; and equal exercise of civil, social, and political rights should be guaranteed.
After Mexico: NGOs and the follow-up to the International Conference on Population. Summary report of the Fourth Annual NGO/UNFPA Consultation on Population in New York (March 6, 1985).
New York, New York, UN Non-Governmental Liaison Service, 1985. 50 p.This Summary Report of the Fourth Annual Nongovernmental Organizations/UN Fund for Population Activities (NGO/UNFPA) contains the following: an opening statement of David Poindexter, Director, Communication Centre of the Population Institute; a presentation devoted to opportunities for action by Bradman Weerakoon, Secretary General, International Planned Parenthood Federation (IPPF); a discussion of global population realities by Sheldon Segal, Director, Population Sciences of the Rockefeller Foundation; panel discussions on the topic of patterns of NGO action; reports from workshop groups (environment, development and population; role and status of women; health and population; reproduction and the family; population policies and funding; population and children; population and youth; and population and aging); a report on financing global population programs, given by Barbara Hertz, Senior Economist, World Bank; discussion of the implementation of the Mexico mandate, Rafael M. Salas, Under Secretary-General of the UN and Executive Director of the UNFPA; recommendations of the Mexico City Conference which refer to the NGO role in followup; and some background material. Recommendations of the workshop groups for ongoing NGO action in the field of population include: linkages between environment, development, and population to be more carefully delineated; the need for the voice of women to be heard at all levels by those formulating population policies and for the status of women to be considered by all as essential to the population issue; couples to be offered a full range of contraceptive choices; all family members to have access to reproductive health information, sex education, and family planning services; organizations to look for multiple sources of funding and to become less reliant on a single source of funding for population and health related activities; support of programs which promote women's development; governments to prepare youth better for their roles within their own countries; and the leadership role of the elderly to be facilitated and utilized in the areas of education, communication, and influencing policies at the village, regional, national, and international level.
In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 403-32. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)Relying on empirical work done by the Economic Commission for Latin America (ECLA), this paper illustrates how the demographic dynamics of Latin America in the last 2 decades and the environmental problems being faced by the people of the region are related to the specific productive structures and consumption patterns which, to different degrees depending on the country, prevailed during that time and are now even more widespread in Latin America. Analysis of the population/styles of development/life styles/environment relationships in Latin America provides some useful guidelines for future action in the field. The dominance of a development style in which transnational corporations play a key role demonstrates that many apparently local manifestations of the problems of population, resources, environment, and development have their cause elsewhere, in distant centers or decision making, or in a process triggered by someone else. A critical part of the interplay of these relationships in future years is likely to occur in the industrialized countries. This is so because of the global reach of many of their domestic and international policies and also because they act as centers which diffuse worldwide patterns and systems of production and consumption, transnational life styles, technologies, and so forth. What occurs in the developing countries is not likely to have such great influence worldwide, though in many instances it will be of critical importance for their domestic development. Everywhere, integrated/systems thinking, planning, policy, and decision making are a prerequisite for dealing with these interrelationships. In this context, different specific population policies will have a critical role to play. The remaining problem is that decision makers still need to learn how to think and act in an integrated and systematic manner. The gap between the desired schemes, models, and plans and the real world tends to be considerable. There are a number of things that could be undertaken internationally and by the UN system to fill the gap, and these are identified.
In: Population, resources, environment and development. Proceedings of the Expert Group on Population, Resources, Environment and Development, Geneva, 25-29 April 1983, [compiled by] United Nations. Department of International Economic and Social Affairs. New York, New York, United Nations, 1984. 359-81. (Population Studies No. 90; ST/ESA/SER.A/90; International Conference on Population, 1984)This discussion focuses on the prospective impact of population growth, within the context of global constraints on resources and the environment, on certain basic conditions of socioeconomic development, i.e., food, education, health, housing, and income distribution. A table presents a basic summary of world demographic conditions as of 1980. About 3/4 of the world population of 4.4 billion is in the less developed countries. The population of these countries grows at an annual rate of about 3 1/2 times that of the more developed countries. Compared to the latter, the LDCs' birthrate is more than double, and its total fertility rate is nearly 2 1/2 times as large. The problem of hunger and undernutrition is serious, and continued population growth only makes the task of dealing with it more difficult over time. According to the US Presidential Commission on World Hunger (1980), 1 out of every 8 persons in the world is malnourished, and the number is rising. Poverty is the root cause of undernutrition. The rate of growth of food production has been slightly above that of population. The influence of population growth on food demand has been far greater than that of income growth. New sources of growth in food supply do not portend to be as readily available as before. In some ways current demographic trends will tend to improve the education, health, and housing (EHH) capital. Parents will be able to afford schooling for their children more easily because of later marriages, wider spacing of children, and fewer children. Lower fertility will make for fewer health risks particularly to mothers and infants. The problem of providing basic services for a rapidly growing population could be made more manageable by concentrating more on the human than on the material linkages between inputs and outputs, between the capital formers and the formed home capital. Population growth helps to perpetuate poverty by restraining the growth of wages. There has been a widening gap in per capita income between the richest and the poorest countries and between the middle income and the poorest. The burden of population growth is lessened through any means that raises factor productivity. 1 means would be the removal of conventions restricting the use of any factor below full capacity.
World Health. 1985 Apr; 19-20.The roles of women in the Eastern Mediterranean region tend to be determined by strong local traditions. In most of the countries concerned, traditional family life makes a clear separation between the parts played by women and men. Men dominate the "public" sphere; women assume full responsibility for the home domain. The 130 million women of this region are active and industrious but largely illiterate. They live in many instances beyond the reach of either governmental or nongovernmental services intended for their well being and development. Weakened by repeated pregnancies and endemic diseases, and sometimes by harmful traditional practices, the women of the region present a health profile that is on the whole poor. In most countries of the region, the percentages of women included in the labor force are among the lowest in the world. Yet "nonsalaried" women -- peasants or housewives -- carry huge responsibilities which may prevent them from spending time on health promotion and family care. Their heavy workload does not count as "employment, and they are not covered by protective legislation. In practice, only a small percentage of women claim their political rights. The natural leadership potential of women, which could be developed and deployed along lines compatible with local tradition, has not yet been recognized. A "women's dimension" has now been added to all World Health Organization (WHO) programs and projects in the Eastern Mediterranean Region, in conformity with resolutions passed during the UN Decade for Women. Maternal and child health and family health head the list of programs bearing directly on women's health. Family health projects aim to improve women's "reproductive health." Looking to the future, the progressive increase in school enrollment among the younger female generation and the gradual improvement in socioeconomic conditions taking place in many Member States of the region are expected to augment the status and well-being of women in their own right as well as the part played by women in health and development.
Development: Seeds of Change. 1984; 2:66-7.UN International Children's Emergency Fund (UNICEF) experience over the last 20 years suggests that successful development for poor people is not possible without substantial grassroots involvement. This is the experience both in the developing and in industrialized countries. In the 1960s it became increasingly clear to UNICEF that if programs were to succeed with the small and landless farmers and the urban slum dwellers, there was no possibility of finding enough money to meet needs of these people through governmental channels. It was equally clear that in most places the existing patterns of development andeconomic growth would not reach these people until the year 2000 or thereabots. It was this that led UNICEF to adopt its basic services approach in the late 1960s and early 1970s, which implied that the cost of the most needed basic health services, education, and water had to be reduced to manageable limits. At this stage UNICEF began to articulate the imperative of using paraprofessionals, the need for much greater use of technology that was appropriate to rural and slum areas, and the importance of involving the people in this effort. Looking at those low income countries which have managed to achieve longer life expectancy and higher literacy rates, they are all societies which have practiced much more people's participation in economic and social activities than most other countries. These 3 very different societies -- China, South Korea, and Sri Lanka -- all have had a rather unique degree of people's participation in the development process. Grassroots participation in development is a very important element in developing and in industrial countries. 1 example concerns the whole question of proper nutrition practices, the promotion of breastfeeding, and the problem of the infant formula code. It was the people's groups which picked up the research results in the 1960s, which showed that breastfeeding was a better and more nutritious way of feeding children. The 2nd example pertains to the US government recommendation of significant cuts in UNDP and UNICEF, and the refusal of Congress to give in to those cuts. In regard to the developing countries, over the last year it has increasingly become the consensus of international experts that a childrens' health revolutioon is possible. The conclusion was based upon the fact that there were 2 new sets of developments coming together that created this new opportunity: some new technological advances in the development of rural rehydration therapy; and the capacity to communicate with poor people. With the whole emphasis on the basic human needs of the last 10 years, and on primary health care in the last 5 years, literally millions of health auxiliaries and community workers have been trained, a group of people who, if a country can mobilize them, can provide a new form of access.
New York, United Nations, 1984. 108 p. (Population Studies, No. 85; ST/ESA/SER.A/85)The 3 parts of this report on world, regional, and international developments in the field of population, present a summary of levels, trends, and prospects in mortality, fertility, nuptiality, international migration, population growth, age structure, and urbanization; consider some important issues in the interrelationships between economic, social, and demographic variables, with special emphasis on the problems of food supply and employment; and deal with the policies and perceptions of governments on population matters. The 1st part of the report is based primarily on data compiled by the UN Population Division. The 2nd part is based on information provided by the Food and Agriculture Organization of the UN (FAO) and the International Labor Organization (ILO), as well as that compiled by the Population Division. The final part is based on information in the policy data bank maintained by the Population Division, including responses to the UN Fourth Population Inquiry among Governments. In 1975-80 the expectation of life at birth for the world was estimated at 57.2 years for both sexes combined. The corresponding figure for the developed and developing regions was 71.9 and 54.7 years, respectively. In 1975-80 the birthrate of the world was estimated at 28.9/1000 population and the gross reproduction rate was 1.91. These figures reflect considerable decline from the levels attained 25 years earlier: a crude birthrate of 38/1000 population and a gross reproduction rate of 2.44. World population grew from 2504 million in 1950 to 4453 million in 1983. Of the additional 1949 million people, 1645 million, or 84%, accrued to the less developed countries. The impact of population growth on economic development and social progress is not well understood. The governments of some developing countries still officially welcome a rapid rate of population growth. Many other governments see cause for concern in the need for the large increases in social expenditure, particularly for health and education, that accompany a young and growing population. Planners are concerned that the rapidly growing supply of labor, compounded by a trend toward rapid urbanization, may exceed that which the job market is likely to absorb. In the developed regions the prospect of a declining, or an aging, population is also cause for apprehension. There is a dearth of knowledge as to the impact of policies for altering the consequences of these trends. Many policies have been tried, in both developed and developing countries, to influence population growth and distribution, but the consequences of such policies have been difficult to assess. Frequently this problem arises because their primary objectives are not demographic in character.
[Operational sequence for the implementation of a subregional food and nutrition strategy] Secuencia operativa para la implementacion de una estrategia subregional de alimentacion y nutricion.
In: Lineamientos de una estrategia Andina de alimentacion y nutricion [by] Junta del Acuerdo de Cartegena. Grupo de Politica Technologica. Proyectos Andinos de Desarollo Technologico en el Area de los Alimentos. Lima, Peru, Junta del Acuerdo de Cartagena, Grupo de Politica Technologica, Proyectos Andinos de Desarollo Technologico en el Area de los Alimentos, 1983. 143-74.This article outlines and diagrams a recommended operational sequence for implementation of food and nutrition strategy for the Andean region. The multisectorial strategy envisioned by the planners would involve the supply and demand for foods; basic health, environmental sanitation and educational services; and food information and technology. The integrated, multisectorial nature of the strategy requires policies, plans, and programming designed to facilitate harmonious development of all the necessary elements within the 5 Andean countries. The proposed methodology for operationalizing the strategy is based on a systems focus which covers all aspects of production, processing, distribution, final consumption, and technoeconomic policies for food and nutrition. Because the food and nutrition strategy is more than a production program, its design should identify interrelations between the availability and prices of foods, external commerce, industrial trends, food commerce and distribution, and food consumption in adquate quantities by the entire population. A basic service component for health should also be included for the Andean population because of its relationship to nutritional aspects. The suggested instrument for operationalizing the systems focus is the "Methodology for Evaluation andprogramming of Technological and Economic Development of Production and Consumption Systems" developed by the Andean Projects for Technological Development Food Group for the Group for Technological Policy of the Cartagena Accord. The methodology consists of a manual and a "Model of Numerical Experimentation", which permits identification of system components, calculation and evaluation of relevant aspects of each production factor, and design and selection of development alternatives. The Model of Numerical Experimentation" allows simulation of goals for satisfaction of needs, exports of final products, import substitution, different production technologies, commercial margins, subidies, customs duties, taxes and exchange rates and related variables. Various food production systems have already been studied using the methodology in each of the 5 Andean countries. It is recommended that implementation of aspects of the food and nutrition strategy involving food production and consumption proceed in 8 operational sequences: 1) characterization of the current industrial, agroindustrial, and fishing economy 2) identification and selection of basic foods and/or strategies 3) representation and quantification of each of the selected systems 4) evaluation of each system and intersystem relationship 5) identification and selection of systems of production of alternative foodstuffs 6) proposal for a national and regional food system 7) concerted development programming for the regional food system and 8) design of mechanisms of evaluation and follow-up.