Nutrition and rural development policy in Latin America: the human nutrition initiative network

 

Políticas de nutrición y desarrollo rural en Latinoamérica. La red de iniciativa de nutrición humana

 

Juan F. Nuñez-Espinoza¹*, Erin Tace-Nelson²

 

¹ Colegio de Postgraduados. Carretera federal México-Texcoco, km 36.5. Montecillo, Estado de México. 56230. (nunezej@colpos.mx) * Author for correspondence

² Universidad de Guelph. Ontario Canada. 50 Stone Road East. Guelph, Ontario, N1G 2W1. Canada. (erintace@gmail.com)

 

Received: january, 2013.
Approved: april, 2014.

 

Abstract

In Latin America, rural communities are increasingly suffering health problems related to both food insecurity and non-nutritious diets. In the face of insufficient government action, non-state actors have, in many cases, taken the lead in addressing this issue; however, their work is deeply intertwined with the policy contexts in which they operate. Using a comparative case study approach, this paper argues that a policy context that moves beyond a food aid approach, limiting free trade and promoting small-scale sustainable food production, can be effective at tackling nutrition issues, in part because of the synergies created with non-state organizations. The paper also highlights the importance of networking as a means of rebuilding the social fabrics of rural communities, thereby furthering development efforts.

Key words: Cooperation, innovation, organization, peasant, poverty.

 

Resumen

En Latinoamérica, las comunidades rurales están sufriendo cada vez más de problemas de salud relacionados con la inseguridad alimentaria y con las dietas poco nutritivas. De cara a la acción insuficiente de los gobiernos, los actores no estatales han tomado el liderazgo para atender este asunto, en muchos casos; sin embargo, su trabajo está profundamente entrelazado con los contextos de política en los que operan. Usando un enfoque de estudio de caso comparativo, este artículo propone que un contexto de política que ha llegado más allá de un enfoque de asistencia alimentaria, limitando el comercio libre y promoviendo la pequeña producción sustentable de alimentos, puede ser eficaz para afrontar problemas de nutrición, en parte debido a las sinergias creadas con instituciones no estatales. El artículo también resalta la importancia de establecer redes como una manera de reconstruir el tejido social de las comunidades rurales, promoviendo así los esfuerzos de desarrollo.

Palabras clave: cooperación, innovación, organización, campesino, pobreza.

 

"...our present challenge lies not only in how to deal with problems, but also in how to cope with the tremendous magnitude of the problems."

Manfred Max-Neef (1991, p. 15)

Introduction

A round the time that Max-Neef wrote those words, estimates put the number of people suffering from hunger and chronic malnutrition at approximately 823 million. In spite of global commitments to reduce that figure, by 2009 it had climbed to a record 1.02 billion (FAO, 2009). To further complicate matters, many households currently experiencing food insecurity, and its related health impacts, also have at least one member suffering health problems related to overweight or obesity, an irony that the World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO) have begun referring to as "the double burden of disease" (Kennedy, 2004). Ironically, rural areas — the source of the global food supply — are often the hardest hit by this double burden. Whereas farmers traditionally tended to produce enough food to meet their family needs, the globalization of the agri-food system has seen growing numbers abandon their land or shift away from low-input, subsistence-based farming towards high-input, intensive monoculture production of export crops (see Bryant and Bailey, 1997). As a result, rural populations increasingly depend on the cash economy to meet their dietary requirements, and as incomes decrease and food prices rise, this becomes more and more challenging, resulting in a decline in both the quantity of food consumed and in the nutritional quality of that food.

As both the magnitude and the complexity of the nutrition problem have grown, it has become increasingly clear that nutrition is a decidedly complex issue that must be viewed not just as a physiological phenomenon, but rather as a primarily social one, that is closely intertwined with the socio-economic structure of a society. Indeed, where levels of nutrition are poor, economic options tend to be limited and social degradation rampant. In recognition of this reality, many actors working to improve nutrition have begun to integrate activities directly aimed at changing food consumption habits into broader programs designed to help rebuild the social fabrics of the communities in which they operate, and help those communities regain a measure of control over their food supplies.

In addition to this holistic focus, those working in the field have also recognized that they cannot work in isolation, but instead must create and maintain relationships with other actors at the local, regional, and even international levels in order to build the kinds of linkages necessary for a vibrant civil society in which the nutrition problem can be adequately addressed. A strong civil society is considered particularly important in light of the fact that the past several decades have been marked by declining government involvement in issues of rural development and nutrition. In spite of this general trend to a decreased state role in rural development efforts, policy decisions and government programs remain important topics of consideration, as they continue to have significant impacts on the well-being of rural communities and on the many non-state organizations conducting rural development work.

The purpose of this paper is to examine the interplay between the work of civil society actors struggling to improve rural nutrition in Latin America and the policy contexts within which they exist. Specifically, the authors will present the case of the Human Nutrition Initiative Network (HNIN) — a network of rural development organizations working in the Dominican Republic, Mexico, Peru and Brazil to improve health and nutrition in some of the region's most isolated and impoverished communities. It will be suggested that, by working as a network, these organizations have made considerable advances in terms of rebuilding the kind of social cohesion necessary to increase food sovereignty and improve rural health and nutrition. In terms of public policy, the authors argue that a policy framework that puts limits on free trade and actively promotes small-scale sustainable farming, as in the case of Brazil, is viewed more positively by local people engaged in food security and nutrition work than a framework that favors trade liberalization and a primarily aid-based response to hunger and malnutrition, as in Mexico, the Dominican Republic and Peru. Furthermore, it will be suggested that the Brazilian policy context has facilitated the creation of local synergies between the state and the Brazilian HNIN member organization, which allow the latter to significantly scale up its efforts, particularly when compared to its three sister organizations.

The paper will begin with a brief overview of the status of rural health and nutrition in Latin America, with a focus on the four HNIN countries. This introduction will be followed by a description of the HNIN's work and the data collection methods used for this study. The regional public policy contexts in Mexico, the Dominican Republic, Peru and Brazil will then be examined, with particular attention paid to positions on free trade and the overall approach taken regarding food security and nutrition. The relationship between different policy contexts and the degree to which HNIN organizations receive support from government agencies will then be explored.

 

Methods

The research presented in this paper is based on a series of interactions with the HNIN, including evaluations of their work conducted in 2000 (Jiménez, et. al., 2002), 2007 and 2008 and both formal and informal communications over the course of several years of collaborative work (Nuñez, 2008:41-42). The bulk of the analysis however is gleaned from field work conducted by the authors in March and May of 2010 and sponsored by the Panamerican Health Organization as part of a wide research proposal which was looking "...show how existing or potential agriculture and food policies or technological innovations (e.g. biotechnology) can make a contribution to population health and diet with focus on obesity and non-communicable disease in Latin America and the Caribbean "(PAHO, 2009). This field work consisted of a two week visit to each of the HNIN's participating organizations in which were organized different round tables discussion on public policy, rural development, nutrition and health (one held in each location). The main data discussed in this paper were obtained through these forums. Participants for these round tables were found using each HNIN organization's network of contacts, and included the organization's own staff, participants in their projects, staff of other NGOs, local government officials, university professors and other community professionals such as teachers, nurses, and doctors. The participants were asked to discuss a range of issues related to the regional health and nutrition context, relevant government policies and programs and their perceived efficacy, and proposals for improvements. The data collected through this method was augmented by interviews with rural producers, NGO workers, and government officials in each location, participant observation and analysis of documentation gathered in the field (e.g. technical reports from the NGO and specialist literature).

 

Results and Discussion

Nutrition and health in rural Latin America

Over the past several decades, Latin America as a region has experienced significant improvements in standard of living indicators such as life expectancy and infant mortality. However, in spite of these positive changes, a recent FAO study found that, in 2009, more than 53 million Latin Americans (or 10 % of the total population) were still not able to meet their nutritional needs on a daily basis (FAO, 2009). Food insecurity is most prevalent in rural areas, where rates of extreme poverty are highest. For example, rural Peruvians are 3 times more likely to be malnourished than their wealthier urban counterparts (Alderman et al., 2003). And, like malnutrition, rural poverty rates show little sign of significant decreases. Indeed, in the countries where the HNIN is active — Brazil, Dominican Republic, Mexico and Peru — the rates of poverty in rural areas in 2003-04 were estimated at 41 %, 56 %, 57 %, and 72 % respectively (FAO, 2009; IFAD, 2010).

While there is no doubt about the direct link between rural poverty and food insecurity, in recent years there has been growing recognition that malnutrition in Latin America is not always simply a function of insufficient caloric intake, but rather is increasingly also related to dietary quality, especially increasing consumption of fats, sugars and processed foods, and decreasing consumption of whole foods, fruits and vegetables (Hawkes and Thow, 2008; Kennedy, 2004; Romieu et al., 1997). A result of this "nutrition transition" is that, in addition to traditional health problems associated with undernutrition (such as stunting), new health problems such as cardiovascular disease and diabetes, as well as problems related to deficiencies in micronutrients, are emerging as a serious problem in Latin America. For example, in 2003, 40.6 % of the Brazilian population was classified as overweight and obesity, cardiovascular disease and diabetes have become the country's most pressing health-related problems (Pinheiro and Carvalho, 2010; Santos et al., 2007; Pérez-Ferrer, 2010).

Similarly, whereas in the 1960s diarrhea was among the leading causes of death in Mexico, by the late 1990s cardiovascular disease, cancer and diabetes had taken over (Romieu et al., 1997). Indeed, in 2005 the Mexican Secretary of Health determined that diabetes had become the country's principle health problem and that it, together with other obesity-related cardio-vascular diseases, was responsible for more than 33 % of female deaths and 26 % of male deaths in the country (SSA, 2007).

Although the state once played a key role in addressing these problems, in recent decades there has been a significant withdrawal of government activity in rural development. Indeed, beginning in the 1980s, economic crises in the region and the ensuing adoption of Structural Adjustment Programs (SAPs) led to severe cuts to public expenditures and a corresponding decrease in public policies and programs designed to improve health and nutrition, and indeed overall well-being, for rural populations (Barquera et al., 2001; Pinheiro and Carvalho, 2010). As a result of this trend, organizations within civil society, such as the members of the HNIN, have taken the lead in the fight against hunger and poor nutrition (Jiménez Sánchez et al., 2002).

 

The human nutrition initiative network

Promoting agri-food system alternatives for improved rural health and nutrition

In response to growing global concern about nutrition as a fundamental development issue, and motivated by the World Food Summit, in 1996 the W.K. Kellogg Foundation (WKKF) launched the Human Nutrition Initiative (HNI). Until its geographical priorities were reoriented in 2002, the WKKF provided sponsorship to more than 80 projects designed to improve health and nutrition in marginalized rural regions of Latin America, not through provision of food aid, but rather by means of empowering small-scale producers to meet their own nutritional needs, and those of their communities, in a sustainable way. Four of the organizations to receive such funding were the Dominican Republic's Program for Sustainable Agriculture in Irrigated Areas (PASAR), the University of Chapingo's Durango Campus Interdisciplinary Outreach Group (GRINVIN-URUZA), Brazil's Alternative Technology Service (SERTA) in Pernambuco (northeastern), and Peru's Centre for the Promotion of Women (CEPROM), Huancayo city.

Each of the aforementioned organizations work in some of the most poverty-stricken communities of their respective countries: the northwestern provinces, including the Haitian border zone, of the Dominican Republic; the semi-arid state of Durango in northern Mexico; northeastern Brazil, which is home to the single-largest concentration of impoverished people in Latin America (IFAD, 2010), and; the highlands of central Peru, where the largely Indigenous populations are among the most marginalized in the country. In addition to economic poverty, these regions also face significant social and environmental degradation, which is closely intertwined with the health and nutrition problems experienced by their populations. One example of this degradation is the social exclusion of Haitian migrants and the severe contamination of water and soil as a result of agrochemical application in the Dominican Republic. Another is the depopulation of, and accompanying withdrawal of social services from, rural communities in Durango, combined with industrial agri-business' over-exploitation of the area's fragile water resources. In each case, problems of social erosion and environmental destruction have combined with problems of poverty to create situations in which marginalized people find it exceedingly difficult to meet their nutritional needs through either food production or in the cash economy. In other words, their food sovereignty has been significantly compromised.

The work done by PASAR, GRINVIN-URUZA, SERTA and CEPROM to address these problems may differ in its specifics; however, all four organizations share the common goal of helping to rebuild the social fabric of rural communities and, in the process, improve the ability of those communities to feed themselves in a nutritious way. In order to work towards this goal, their projects include a range of components, from personal development to community organizing to water management to household hygiene; however, at the heart of their efforts is a strong focus on alternative agri-food projects, including the promotion of organic and low-input agriculture, kitchen gardens, the use of eco-technologies in food production, small-scale food processing and micro-enterprise, and local production-consumption chains. Each organization also runs a Centro de Aprendizaje e Intercambio de Saberes (Centres for Learning and Knowledge Exchange, or CAIS). These CAIS serve as demonstration centers for hands-on education regarding low-input techniques and technologies for sustainable food production and processing, as well as other forms of resource management.

The kind of support that PASAR, GRINVIN-URUZA, SERTA and CEPROM offer to small-scale farmers is essential for improving rural nutrition, particularly in light of the president of the International Fund for Agricultural Development's (IFAD) assertion that "small family farms make a fundamental contribution to the economies and the food security of [Latin American] countries..." (Nwanze, 2009).

In addition to a focus on small-scale farms, projects that support both subsistence-based and low-input agroecological production have been shown to increase food security and help stabilize rural incomes (IFAD, 2003; Pretty and Hine 2001). Engaging in sustainable subsistence agriculture also helps rural people increase the diversity of their diets, particularly by providing them with a source of fruits and vegetables — nutrient-rich products that Ruel et al. (2005) note are often either unavailable or prohibitively expensive in the markets of developing nations. During interviews, HNIN project participants were often eager to discuss these benefits. For example, a female producer from the community of San Balvin, Peru explained that CEPROM had "taught us how to raise animals and how to make jams, and to work our fields...they have also told us that we can have vegetable gardens."

Another female farmer states: "[CEPROM staff] [...] taught us to produce jam...shelter...the composting. [...]that is where we put the cow's urine, the cuy [Guinea pig]... and what we get from the house cleaning, we put it all there... mixing we harvest [...] the manure in the potato... the flavor of corn and potato in better..."

Similarly, a producer from Las Matas de Santa Cruz, where PASAR's CAIS is located, explained that the organization had provided him with banana plants for his garden in order to help him increase the availability of the fruit for his family. "The majority [of the household's banana plants] are (donated) from them [PASAR]...It's a defense in case we need it...and right now we need it, so we're going to cut this bunch of fruit to make mangú [banana meal]... and the thing is...if there is a neighbor or someone else who needs, we are able to help..." (Las Matas de Sta. Cruz farmer, Northeast Dominican Republic.)

 

The importance of working as a network

While the four organizations introduced above are just a small sample of the more than 80 HNI projects, in 2005 they were invited by Mexico's Colegio de Postgraduados to form the Human Nutrition Initiative Network, with the idea that creating a formal network structure based around four regional representatives could help maintain active communication and exchange of knowledge and ideas between HNI members, thereby facilitating their work. One result of this kind of networking has been the creation of a kind of informal "encyclopedia" of alternative agri-food technologies and best practices that is continuously developed by, and shared between, the various HNIN members as well as others regional and local actors. A demonstrative example of the usefulness of this kind of information-sharing is the case of the mecate pump — a simple rope-based technology used to pump water that has been adopted and adapted to local needs and conditions by all four HNIN members and by other rural development organizations.

It should be noted that the HNIN organizations do not limit their networking activities to just that network. Rather, each organization also acts as a regional hub, participating in a variety of other networks at the international, national and local levels. A recent example of the functionality of these networks was the organization of a workshop on rain water collection to be held in Haiti in August, 2010. The workshop was hosted by Haiti's Centre for Health and Integrated Development in Cerca-Carvajal, and was administered by experts from the GRINVIN-URUZA node of the HNIN. The Colegio de Postgraduados, with the helping of the Panamerican Health Organization, provided funding, including resources for the construction of two cisterns capable of storing 12 000 liters of water, PASAR played the role of direct contact between the HNIN and the Haitian organization, CEPROM promoted the event amongst its partners active in Haiti, and SERTA donated a small machine that recycles plastic bottles to be used as part of the workshop. In addition to the collaboration between various HNIN members and the Haitian host organization, itself originally part of the HNI, other groups such as World Vision were invited to participate in the project. As a result, above and beyond the potential direct benefits of the workshop in terms of water management to improve food production possibilities, linkages were strengthened between Haitian development organizations, between HNIN members and other regional development actors, and between the HNIN members themselves. It is these kinds of linkages that made the workshop possible in the first place, and will create the potential for future initiatives of a similar nature.³

 

Rural health-and nutrition-related policy in the four regions of HNIN work

The trade liberalization trap

Turning now to a focus on public policy, results of the research presented here demonstrated that one of the most important measures impacting the lives of people in marginalized rural communities is entrance into free trade agreements. Because of the sheer size and power of the American economy, this impact is particularly pronounced when the agreement includes the United States. Of the countries included in the study, three (Mexico, the Dominican Republic, and Peru) had entered into free trade agreements with the United States, and all three support the development of the Free Trade Agreement of the Americas (FTAA), which would further liberalize trade in the region. In contrast, although since 1994 it has been a member of MERCOSUR (a free trade arrangement with Argentina, Paraguay and Uruguay, with several other Latin American countries enjoying associate member status), Brazil has steadfastly declined to enter into a free trade agreement with the United States, and although they initially supported negotiation of the FTAA, they later withdrew that support, noting that unless the United States removed agricultural subsidies, any free trade agreement would be inherently unjust and would lead to unfair competition undercutting the domestic agricultural sector (Grinberg, 2010).

In the cases of the Dominican Republic and Peru, agreements came into effect only recently (2007 and 2009 respectively), making it difficult to clearly determine impacts; however, because the agreements share much in common with the North American Free Trade Agreement (NAFTA), which was signed in 1994 between the United States, Mexico and Canada, it is widely believed the results will be similar. These results include a decreasing viability of small-scale farming, as competition from highly subsidized and industrialized American production undercuts national production, fewer rural jobs, declining rural incomes, and an increasing agricultural trade deficit, all of which contribute to an erosion of rural social structures and declining rural food security and sovereignty (Rivera, 2009a). In terms of health and nutrition more specifically, free trade has been found to accelerate the aforementioned nutrition transition and thus precipitate a rise in health problems related to overconsumption of fats and sugars and underconsumption of nutrient-rich foods such as fruits and vegetables (Hawkes and Thow, 2008).

During the public policy round table discussion held in Durango, Mexico, it became clear that Mexico's entry into NAFTA had had a noticeable effect on the region's producers — particularly those engaged in small-scale farming. A number of people working for GRINVIN-URUZA explained that the signing of NAFTA precipitated a change to the Mexican constitution in order to permit ejidatarios (members of communal land-ownership arrangements) to sell or rent their land and/or water rights. They noted that this had led to a significant decline in production for both subsistence and local sale, as many small-scale producers gave up their land, in almost all cases to the two large agribusinesses active in the region — the US-based Tyson Foods, which is the largest meat producer in the world and sources much of its chicken from Mexico, and the Mexican dairy company LALA⁴. In accordance with the literature on NAFTA impacts, producers in Durango noted that one of the primary reasons for a shift in land control was that the post-NAFTA flooding of local markets with cheap American imports, and the accompanying removal of price guarantees had rendered their production uncompetitive and unprofitable. As one producer from the 7 family community of Santa Librada (left desolate as a result of migration) explained, "we can harvest a little bit of maize, and it is good quality criolla maize, but aside from what my family eats, the rest just sits in storage and ends up being eaten by moths, because there is nowhere to sell it, no one wants to buy it. The same is true for my cattle — the prices are so low that it's hardly worth investing in production, and there is no way to get a better price."

Likely because the US-Peru free trade agreement was so new at the time of field work, research participants made no mention of its impacts; however, although it had been less than 3 years since its implementation in the Dominican Republic, the director of PASAR did note that, as early as the negotiations phase, the Dominican Republic-Caribbean Free Trade Agreement with the United States (DR-CAFTA) elicited widespread protest from the region's small-scale rice producers. As a result of these protests, rice in the Dominican Republic will remain a protected crop for a 20 year period, with the government arguing that this will allow producers time to diversify their production and/or increase productivity in order to compete with eventual US imports. However, if the case of Mexico can again be used as an example, protections for domestic corn production which had been negotiated into NAFTA were quickly abandoned after the agreement came into effect, resulting in a doubling of imports between 1994 and 1999, and a decline in small-scale, subsistence-based, low-input production (Baker, 2008), thus raising doubt regarding the degree to which Dominican rice production will truly be protected.

 

Limitations of an aid-based approach

As in the case of trade-related policy frameworks, when it comes more specifically to addressing issues of rural health and nutrition, research demonstrated a distinct difference between Mexico, the Dominican Republic and Peru on the one hand, and Brazil on the other. While a detailed description of all potentially relevant public policies in each of the four countries in question is beyond the scope of this paper, this section outlines the general approach taken by each, and suggests that in Mexico, the Dominican Republic and Peru policies and programs tend to focus on aid-based measures, such as subsidized consumption and cash handouts, while in Brazil efforts tend to view nutrition in a more holistic way and thus are designed to induce more structural changes to the agri-food system.

A participant in the public policies in health and nutrition workshop in Peru highlights the problematic nature of the aid-based as opposed to more systemic approach to rural development, noting that the various programs designed to improve health and nutrition in her region: "have had hardly any impact on the population, are not sustainable, and don't meet their goals. Basically the projects only last two or three years, then there is a change of government, new policies...and there is very little coordination. All of the social programs get directed to the same families...and these families are now very accustomed to paternalism. [They say] 'I get my 100 soles...now they are going to give me my garden, and my improved kitchen.' But projects appear and disappear, and the issue of a disempowered population remains." This problem is exacerbated by "a lack of monitoring and evaluation of social programs and design that is farm removed from regional reality, but instead based on the perspective from Lima."

In the case of Mexico, the majority of the health and nutrition related policies identified during the round table discussion were based on a food aid approach, including the sale of subsidized basic foodstuffs to the poor, school breakfast programs, milk distribution, and Oportunidades — a program designed to, among other things, provide micronutrient-rich foods to children. Although participants were able to identify these policies, they had difficulty identifying associated benefits, and instead discussion focused on a perceived lack of efficacy. For example, in the case of school breakfast programs, a single mother working as an administrator for GRINVIN-URUZA argued that the program is ineffective in the local municipality of Mapimí because those running it are not paid sufficiently, a donation is required for participation thus limiting accessibility, and program design did not take into account local dietary traditions. Ironically, she explained that, in an effort to salvage the initiative, it was converted from a nutrition-promoting endeavor into the subsidized sale of nutrient-poor fast foods in schools.⁵

"I have participated in parent committees from nursery schools to high schools and it is very disillusioning to see that school breakfast programs are not working in this region...At one point they used formula, soy products, atoles [traditional maize-based drink] from DICONSA [a government-managed distribution outlet], but the children didn't like [those products], so they didn't eat them...because they're not used to that kind of nutritious food. And because they were failing, they cut the programs. Three years ago, they located a breakfast program in Bermejillo...it's in a well outfitted building, that has an attendant working...but they don't offer food from DICONSA or the foods recommended by DIF [a government organization responsible for child welfare]...they make gorditas, wheat tortillas, fillings of bean, potato, cheese, pork rinds, and that is the breakfast...The students don't go, because they are in school...so some mothers, and other people from the community...go and buy gorditas at a very low price, so what I see is that it is not a breakfast program anymore...they do not sell milk, or atole, but rather bottled flavored, sweetened drinks...and that is how they maintain the place, selling to the public. when the ideal is that they should be providing free breakfasts within the schools."

The director of GRINVIN-URUZA noted that a more general reason for the ineffectiveness of public policies aimed at improving health and nutrition in the marginalized rural communities of Durango is that "the government programs act like Aspirin — they relieve symptoms, but do not cure the underlying problem. They therefore have some benefit, but there is a lack of more holistic policies to truly change things." In other words, they target nutrition as an isolated issue, removed from the deeper socio-economic context in which it is, in reality, enveloped. This may help explain Rivera's (2009b) finding that, although in the early 1990s Mexico spent approximately 2 million US dollars per day on food aid "rates of malnutrition, anemia, and micronutrient deficiencies remained high, and the decline in the prevalence of stunting, an indicator of chronic malnutrition, was less than what was expected..." This lack of impact on the part of government programs was recognized by a Durango representative to the national government who, when interviewed, suggested that the majority of the rural population in his region live in extreme poverty primarily because of "a failure of the political system." He went on to argue that "Mexico has lost its way in terms of policies for rural development. Mexico used to produce everything, but the governments have strangled production" and noted that the programs that do exist are extremely difficult for target populations to access because of "dense bureaucracy."

In both the Dominican Republic and Peru results were similar. In the case of the former, the primary policies identified were Solidaridad (subsidies for food consumption), Funditas (distribution of basic household supplies), Bonogas (assistance for the purchase of cooking gas), and a program to distribute milk to poor children. The overall opinion of participants regarding these programs was summed up by the director of a local orphanage, who explained that they are essentially palliative measures that may alleviate crises in the short-term, but do little or nothing to create long term positive impacts. In his opinion, the programs often have more to do with politicians looking to consolidate rural votes than with truly addressing the root causes of food insecurity and poor nutrition. In Peru, identified programs included Programa Juntos (which saw rural mothers receiving 100 soles, or approximately 35 US dollars, per month provided they ensured their children were regularly attending school and health clinics) and Vaso de Leche (distribution of milk to poor children). In both cases, round table participants accused the programs of representing what they perceived as the government's "band-aid solution" approach to rural health and nutrition problems. As one Peruvian university professor put it, "a true food security program has to be bottom-up, and begin with our campesinos. They have to know their value, and not have to depend on something like Vaso de Leche, but rather know that they can produce and process, add value, enter the market, generate their own incomes with their work, and not be dependent. Waiting for a government program to give them food is not sustainable in the long term." As was the case in Mexico then, there was a feeling that nutrition needed to be treated as an issue that lies at the heart of a society's social well-being, and not merely as a question of caloric intake.

Participants in the round table held in Brazil identified a number of policies mirroring those in Mexico, the Dominican Republic and Peru, including milk distribution to children and school meal programs; however, the policies that were perceived as most important in terms of improving health and nutrition in the marginalized rural communities of the region were not those related to food aid, but rather those that sought to help make small-scale, subsistence-based, low-input production both valued and viable. For example, although it was criticized for insufficient monitoring of results and uneven application in some areas, the Programa Nacional de Fortalecimento da Agricultura Familiar (PRONAF) and Programa de Aquisição de Alimentos da Agricultura Familiar (PAA) were hailed as useful measures in the support of family farming, as they help small-scale producers access credit and ensure that public procurement programs favor direct purchasing from family farms.

Both the Brazilian food aid programs and the policies designed to support small-scale, subsistence-based production exist within the unified framework of Fome Zero (Zero Hunger), a broad-based initiative introduced by the government of Luis Inacio Lula da Silva in 2003 to combat food insecurity and malnutrition and increase levels of food sovereignty. Pinheiro and Carvalho (2010) assert that the development and implementation of the Fome Zero programs represent the first time that issues of hunger and nutrition have been front and center on the national agenda. Although there is some debate regarding the degree to which it has achieved its goals, the very existence of an integrated program that clearly views the reconstruction of rural communities' socioeconomic integrity as central to improving nutrition is an important achievement, and is precisely what research participants in the other countries of the study expressed longing for. In addition, there is no doubt that the Fome Zero programs have had at least some impact. For example, although a Fome Zero program aiming to build one million cisterns for rural rainwater storage did not achieve its target, it still managed to build 700 000 cisterns, thus helping many small-scale farmers adopt a low-input method of crop irrigation.⁶

In addition to its support for small-scale subsistence-based food production, Brazil is notable for being the only one of the four case study countries where comprehensive public policy exists to encourage organic production and consumption.⁷ Like Fome Zero, a national program designed to support the organic sector was implemented by the government of Lula. This program includes support for organic certification (including the development of participatory certification systems designed to help make organic production more accessible to small-scale low-income producers), the creation of community seed banks for distribution of green manure seed, and the introduction of agroecology as a topic in school curricula from the primary to post-secondary levels. In addition, public procurement programs must not only source 30 % of their food from family farms, but must also give priority to organic products when they are available, and pay a 30% price premium for those products. Small-scale organic producers interviewed in the region noted that these kinds of policies, as well as state support for local organic markets, help them grow healthy foods that provide a diversified diet for themselves and their families, as well as for local communities. Indeed, many young people participating in SERTA's youth education programs expressed interest in converting their parents' farms into organic operations or starting their own organic production initiatives.

One final note regarding the Brazilian policy context is that, while it may have been viewed by research participants in a more positive light relative to the Mexican, Peruvian and Dominican cases, there was still significant room for critique. Indeed, pointing to a National Association of Vegetation Defense statistic, one SERTA worker pointed out that, in spite of some support for sustainable agriculture, Brazil is actually the global leader in agrochemical use, applying them in larger quantities than even the United States (Marzabal et al., 2009: 36). An effect of this is that in Brazil, the second cause of intoxication after medication is pesticide (Gorenstein, 2009). Similarly, the country continues to rely heavily on large-scale monocrop sugar production as an engine of economic growth. An official with the Pernambuco State Ministry of Agriculture helped to explain this apparent disconnect, noting that although the Brazilian government may ideologically support small-scale sustainable agriculture and recognize its benefits in terms of improving the well-being of marginalized rural communities, for pragmatic reasons (including geopolitical issues, prioritization of macroeconomic growth, and pressure from powerful corporate actors such as Bayer and Monsanto) its support for an alternative model remains limited in scope.

 

The view from the ground: interplay between public policy frameworks and the efforts of hnin organizations

It is not surprising that, just as research participants in Brazil tended to be more positive about their country's health- and nutrition-related policies than their Mexican, Peruvian and Dominican counterparts, those involved with SERTA clearly had more support from state agencies than GRINVIN-URUZA, CEPROM or PASAR. The way in which each HNIN organization has responded to the presence or absence of state support demonstrates the kind of ripple effects that public policy frameworks and government priorities can have, as they either facilitate or constrain the work of rural development organizations, such as those of the HNIN, dedicated to improving rural nutrition and health.

 

Funding opportunities

As noted above, hunger and nutrition has been made a public policy priority in Brazil, and the combination of the country's position on free trade, its Fome Zero framework, and its organic agriculture programs make clear that protection and promotion of small-scale sustainable food production is viewed as a means of increasing food sovereignty, thereby addressing the problem. There is thus a clear alignment between the priorities and approach of the state, and those of the HNIN. According with Burlandy (2009), this would be an example of the strategy of the Brazilian federal government that aim at promoting intersectorality in the field of Food and Nutrition Security." As a result of this, SERTA receives substantial direct support from state agencies for its agri-food work. For example, its projects that provide small-scale farmers with training in organic agriculture are funded by the Ministry of Agricultural Development and the Secretary of Science, Technology and the Environment, while the state-controlled oil and gas company Petrobras funds work to develop participatory guarantee systems for organic certification, which are designed to help small-scale producers farm sustainably and access the organic market. Similarly, a variety of government agencies have contributed to financing SERTA's youth education program, which has a strong focus on encouraging rural youth to adopt subsistence-based sustainable farming techniques, engage in small-scale food processing, and enter organic markets".

Given that the viability of small-scale sustainable food production has not been made a public policy priority in Peru or Mexico, it should perhaps not be surprising that neither CEPROM nor GRINVIN-URUZA receive the same kind of financial support from state agencies as SERTA. Although both organizations have managed to maintain projects aimed at improving rural health and nutrition through the promotion of agri-food alternatives, the scale of their efforts has been significantly limited by funding challenges, which have become particularly pronounced following the global financial crisis and ensuing contraction of international aid funding. The comparison with the Brazilian context was highlighted by GRINVIN-URUZA's director, who noted that was an effort for his organization to find the resources to build just one cistern for rainwater storage, while participants in SERTA projects were able to take advantage of the national cistern-building initiative to help further their work. The case of the cisterns is a small but illustrative example of the increased scale at which an NGO is able to work when its projects are consistent with public policy frameworks (Belik, 2007).

A much starker demonstration of the interrelationship between policy context, funding opportunities, and the ability of an NGO to effectively conduct work to support small-scale, subsistence-based sustainable food production, is provided by the case of PASAR. As its name indicates, the organization began as a project specifically dedicated to the promotion of sustainable agriculture with a focus on meeting subsistence needs. However, because this work was highly dependent on international funding (including that received from the WKKF), when that support came to an end PASAR faced a crisis, with one of its board members noting that, for a time, the organization's very survival was threatened. In order to maintain its existence in the face of reduced international financing and a lack of government interest in its agricultural work, PASAR was forced to make some significant changes. Responding to the availability of funding from the Dominican Ministry of Education (through its administration of a World Bank program), it began to focus on child education programs. Although PASAR's director made clear that the organization has not abandoned its commitment to alternative agri-food projects, particularly the promotion of kitchen gardens and organic production, at the time of research active work on those projects had been severely limited, offering evidence of the degree to which an unfriendly policy context can constrain an NGO's ability to do the work it deems important.

 

Partnerships and joint initiatives

Although funding is certainly important, state support for an NGO's work can extend beyond the simple provision of financial resources and into the realm of collaborative projects. As was the case with an examination of government funding and the HNIN, when it comes to developing and implementing joint initiatives aimed at supporting small-scale sustainable food production as a means of improving rural health and nutrition, SERTA benefited from a supportive public policy environment not shared to the same degree by its three sister organizations.

One of the most illustrative examples of government-NGO collaboration was SERTA's work with the government of Pernambuco (and a variety of other organizations, including the Associação dos Profissionais da Agricultura Orgânica) to turn the state into a polo organico, or recognized centre of organic production and consumption. While the project was spearheaded by the government, several SERTA staff" members noted that active efforts were made to include NGO participation in the initiative, which aims to certify 1000 local producers using participatory guarantee systems, help them access local markets, and spur demand for local organic products through education and marketing campaigns. In addition to the polo organico initiative, SERTA also collaborated with government agencies on a range of related projects and, during the two-week field work period, government representatives visited the organization on more than one occasion, for example, to participate in a meeting with small-scale organic producers involved in a state-funded SERTA-run project. Just as state funding helped SERTA achieve a greater scale of operation than the other three HNIN organizations, the kind of direct collaboration described here provided them with the opportunity to significantly expand their realm of action and impact.

In the case of CEPROM, although there was no evidence of this kind of active collaboration with government agencies, the organization's director did note that a number of regional municipalities had, in recent years, begun to adopt rural development projects mirroring those of CEPROM. Specifically, they were introducing a number of the eco-technologies long advocated by the organization, including the aforementioned mecate water pumps, energy-saving stoves, sewage water filtration for irrigation, worm compost, and organic agriculture. Although no formal collaborative initiatives existed at the time of research, at least one local government official involved in his municipality's efforts to promote small-scale sustainable food production commented that he had visited CEPROM's CAIS in an effort to learn about relevant technologies. Thus, there may be some potential for CEPROM's efforts to be scaled up should more municipalities, and potentially higher levels of government as well, begin to adopt elements of their projects in the future.

Finally, if SERTA represents a case of active NGO-government collaboration at a variety of levels, and CEPROM one where indirect cooperation with the state is occurring at least locally, if not nationally, both PASAR and GRINVIN-URUZA represent the other end of the spectrum, as both have struggled to achieve and maintain the same level of government collaboration in their alternative agri-food nutrition-promoting work as the other two HNIN organizations. A woman who had participated in a number of PASAR's local projects explained that there was no interest on the part of the state in collaborating with the NGO because, in her view, "the authorities simply do not care about us [rural people in her region of the country]. It has always been that way here." While the same kind of perceived indifference to their problems was also noted by participants in GRINVIN-URUZA projects, a staff member of that organization added that their own feelings about government were also a contributing factor in the lack of collaborative initiatives. Although he recognized the need to work with government in order to achieve an impact beyond isolated local communities, he explained that "politicians are not well-liked here, because they are so often corrupt. As a result, we feel hesitant about making an effort to try to work with them."⁸ There is a challenge then, as in both cases collaboration with government agencies was recognized for its potential to increase the scale of operations and the reach of impacts, yet it was not perceived as a viable strategy (at least at the present moment) given the local political contexts.

 

Conclusions: cooperating to confront the magnitude of the nutrition problem

The interrelated issues of rural poverty, social and environmental degradation, food insecurity, poor nutrition and ill health often seem like intractable problems, as they have persisted, and even increased in scale, in spite of decades of development efforts aimed at addressing them. Nevertheless, as the case of the Human Nutrition Initiative Network demonstrates, civil society actors can have a positive impact in terms of addressing the nutrition problem, and its root causes of economic marginalization, social erosion and environmental destruction. These organizations are most effective when they treat nutrition, not as an isolated physiological concern, but rather as an issue at the core of a society's overall well-being, and when they take advantage of synergistic relationships with other actors (both state and non-state) that permit them to increase their own legitimacy and the scale of their efforts. By taking both of these factors into account, the HNIN has been able to have some success both in terms of direct improvements in rural health and nutrition, and in terms of helping to rebuild the social fabric of marginalized rural communities by increasing social capital and empowering local people, helping them realize (or remember) that they have the ability to nourish themselves, their families and their communities.⁹

Unfortunately, although research on the HNIN presented ample evidence of the potential for improving rural health and nutrition, the policy contexts within which the organizations operate proved, in most cases, to be indifferent (at best) or detrimental (at worst) to their work. Even in Brazil, where the data suggested that there was more hope for change than in the other three locations, the industrial food model remained the norm, those seeking alternatives remained a minority, and the double burden of both insufficient and unhealthy food consumption in rural areas had not yet been solved.

Although none of the case studies considered could be deemed ideal in terms of the interplay between public policy and the work of civil society organizations to combat hunger and poor nutrition and increase food sovereignty, when contrasted against the Mexican, Peruvian and Dominican contexts, the case of Brazil did offer some insight into the kinds of policies perceived as beneficial by those working in the field. Shaped at least in part by government members whose careers were built working for NGOs and participating in broad social movements for rural development, the Brazilian government has chosen to limit free trade and provide support for small-scale sustainable food production as well as locally-based production-consumption chains. This policy framework demonstrates that, at least to an extent, the Brazilian state recognizes the need to halt and reverse the socio-economic erosion that has plagued rural communities in order to achieve improvements to health and nutrition. Its support of civil society organizations, such as SERTA, that share that vision provides evidence of how the impacts of these actors can be amplified when they are able to take advantage of synergies with the state.

In conclusion, the central message that this paper hopes to convey is twofold. In the first place, the authors believe that nutrition must be viewed as perhaps the most fundamental element of a society's well-being, and as an issue that cannot be divorced from the economic, social and environmental status of rural communities. Initiatives and policies built on this premise will be significantly more successful than those that are not. Secondly, in order to maximize their effectiveness in the face of a problem that, as mentioned in the introduction to this paper, continues to stubbornly increase in magnitude and complexity, projects and policies aiming to address the nutrition problem must seek to build linkages between a wide variety of actors, including civil society organizations, state agencies and marginalized rural people themselves. The construction of a broad and inclusive social movement, based on these linkages, offers the best hope of truly rebuilding the eroded socio-economic structures and natural resource bases of rural communities in Latin America, thereby helping empower rural people to improve their health and nutrition in a lasting way.

 

Recognition

Thanks to the Pan American Health Organization (PAHO) that funded this research and, therefore, the making of this article.

 

Works Cited

Alderman H., J. Hentschel, and R. Sabates. 2003. With the help of one's neighbors: externalities in the production of nutrition in Peru en Social Science and Medicine, N° 56, 2019-2031.         [ Links ]

Baker L. 2008. Local food networks and maize agrodiversity conservation: two case studies from Mexico. Local Environment, 13(3), 235-251.         [ Links ]

Barquera S., J. Rivera-Dommarco, y A. Gasca-García. 2001. Políticas y programas de alimentación y nutrición en México (Food and nutrition politics and programs in Mexico) en Salud Publica Mex, 4, 464-477.         [ Links ]

Belik W, e N. Abrahão. 2007. O programa nacional de alimentação escolar e a gestão municipal: eficiencia administrative, controle social e desenvolvimento local (The national school food program and municipal management: administrative efficiency, social control and local development) Revista de Nutrição, 22(5), 595-607.         [ Links ]

Bryant R., and S. Bailey. 1997. Third World Political Ecology. Routledge, London.         [ Links ]

Burlandy L. 2009. A construção da política de seguraça alimentar e nutricional no Brasil: estratégias e desafios para a promoção da intersetorialidade no ambito federal de governo" (The construction of a food security and nutrition policy in Brazil: strategies and challenges for the promotion of intersectoral work in the federal government) en Ciencia & Saude Colectiva, 14(3), 851-860.         [ Links ]

FAO (Food and Agriculture Organization of the United Nations). 2009. The State of Food Insecurity in the World: Economic Crises — Impacts and Lessons Learned FAO.         [ Links ]

Grinberg N. 2010. "Where is Latin America Going? FTAA or '21^st Century Socialism'? In: Latin American Perspectives, 30(1), 185-202.         [ Links ]

Gorenstein O. 2009. Considerações necessárias sobre o relatório da ANVISA en Defesa Vegetal (Agosto, 2009). Associacao Nacional de Defesa Vegetal (ANDEF). Published http://www.andef.com.br/revista/arquivos/agosto2009.pdf (02/05/2014).         [ Links ]

Hawkes C., and M. Thow A. 2008. Implications of the Central America-Dominican Republic-Free Trade Agreement for the nutrition transition in Central America. Revista Panamericana de salud Pública/Pan American Journal of Public Health. Nov;24(5):345-60. Recuperado de http://75.102.22.228/uploadsA228839686.pdf (22/08/2010)        [ Links ]

IFAD (International Fund for Agricultural Development). 2010. Rural Poverty Portal. Publicado en línea www.ruralpoverty.org. (12/11/2011)        [ Links ]

IFAD (International Fund for Agricultural Development). 2003. The Adoption of Organic Agriculture among Small Farmers in Latin America and the Caribbean (IFAD). Publicado en línea http://www.ifad.org/evaluation/public_html/eksyst/doc/thematic/pl/organic.htm (11/12/2010)        [ Links ]

Jiménez Sánchez L., M. Hernández Juárez, O. Figueroa Rodríguez, y J. Nuñez Espinoza. 2002. Evaluación de los Proyectos de la Iniciativa de Nutrición Humana Apoyados por la Fundación W.K. Kellogg (Evaluation of the Projects of the Human Nutrition Initiative Supported by the W.K. Kellogg Foundation). Colegio de Postgraduados Área de Evaluación y Planeación de Programas y Proyectos de Desarrollo Rural, Montecillo, México.         [ Links ]

Kennedy E. 2004. Food Security, Overweight, and Agricultural Research — A View from 2003, en Journal of Food Science, 69(1), 18-20.         [ Links ]

Pretty J., and R. Hine. 2001. Reducing Food Poverty with Sustainable Agriculture: A Summary of New Evidence. Recuperado de www.essex.ac.uk/ces/esu/occasionalpapers/SAFErepSUBHEADS.shtm (15/03/2011)        [ Links ]

Santos L. M, P., P. N. Araújo M., C. Martins M., S. Veloso I., P. Assunção M., e M. C. Santos S. 2007. Avaliação de políticas públicas de segurança alimentar e combate à fome no period 1995-2002. 2 — Programa de Alimentação do Trabalhador en Cad. Saúde Pública, Rio de Janeiro, v. 23, n. 8, Aug. Recuperado de http://www.scielo.br/pdf/csp/v23n8/20.pdf (12/05/2011)        [ Links ]

Marzabal Neves E., M. Menten J. O., M. Menten M., e N. Campos Trombeta. 2009. Brasil: demanda e perspectivas en Defesa Vegetal (Octubre, 2009). Associacao ANDEF (Nacional de Defesa Vegetal). Published http://www.andef.com.br/revista/arquivos/dv_out09.pdf (10/05/2014)        [ Links ]

Max-Neef M. 1991. Human Scale Development: Conception, Application and Further Reflections. Apex Press, New York.         [ Links ]

Nwanze K. 2009. Smallholder farming key to development in Latin America and the Caribbean. IFAD Editorial. Publicado en línea www.ifad.org/events/op/2009/editorial_brazil.htm. (20/07/2010)        [ Links ]

Nuñez J. F. 2008. Redes sociales de comunicación para el desarrollo rural en zonas marginadas de Latinoamérica (ALC): Modelización del desarrollo. Centro de Cooperación y Desarrollo. Universidad Politécnica de Cataluña. Memoria de actividades 2007-2008. Publicado in https://www.upc.edu/ccd/el-ccd-1/memorias-anuales-de-actividades/memoria-2007-2008/view        [ Links ]

PAHO (Panamerican Health Organization). 2009. Promising Agriculture & Food policies and innovations to better health and nutrition in Latin America and the Caribbean Project. Recuperado de http://www.paho.org/equity/index.php?option=com_docman&task=doc_download&gid=7&Itemid=158. (15/05/2014)        [ Links ]

Pinheiro A. R de O., y Carvalho M. de F. C. C. 2010. Transforming the hunger problem into food and nutritional approach: a continuous social inequality, en Ciência & Saúde Coletiva Ciênc. saúde coletiva vol.15 n.1 Rio de Janeiro Jan.         [ Links ]

Pérez-Ferrer C., K. Lock, and J. A. Rivera. 2010. Learning from international policies on trans-fatty acids to reduce cardiovascular disease in low- and middle-income countries, using México as a case study, en Health Policy and Planning, 25, 39-49.         [ Links ]

Rivera, J. 2009a. Conclusions: Mexican Agriculture and NAFTA — The Challenges Ahead. In: NAFTA and the Campesinos: The Impact of NAFTA on Small-Scale Agricultural Producers in Mexico and the Prospects for Change. (eds) J. M. Rivera, S. Whiteford, M. Chávez (University of Scranton Press, Chicago) pp: 171-178.         [ Links ]

Rivera, J. 2009b. Improving nutrition in México: the use of research for decision making. In: Nutrition Reviews, 67(Suppl. 1), S62-S65.         [ Links ]

Romieu I., M. Hernández-Avila, J. A. Rivera, T. M. Ruel, and S. Parra. 1997. Dietary studies in countries experiencing a health transition: Mexico and Central America. The American Journal of Clinical Nutrition 65:1159S-1165S. Recuperado de http://ajcn.nutrition.org/content/65/4/1159S.long (22/03/2011)        [ Links ]

Ruel M. T., N. Minot, and L. Smith. 2005. Patterns and determinants of fruit and vegetable consumption in sub-Saharan Africa: a multicountry comparison. International Food Policy Research Institute and World Health Organization. Publicado en línea www.who.int/dietphysicalactivity/publications/f&v_africa_economics.pdf (09/10/2010)        [ Links ]

SSA (Secretaría de Salud de México. 2007. Programa Nacional de Salud 2007-2012. Por un México sano: construyendo alianzas para una mejor salud (National Health Program 2007-2012. For a healthy Mexico: building alliances for better health. Secretaría de Salud. Recuperado de, www.alianza.salud.gob.mx/descargas/pdf/pns_version_completa.pdf. (04/03/2011)        [ Links ]

 

Notes

³Other examples of regional networking include: 1) in the case of CEPROM, the development of good working relationships with the Spanish NGO Manos Unidas, in addition to with an array of locally-based organizations, helped them act as an effective coordinator of efforts to rebuild in the wake of the 2007 earthquake that devastated rural communities in the region; and 2) SERTA has managed to significantly extend the reach of its work by supporting the creation of a number of independent NGOs, the seeds for which were initially planted by SERTA projects. Accredita, Giral, and Geração Futuro offer microcredit, technological training and education, and youth-focused arts-based human development projects respectively. Through the maintenance of close working relationships, both SERTA and the fledgling organizations it helped to create benefit from increased possibilities for action.

⁴In addition to decreasing the amount of small-scale subsistence-based agriculture in the region, this NAFTA-facilitated shift led to an increase in the pressure on the area's fragile natural resource base. Indeed, research participants note that the industrial production practices of LALA and Tyson have depleted water resources to the point where wells must now be dug to 300 meters in order to access the water table, and that this has led to serious problems of heavy metal contamination. A GRINVIN-URUZA agronomist explained that neither Tyson nor LALA engage in any rural development activities to offset the significant social and environmental impacts of their presence. He (and many locals) felt strongly that the state or national government have a responsibility to legislate them to do so, though there was no sign, and little hope, that this would be likely to occur.

⁵Sale of unhealthy foods in schools, including potato chips and sugar-rich sodas, was recently outlawed in Mexico; however, the effects of the policy have yet to be determined.

⁶It is worth noting that the Minister in charge of family farming in Brazil, who played an integral role in the implementation of the one million cistern program, once worked for an organization participating in the Human Nutrition Initiative.

⁷Both Peru and Mexico have legislation regulating the organic sector; however in both countries government action has been largely limited to a regulatory role. While some state support for organic production and consumption exists, for example in the Mexican state of Chiapas subsidies for organic certification are available, this support is still very limited in nature, generally focused on the export-oriented organic sector, and cannot be considered comprehensive in a way that is comparable to the Brazilian framework.

⁸It is important to note that, in spite of these reservations, GRINVIN-URUZA has collaborated with government agencies in the past, and the legacies of this cooperation are still evident; however, in recent years linkages with government bodies has declined to the point of near non-existence.

⁹The writing of this article, done in collaboration with HNIN members, is in and of itself a manifestation of the work to build linkages, integrate information and experiences from a variety of contexts. Indeed, the creation of this article and the field work that contributed to its writing serve as proof that the past 15-20 years of work done by the HNIN (and a range of other actors from the public and private sectors) to create integrated networks of people furthering a rural development agenda has had some success.