Food and Nutrition Policies and Programs under the Colombian market’s logic

López, Lorena Patricia Mancilla; Delgado, Carlos Enrique Yepes; Marín, Gloria Molina

doi:10.1590/1413-812320202511.06142019

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ARTICLE • Ciênc. saúde coletiva 25 (11) • Nov 2020 • https://doi.org/10.1590/1413-812320202511.06142019 copy

Food and Nutrition Policies and Programs under the Colombian market’s logic

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This paper aims to understand the meanings of food and nutrition policies for beneficiary mothers and for technicians designing and implementing said policies. The Grounded Theory method was employed. The data collection techniques adopted were the semi-structured interview and the focus group. The participants were beneficiaries of food and nutrition programs, with a minimum two-year experience, and technicians with five-year experience in designing or implementing these policies and programs. Food and nutrition policies are conceived and managed under a market logic, which has required an institutional framework that adopted this commercial model to provide public services, which is implemented in the scheme of outsourcing third parties, especially private companies, who implement these policies to achieve financial profitability. The market is imposed as the benchmark for the State’s actions, and, therefore, the State’s action is limited the oversight of outsourced actions, and food policies become devices for the diversion of public resources to the private sector.

Key words
State; Food and nutrition programs and policies; Nutrition in public health; Food assistance; Outsourced services

Scope	Food and nutrition policies and programs	Target population	Intervention type
National	State Policy for the Comprehensive Development of Early Childhood: from Zero to Always (Law 1804 of 2016).	. Pregnant women. . Nursing mothers. . Children under the age of two.	Family Environment Modality: pedagogical processes of training and support for the family, caregivers, and pregnant women. The traditional Family, Women, and Childhood program -FAMI- belongs to this modality.
		Children aged 2-5 years.	Institutional Environment Modality. Children are assisted in nurseries called Integral Development Centers -CDI-. They receive food and pedagogical care from professionals. This has a daily duration of 5 or 8 hours.
		Children aged 2-5 years.	Community Modality: Family Welfare Community Homes -HCBF-. The children attend for eight hours a day at a house of a community mother, known as a community mother, where they carry out some recreational activities and receive food.
	Families in Action (Social Protection Network against Extreme Poverty. Document of the National Social Policy Council # 102 of 2006).	Children under the age of six.	Economic transfer to the mother of the beneficiary child, conditional on attendance at the growth and development program in a health care institution.
Provincial and local	Antioquia Food and Nutritional Improvement Plan -MANA- (Ordinance # 46 of 2016 of the Departmental Assembly of Antioquia).	Children under the age of six.	It provides a food allowance consisting of fortified cookies and milk and also performs an anthropometric assessment.
Provincial and local	Good Start Antioquia (Ordinance # 26 of 2015 of the Departmental Assembly of Antioquia) and Good Start Medellín (Agreement # 14 of 2004 of the Council of Medellín).	. From pregnancy to 23 months of age. . From pregnancy to five years of age in a rural zone. . From pregnancy to three years of age in a prison and penitentiary complex.	Family Environment Modality: promotes comprehensive development by enhancing the educational role of the family and caregivers. It holds educational group nutrition meetings, family counseling, anthropometric assessment and delivery of food packages.

Characteristics
# Interview	Type of interview	Area of residence	Age	Sisbén Level	Educational level	Role in the program	Participates in several programs
1	I	Urban	20	1	Secondary	Beneficiary	No
4	I	Urban	41	2	Secondary	Leader mother	No
5	I	Rural	43	2	Elementary	Leader mother	Yes
7	I	Rural	58	1	Elementary	Beneficiary	Yes
8	I	Rural	41	1	Elementary	Beneficiary	Yes
9	I	Rural	41	2	Elementary	Beneficiary	Yes
10	I	Rural	35	1	Elementary	Beneficiary	Yes
11	I	Urban	18	1	Technician	Beneficiary	Yes
12	I	Urban	35	2	Technician	Beneficiary	Yes
14	I	Urban	18	1	Technician	Beneficiary	No
15	I	Urban	48	1	Elementary	Beneficiary	No
16	I	Urban	38	2	Secondary	Beneficiary	Yes
17	I	Urban	42	2	Technician	Beneficiary	Yes
18	I	Urban	53	1	Elementary	Beneficiary	No
19	I	Urban	32	1	Technician	Beneficiary	No
20	I	Rural	23	1	Technician	Beneficiary	Yes
2	G	Urban	35	1	Elementary	Beneficiary	Yes
	G	Urban	54	1	None	Beneficiary	Yes
	G	Urban	77	2	Elementary	Beneficiary	Yes
	G	Urban	35	1	None	Beneficiary	Yes
26	GF	Rural	28	1	Secondary	Beneficiary	No
	GF	Urban	32	1	Technician	Beneficiary	No
	GF	Urban	20	1	Technician	Beneficiary	No
	GF	Urban	21	1	Technician	Beneficiary	No
	GF	Urban	26	1	Technician	Beneficiary	No
	GF	Rural	31	1	Secondary	Beneficiary	No
	GF	Rural	21	1	Technician	Beneficiary	No
	GF	Rural	43	1	Elementary	Beneficiary	No
	GF	Rural	23	1	Elementary	Beneficiary	No
	GF	Rural	35	1	Elementary	Beneficiary	No
	GF	Urban	31	1	Elementary	Beneficiary	No
	GF	Rural	32	2	Elementary	Beneficiary	No
	GF	Rural	22	1	Secondary	Beneficiary	No
	GF	Urban	19	1	Secondary	Beneficiary	No

# Interview	Role in the policy or program	Territorial level	Gender	Age	Educational level	Years of
experience with the PPANs	Formulación	Nacional	Femenino	54	Universitario	> 8
21	Formulation	National	Female	54	Higher education	> 8
22	Formulation	National	Female	43	Postgraduate	> 8
23	Formulation	National	Female	35	Postgraduate	> 8
24	Formulation	National	Female	40	Postgraduate	> 8
3	Coordination	Municipal	Male	41	Higher education	> 8
6	Coordination	Departmental	Female	38	Postgraduate	8
13	Implementation	Municipal	Female	45	Higher education	> 8
18	Implementation	Departmental	Female	30	Higher education	5
25	Implementation	Municipal	Female	41	Technician	5

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

LPM López, CEY Delgado and GM Marín have equally participated in the entire construction process of the manuscript, which implies contributions in the design of the work, analysis of the information, drafting and approval of the final version, and, thus, its content.