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自分が読んで興味深く感じた英文記事を中心に取り上げる予定です

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機能主義的な見方

 
緊急医療で「トリアージ」という言葉もあるくらいですし、有効な資源を効果的に分類しなくてはいけない状況はいろいろな分野でも大切なことでしょう。Atlanticで紹介されていたのは食糧支援での効果的な資源配分の方法でした。

The Case Against Feeding Every Hungry Child
MAR 15 2013, 2:57 PM ET 52
Why you can only solve a food crisis by targeting those starving most.

Say you're an aid worker toiling in an area that's been devastated by an overwhelming calamity -- a war-torn conflict zone, a famine-stricken village, or a crowded refugee camp. You have a finite amount of emergency food and see far too many outstretched hands. The kids around you are all much too short and scrawny for their ages, and most seem sickly and under-fed. What's more, many of the youngsters show sure signs of acute malnutrition -- they literally are skin and bones.

Who do you feed first?

In this type of situation, aid groups might be tempted to spread out the food supplies to as many needy children as possible, giving each a small amount until there's nothing left. But according to a new study out of Stanford's Graduate School of Business and the University of Bergen in Norway, relief workers should instead give as much emergency food as possible to only those children who are in the greatest danger of dying. The rest should get nothing.

この記事の元になった調査は下記リンク先で全文も読むことができます。

Ready-to-use food-allocation policy to reduce the effects of childhood undernutrition in developing countries
Yan Yanga, Jan Van den Broeckb, and Lawrence M. Weinc,1
Author Affiliations
Edited by Burton H. Singer, University of Florida, Gainesville, FL, and approved January 28, 2013 (received for review September 14, 2012)

Abstract
Several aid groups have proposed strategies for allocating ready-to-use (therapeutic and supplementary) foods to children in developing countries. Analysis is needed to investigate whether there are better alternatives. We use a longitudinal dataset of 5,657 children from Bwamanda to construct a bivariate time-series model that tracks each child’s height-for-age z score (HAZ) and weight-for-height z score (WHZ) throughout the first 5 y of life. Our optimization model chooses which individual children should receive ready-to-use therapeutic or supplementary food based on a child’s sex, age, HAZ, and WHZ, to minimize the mean number of disability-adjusted life years (DALYs) per child during 6–60 mo of age [which includes childhood mortality calculated from a logistic regression and the lifelong effects of stunting (i.e., low HAZ)] subject to a budget constraint. Compared with the strategies proposed by the aid groups, which do not use HAZ information, the simple strategy arising from our analysis [which prioritizes children according to low values of a linear combination of HAZ, WHZ, and age and allocates the entire budget to therapeutic (i.e., 500 kcal/d) food for the prioritized children] reduces the number of DALYs by 9% (for the same budget) or alternatively incurs the same number of DALYs with a 61% reduction in cost. Whereas our qualitative conclusions appear to be robust, the quantitative results derived from our analysis should be treated with caution because of the lack of reliable data on the impact of supplementary food on HAZ and WHZ, the application of our model to a single cohort of children and the inclusion and exclusion errors related to imperfect food targeting.

調査の全文。

you can only solve a food crisis by targeting those starving mostとAtlanticの記事が書いた根拠となるのはAbstractでは以下の部分でしょう。

Compared with the strategies proposed by the aid groups, which do not use HAZ information, the simple strategy arising from our analysis [which prioritizes children according to low values of a linear combination of HAZ, WHZ, and age and allocates the entire budget to therapeutic (i.e., 500 kcal/d) food for the prioritized children] reduces the number of DALYs by 9% (for the same budget) or alternatively incurs the same number of DALYs with a 61% reduction in cost.

Atlanticの記事ではControversialであることも理解しているし、こういう研究がなくても援助の現場ではこのような判断は常になされていることを指摘しています。

Stanford acknowledged that the findings might be controversial -- who wants to keep food out of the hands of starving children, after all, even if they're less-starving than others? But Wein said that in reality, aid groups already make cutoffs to determine which children are fed first in emergency situations, based on wasting, disease, or other metrics.

"They already draw a line in the sand and say 'anyone worse than this, we're going to go all out and save you,'" he said.

This finding, it seems, recommends concentrating life-saving food resources on only one side of that line.


論文を見てもらうと分かるんですが、数式を使ったデータ分析なんですよね。政治や行政が好きになれないのは、政策を決めるさいにはどうしてもこのような機能主義的な分析が幅をきかせやすいことでしょう。「有限な資源の効率的な配分」が命題としても、you can only solve a food crisis by targeting those starving mostという結論をどんな状況にも機械的に当てはめるようにはなって欲しくはありません。



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