Poverty and health

Agriculture and trade opportunities for Tanzania: Past volatility and future climate change
Ahmed SA, Diffenbaugh NS, Hertel TW and Martin WJ: WIDER Working Paper 2011/91, December 2011

The authors of this paper argue that Tanzania has the potential to substantially increase its maize exports to other countries, if global maize production falls due to supply shocks in major exporting regions. Tanzania may be able to export more maize at higher prices, even if it also experiences below-trend productivity. Future climate predictions suggest that some of Tanzania’s trading partners will experience severe dry conditions that may reduce agricultural production in years when Tanzania is only mildly affected. Tanzania could thus export grain to countries as climate change increases the likelihood of severe precipitation deficits in other countries while simultaneously decreasing the likelihood of severe precipitation deficits in Tanzania. Trade restrictions, like export bans, prevent Tanzania from taking advantage of these opportunities, foregoing significant economic benefits.

Agro-ecology and the right to food
De Schutter O: United Nations, March 2011

This report explores how States can and must achieve a reorientation of their agricultural systems towards modes of production that are highly productive, highly sustainable and that contribute to the progressive realisation of the human right to adequate food. Drawing on an extensive review of the scientific literature published in the last five years, de Schutter identifies agro-ecology as a mode of agricultural development with strong conceptual connections with the right to food. Moreover, agro-ecology delivers advantages that are complementary to better known conventional approaches such as breeding high-yielding varieties. In the report, de Schutter argues that the scaling up of these experiences is the main challenge today. Appropriate public policies can create an enabling environment for such sustainable modes of production, such as: prioritising the procurement of public goods in public spending rather than solely providing input subsidies; investing in knowledge by reinvesting in agricultural research and extension services; investing in forms of social organisation that encourage partnerships, including farmer field schools and farmers’ movements innovation networks; investing in agricultural research and extension systems; empowering women; and creating a macro-economic enabling environment, including connecting sustainable farms to fair markets.

Alcohol consumption in relation to maternal deaths from induced-abortions in Ghana
Asamoah BO and Agardh A: Reproductive Health 9:10, 6 August 2012

According to this paper, in Ghana, alcohol consumption and unwanted pregnancies are on the ascendancy. The authors examined the association between alcohol consumption and maternal mortality from induced-abortion, as well as the factors that lie behind the alcohol consumption patterns in the study population. They extracted data from the Ghana Maternal Health Survey 2007, identifying 4,203 female deaths through verbal autopsy, among which 605 were maternal deaths in the 12 to 49 year-old age group. Alcohol consumption was significantly associated with abortion-related maternal deaths. Women who had ever consumed alcohol, frequent consumers and occasional consumers were about three times as likely to die from abortion-related causes compared to those who abstained from alcohol. Maternal age, marital status and educational level were found to have a confounding effect on the observed association. The authors recommend that policy actions directed toward reducing abortion-related deaths should consider alcohol consumption, especially among younger women. Policy makers in Ghana should also consider increasing the legal age for alcohol consumption. In addition, information on the health risks posed by alcohol and abortion be disseminated to communities in the informal sector where vulnerable groups can best be reached.

Alternatives to the food crisis
Angus I: Pambazuka News, 15 May 2008

The regressive food policies imposed on poor countries by the World Bank and IMF are codified and enforced by the World Trade Organization's Agreement on Agriculture (AoA). The AoA, as Afsar Jafri of Focus on the Global South writes, is "biased in favour of capital-intensive, corporate agribusiness-driven and export-oriented agriculture." AoA should be abolished, and Third World countries should have the right to unilaterally cancel liberalization policies imposed through the World Bank, IMF, and WTO, as well as through bilateral free trade agreements such as NAFTA and CAFTA.

Ambient pollution and respiratory outcomes among schoolchildren in Durban, South Africa
Naidoo RN, Robins TG, Batterman S, Mentz G and Jack C: South African Journal of Child Health 7(4), 127-134, November 2013

The author examines associations between ambient air pollutants and respiratory outcomes among schoolchildren in Durban, South Africa, in a cross sectional survey of primary schools from within each of seven communities in two regions of Durban (the highly industrialised south compared with the non-industrial north) and measurement of particulate matter (PM), sulphur dioxide (SO2) and carbon monoxide at each school, and nitrogen oxides (NOx) at other sites. Children had a prevalence of asthma symptoms of any severity of 32%, higher in schools with higher SO2 levels. Schoolchildren from industrially exposed communities experienced higher covariate-adjusted prevalences of persistent asthma than children from communities distant from industrial sources. The authors indicate that the findings are strongly suggestive of industrial pollution-related adverse respiratory health effects among these children.

An assessment of current support strategies for patients with TB in KwaZulu-Natal
Lutge E, Ndlela Z and Friedman I: Health Systems Trust, November 2009

In order to ameliorate poverty among tuberculosis (TB) sufferers, a few initiatives to support patients with TB have been made in KwaZulu-Natal, South Africa, including free treatment at government hospitals and clinics, and nutritional supplementation and social grants. Although these programmes have been functioning for a number of years, they have never been formally assessed in terms of the costs involved, the effects on the target populations, and the responses of patients. A recent study in Brazil (Belo et al, 2006) investigated a range of support strategies for patients with TB that included material and financial assistance, improved health services support and better administrative organisation – from the patient's perspective. Such a study has not been undertaken in South Africa, however, and given the large amount of money spent on support to TB patients, this is necessary to better inform such programmes.

Analysing TB and poverty

While tuberculosis (TB) is not exclusively a disease of the poor, the association between poverty and TB is well established and widespread. Globally, the highest burden of TB is found in poor countries. Seventeen of the 22 countries that account for 80 per cent of the world’s TB burden are classified as low income and within countries the prevalence of TB is higher among the poor. This paper, produced by the EQUI-TB Knowledge Programme, analyses the existing evidence that TB causes or worsens poverty and that TB control (or elements of TB control) benefits the poor.

Analysing the food crisis: Key ways of improving food security
Nellemann C, MacDevette M and Manders T: GRID Arendal, 2009

This report provides the first summary by the UN of how climate change, water stress, invasive pests and land degradation may impact world food security, food prices and how we may be able to feed the world in a more sustainable manner. It offers short-, mid- and long-term recommendations for improving food security, such as regulating food prices and providing safety nets for the impoverished by reorganising the food market infrastructure and institutions that regulate food prices and provide food safety nets, avoiding biofuels that compete for cropland and water resources, reallocating cereals used in animal feed to human consumption, supporting small-scale farmers, increasing trade and market access, limiting global warming by promoting climate-friendly agricultural production systems and land-use policies, and raising awareness of the ecological pressures of increasing population growth and consumption.

Analysing the governance and political economy of water and sanitation service delivery
Harris D, Kooy M and Jones L: Overseas Development Institute Working Paper 334, August 2011

Failure to achieve desired human development outcomes in the water supply and sanitation sector over the last decade has prompted this re-assessment of sector strategies and a focus on issues of governance and political economy. The authors assess the applicability of the various political economy analysis (PEA) frameworks for the water and sanitation (WATSAN) sector, drawing out five key points to take into account when developing a sector level PEA framework. First, the sector’s diversity (both the sub-sectors of water supply, sanitation and geographical locations of sub-sector service delivery contexts urban, rural, peri-urban) does not mean that different elements of the WATSAN sector require the application of separate frameworks, but the different historical, institutional and political contexts do need to inform the tailoring of questions and areas of focus across the subsectors. Second, a multi-sector and multi-scalar analysis can help to identify actions and decision making influenced by external processes and actors operating at various scales. Third, a combined sector governance and political economy analysis for the sector is not recommended: a joint analysis requires considerable time and research, and leads to overly normative and prescriptive mindset preventing consideration of a full scope of non-obvious opportunities for intervention. Fourth, a PEA framework for WATSAN requires flexibility in its application to the sector. Fifth, a PEA WATSAN framework needs to focus on both process and outcomes: the majority of PEA and governance studies have failed to drive forward change in the water and sanitation sector.

Analysis: The future of food aid
IRIN, Johannesburg, 26 July 2013

By 2023 the number of food-insecure people is likely to increase by nearly 23 percent to 868 million (at a slightly faster rate than projected population growth of 16 percent). Despite improvements over the years, sub-Saharan Africa is projected to remain the most food-insecure region in the world. In the past decade global food aid, including the amount making its way to sub-Saharan Africa, has been on a downward trend. Only 2.5 million tons reached sub-Saharan Africa in 2011, whereas during the decade as a whole it ranged from just under three million tons to just over 5 million tons, according to World Food Programme (WFP) data. In this article IRIN presents views of some of the world’s leading experts on the future of food aid.