Poverty and health

Zimbabwe National Nutrition Survey 2010
National Nutrition Surveillance Assessments: July 2010

New data on the nutritional status of Zimbabwe’s children reveals that more than one third of Zimbabwe’s children under the age of five are chronically malnourished and consequently stunted. Zimbabwe’s current food production remains too low to meet national requirements. Years of persistent droughts and the downturn of the Zimbabwean economy over the past decade have adversely affected food availability in many homes in Zimbabwe. The report calls for accelerated action to reverse chronic malnutrition and maintain the low levels of acute malnutrition highlighted by the report. Chronic malnutrition poses long-term survival and development challenges for Zimbabwe. The survey also shows plummeting exclusive breastfeeding rates. However, the low and stable rates of severe acute malnutrition that were found are a sign that the food security programmes supported by the international community are reaping benefits. The report also acknowledges the tremendous coping mechanisms of the Zimbabwean people at a time of great difficulty.

Zimbabwe's children enter new phase of hardship
Schlein L: Voice of America News, 18 July 2007

The UN Children's Fund says the children of Zimbabwe have entered a new phase of hardship. UNICEF says millions of children are missing out on their most basic needs because of a severe drought and the dramatic deterioration of Zimbabwe's economy. The unprecedented hardship facing Zimbabwe is biting particularly hard among children and quality health care in the country's schools has all but collapsed.

Zimbabwe: New food security tool first for the region
Integrated Regional Information Network, 23 April 2008

Zimbabwe will be the first country in Southern Africa to adopt a new food security analysis tool, developed in Somalia in 2004. The Integrated Food Security Phase Classification Framework (IPC) categorises the severity of a situation using a five-phase scale ranging from 'generally food secure' to 'famine/humanitarian catastrophe', based on comprehensive data on the impact of a crisis on food security and nutrition.

Zimbabwe’s child marriages on the rise as food runs short
Mutizwa G: CNBC Africa, August 2016

The author reports that food is becoming scarce in large parts of rural Zimbabwe with United Nations agencies and government warning more than one in three Zimbabweans may need food assistance by next March. The government has appealed for $1.5 billion in emergence support to cover the food and nutrition, agriculture, water, education, and health sectors. Mbire is a traditionally rain starved area, which lies in the Zambezi escarpment, near the border with Zambia. In Mbire, George Nyarugwe, the Acting District Administrator, said at the local clinics there was growing anecdotal evidence of forced child marriages with many of the young mothers telling nurses they were forced to marry because of the drought. Similar reports have been made in Mt Darwin in the country’s northeast and in Seke, near Harare, according to the Zimbabwe Vulnerability Assessment Committee report released in January. Between last December and April, UNICEF says 3,042 new child protection cases were reported in 65 districts in Zimbabwe, with child neglect showing the highest incidence at 568, followed by sexual abuse at 306 and physical abuse at 218. There are plans to train government, non-government organisation and community social workers to better protect children in drought afflicted areas.

ZimVAC Rapid Assessment Report
Government of Zimbabwe Food and Nutrition Council, Zimbabwe Vulnerability Assessment Committee: Food Security Cluster, April 2016

In response to the advent of the El Nino phenomena which has resulted in the country experiencing long dry spells, the ZimVAC undertook a rapid assessment focussing on updating the ZimVAC May 2015 results. The process followed a 3 pronged approach which were, a review of existing food and nutrition secondary data, qualitative district Focus Group Discussions (FGDs) and for other variables a quantitative household survey which in most cases are representative at provincial and national level. This report provides a summation of the results for the 3 processes undertaken. The report concludes that there is an urgent need to strengthen and expand current livestock support programmes to prevent further deterioration of livestock condition and deaths; to implement a Drought Relief Policy and Food Deficit Mitigation Strategy through multi-sectoral participation of all relevant Government structures, and to adopt registration, distribution and monitoring strategies that are inclusive. Gender based violence cases were found to be on the increase in most districts, while noting that this may be attributable to an increase in awareness and reporting and not necessarily to an increase in incidents.

‘Land occupations are the new way of doing land reform’
Food Sovereignty Campaign: December 2011

The Food Sovereignty Campaign is a movement of emerging farmers and farm dwellers is based in the Western and Northern Cape provinces. They point out that while property rights are enshrined in the constitution of the country, in a land reform programme based on a ‘willing buyer, willing seller’ model, land is being priced out of reach of the poor and of the state. The authors argue that there is no provision in law, as in Brazil, to allow hungry people to grow food on unused land of absent owners. Land occupations are happening in South Africa, fuelled by growing frustration among the rural poor due to persistent and unaddressed inequality. The Food Sovereignty Campaign argues that land occupations are an expression amongst small farmers and farm dwellers of their frustration over their landlessness, powerlessness and exploitation.

‘No access to sanitation’ – the big euphemism
de Albuquerque C: United Nations Special Rapporteur on the human right to safe drinking water and sanitation, 15 November 2013

The United Nations Special Rapporteur on the human right to safe drinking water and sanitation, Catarina de Albuquerque, has warned that the sanitation target set by the UN Millennium Development Goals (MDG) is today the most off-track of all, leaving around one billion people still practicing open defecation on a daily basis, and one-third of the world’s population ‘without access to improved sanitation.’ The human rights expert hailed the UN General Assembly’s decision declaring 19th of November as UN World Toilet Day. “I hope this declaration galvanises national and international action to reach the billions of people who still do not benefit from this basic human right,” the Special Rapporteur said.

‘Our land, our lives’: Time out on the global land rush
Oxfam Briefing Note: October 2012

In the last decade, enough agricultural land has been sold off to grow food for a billion people, which is equivalent to the number of people who go hungry in the world each night, according to Oxfam. Over 60% of investments in agricultural land by foreign investors between 2000 and 2010 were in developing countries with serious hunger problems. However, two-thirds of those investors plan to export everything they produce on that land. While Oxfam supports greater investment in agriculture and to small-scale producers, it argues that the unprecedented rush for land has not been adequately regulated or policed to prevent land grabs. This means that poor people continue to be evicted, often violently, without consultation or compensation. Many lose their homes and are left destitute, without access to the land they rely on. Oxfam calls on the World Bank to temporarily freeze investments involving large-scale land deals so it can review its advice to developing countries, help set standards for investors, and introduce more robust policies to stop land grabs.

‘These are not luxuries, it is essential for access to life’: Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa
Hanass-Hancock J; Nene S; Deghaye N; Pillay S: African Journal of Disability 6(0), a280, 2017

Middle-income countries are home to a growing number of persons with disabilities but with limited evidence on the factors increasing economic vulnerability in people with disabilities in these countries. This article presents data related to elements of this vulnerability in one middle-income country, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs. A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices. The development of poverty alleviation and social protection mechanisms in middle-income countries like South Africa should, the authors argue, better consider diverse disability-related care and support needs not only to improve access to services such as education and health but also to increase the effect of disability-specific benefits and employment equity policies

“If my husband leaves me, I will go home and suffer, so better cling to him and hide this thing”: The influence of gender on Option B+ prevention of mother-to-child transmission participation in Malawi and Uganda
Flax V; Yourkavitch J; Okello E; Kadzandira J; Katahoire A; Munthali A: PLOS One, doi: https://doi.org/10.1371/journal.pone.0178298, 2016

The role of gender in prevention of mother-to-child transmission (PMTCT) participation under Option B+ has not been adequately studied, but it is critical for reducing losses to follow-up. This study used qualitative methods to examine the interplay of gender and individual, interpersonal, health system, and community factors that contribute to PMTCT participation in Malawi and Uganda. The authors conducted in-depth interviews with women in PMTCT, women lost to follow-up, government health workers, and stakeholders at organisations supporting PMTCT as well as focus group discussions with men. They analysed the data using thematic content analysis. The authors found many similarities in key themes across respondent groups and between the two countries. The main facilitators of PMTCT participation were knowledge of the health benefits of ART, social support, and self-efficacy. The main barriers were fear of HIV disclosure and stigma and lack of social support, male involvement, self-efficacy, and agency. Under Option B+, women learn about their HIV status and start lifelong ART on the same day, before they have a chance to talk to their husbands or families. Respondents explained that very few husbands accompanied their wives to the clinic, because they felt it was a female space and were worried that others would think their wives were controlling them. Many respondents said women fear disclosing, because they fear HIV stigma as well as the risk of divorce and loss of economic support. If women do not disclose, it is difficult for them to participate in PMTCT in secret. If they do disclose, they must abide by their husbands’ decisions about their PMTCT participation, and some husbands are unsupportive or actively discouraging. To improve PMTCT participation, the authors propose that Ministries of Health use evidence-based strategies to address HIV stigma, challenges related to disclosure, insufficient social support and male involvement, and underlying gender inequality.

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