Poverty and health

Central African farmers gear up to influence future agricultural policy in their region
Van Seters J: ECDPM Talking Points, 9 August 2012

Food security in Central Africa has been worsening over the last two decades. To address this challenge, Central African states have embarked on a process to develop a common agricultural policy and to put the Comprehensive Africa Agriculture Development Programme (CAADP) into practice. Farmers’ organisations from all member states are now shaping up to influence these policy-making processes at national and regional level in the coming months. The main challenge for them is to identify proposals that respond to the needs and priorities of all the farmers they represent, and to ensure that policy makers will take them into account during negotiations. In doing so, they could learn from their counterparts in West Africa, argues the writer of this blog, the Deputy Programme Manager for Food Security at ECDPM. West African farmers managed to play an important role in the formulation of the region’s common agricultural policy through their regional farmers’ network ROPPA. Key to ROPPA’s success was its participation in decision-making organs and meetings, but more so, its preparations for these events, which included consultations of ROPPA’s members at regional, national and local levels, analytical work to check and back their arguments, and a continuous search for allies among national and regional authorities and non-state actors.

Characteristics of community savings groups in rural Eastern Uganda: opportunities for improving access to maternal health services
Mutebi A; Kananura R; Ekirapa-Kiracho; et al.: Global Health Action 10(S4)82-91, 2017

Data on the characteristics of community-based savings groups were collected from 247 community-based savings group leaders in the districts of Kamuli, Kibukuand Pallisa using a self-administered open-ended questionnaire, and in-depth interviews with seven community-based savings group leaders. Ninety-three percent of the community-based savings groups said they elected their management committees democratically to select the group leaders and held meetings at least once a week. Eighty-nine percent used metallic boxes to keep their money, while 10% kept their money in mobile money and banks. The community-based savings groups were formed mainly to increase household income, to develop the community and to save for emergencies. The community-based savings groups faced challenges of high illiteracy among the leaders, irregular attendance of meetings, and lack of training on management and leadership. Saving groups in Uganda are reported to have the basic required structures, but with challenges in relation to training and management of the groups and their assets, calling for technical support in these areas.

Characteristics of households experiencing under- five deaths: A case of Tropical Institute of Community Health and Development (TICH) partnership districts
Oindo C, Otieno C, Okeyo N, Olayo R, Muga R and Kaseje C: African Journal of Food, Agriculture, Nutrition and Development: 2009

In this paper, child mortality and its relationship to specific variables relating to background and proximate factors were considered. Between 2006 and 2007, proportions of households with child deaths declined in all the districts and the proportions of health facility deliveries decreased in households that experienced under-five deaths. Measles vaccination coverage was lower among households with child deaths and so was use of insecticide-treated nets (ITNs). Households living in poor conditions experienced the highest proportions of child mortality. Education of mothers remains a significant determinant of child mortality along with health facility delivery. No difference in child mortality was realized between mothers having primary education and those that had none. Better health-seeking behaviour should be encouraged to help stem the high child mortality rates.

Child disability screening, nutrition, and early learning in 18 countries with low and middle incomes: Data from the third round of UNICEF's Multiple Indicator Cluster Survey (2005–2006)
Gottlieb CA, Maenner MJ, Cappa C and Durkin P: The Lancet 374(9704): 1831–1839, 28 November 2009

This study examined child disability screening and its association with nutrition and early learning in countries with low and middle incomes. Cross-sectional data for the percentage of children screening positive for or at risk of disability were obtained for 191,199 children aged 2–9 years old in 18 countries. Screening results were descriptively analysed according to social, demographic, nutritional, early-learning and schooling variables. A median 23% of children aged 2–9 years old screened positive for disability. For children aged 2–4, screening positive for disability was significantly more likely in children who were not breastfed and who did not receive vitamin A supplements. Children aged 6–9 who did not attend school screened positive for disability more often than did children attending school. These results draw attention to the need for improved global capacity to assess and provide services for children at risk of disability. Further research on childhood disabilities is needed in countries with low and middle incomes to understand and address the role of nutritional deficiencies and restricted access to learning opportunities.

Child health now: Together we can end preventable deaths
World Vision: October 2009

The epicentre of the child health emergency is sub-Saharan Africa and South Asia but, without a concerted and sustained effort in their countries, there’s little prospect of Millennium Development Goal 4 being met at a global level. The causes of this emergency vary according to the local context, and will require tailored responses by governments, donors and international institutions. Examples of good leadership exist in countries like Liberia, where President Ellen Johnson Sirleaf has used the peace dividend to triple health spending, withdraw user charges and focus on the prevention of malaria. The first tier of healthcare for children is the household level, and beyond that the immediate community. Yet relatively little attention is paid by most governments to low-cost and easy-to-deliver measures that can be taken at this level, which can have a decisive impact on child health, from hand washing and breastfeeding to early identification of pneumonia. World Vision estimates that a comprehensive package of family and community care alone could prevent 2.5 million child deaths each year. What’s needed is a redefinition of health systems to incorporate family- and community-level care, in tandem with a fundamental rebalancing of public spending placing much greater emphasis on prevention. Safe water and sanitation and basic hygiene are necessary to achieve this aim – the World Health Organization estimates that they could together save US$7 billion in health care costs each year.

Child Nutritional Status And Household Patterns In South Africa
Bomela N: African Journal of Food, Agriculture, Nutrition and Development 7(5): 1684-5374, 2007

The influence of person-related and household related characteristics on the nutritional status of children were assessed, taking into account variables such as, gender of household head, de jure and de facto household head, relationship of child to household head, size of household, type of toilet facility and type of dwelling. Chronic malnutrition and underweight were significantly pronounced in children from households with de jure household heads.

Child poverty in Africa: An overview
Tsegaye S: African Child Policy Forum, 2008

This book aims to give a bird’s eye view of the situation of child poverty in Africa. It highlights the paradox of countries that have an abundance of natural resources, especially oil and diamonds, yet whose populations largely suffer from poverty, such as Angola, Equatorial Guinea and Nigeria. The book points to a symbiotic relationship between poverty and armed conflicts as Africa is slowly extricating itself from the intertwined problems of conflict, poverty, hunger and illiteracy. The book argues that improved governance and increased investments in key social sectors have created an unprecedented sense of optimism. Nevertheless, millions of African children still struggle on the margins. At least 600 million children under the age of 18 are surviving on less than US$1 a day worldwide and 40% of these children live in developing countries.

Child survival in sub-Saharan Africa: the role of CAPGAN and regional child health practitioners and scientists
Heikens GT, Manary M, Sandige H and Kalilani L: Malawi Medical Journal 21(3): 94–95, September 2009

In a statement, the Commonwealth Association of Paediatric Gastroenterology and Nutrition (CAPGAN) calls for maternal, neonatal and child health to be more closely linked to improve child survival from HIV, diarrhoea and malnutrition. Colleges of Health Sciences, Nursing and Medicine should become important backbones of maternal and child health systems, through education and implementation research, and through training and retaining of their staff in HIV, diarrhoea and malnutrition in the widest sense. The statement presents that leadership, collaboration and country-capacity support, development of evidence-based guidelines and systems must be stimulated, to ensure coverage and monitoring of equity and progress in achieving Millennium Development Goals 4 and 5.

Children are on the brink of death in northeast Kenya
AllAfrica.com: 23 September 2009

The drought that has ravaged parts of northeastern Kenya, killing a large number of livestock, has affected the availability of milk, in turn undermining child nutrition, say officials. Most of the rural population in the areas where Save the Children is working is heavily dependent on relief food and many children are eating only one meal a day, of corn porridge. ‘This poor diet means they are missing out on vital nutrients, which can mean they grow up stunted and their brains and bodies can suffer permanent damage,’ the organisation said. Since July, the number of severely malnourished children seeking treatment at its northeastern emergency feeding centres has increased by 25%. ‘The government and donors need to be aware of the changing climate now and in future, and shape their policies accordingly,’ Philippa Crosland-Taylor, head of Oxfam in Kenya, said in August. ‘Emergency aid is urgently needed now, but in the long term we need to rethink policies to focus on mitigating the risks of droughts before they occur, rather than rushing in food aid when it is too late.’

Chronic Poverty Report 2004-2005

The Chronic Poverty Research Center's latest report examines what chronic poverty is and why it matters, who the chronically poor are, where they live, what causes poverty to be persistent and what should be done. A section of regional perspectives looks at the experience of chronic poverty in sub-Saharan Africa, South Asia, Latin America and the Caribbean, transitional countries and China. The report argues that the chronically poor need targeted support, social assistance and social protection.