While recent evidence established a positive causal relationship between some social protection programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho. This study used cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey to examine the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people living in poverty. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Among the 3 506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use, educational attainment, and school enrolment. Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females and higher odds of educational attainment and school enrolment among males. The study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. The author recommends implementing and expanding such social protection initiatives to improve the well-being of vulnerable adolescents.
Poverty and health
This paper documented the contexts in which women selling sex in Kampala Uganda meet and provide services to their clients, using qualitative data from semi-structured interviews with 20 women 18 years or older, who were self-identified as sex workers. Women met clients in physical and virtual spaces. Physical spaces included venues and outdoor locations, and virtual spaces were online platforms like social media applications and websites. Of the 20 women included, 12 used online platforms to meet clients. Generally, women from a clinic sample were less educated and predominantly unmarried, while those from a snowball sample had more education, had professional jobs, or were university students. Women from both samples reported experiences of stigma, violence from clients and authorities, and challenges accessing health care services due to the illegality of sex work. Even though all participants worked in settings where sex work was illegal and consequently endured harsh treatment, those from the snowball sample faced additional threats of cybersecurity attacks, extortion and high levels of violence from clients. To reduce risk of HIV acquisition among women who sell sex, the authors suggest that researchers and implementers consider these differences in contexts, challenges, and risks to design innovative interventions and programs that reach and include all women.
This study explored how food insecurity influences child marriage practices in Chiredzi, Zimbabwe. It used mixed methods, including participant-led storytelling and key informant interviews. A total of 1,668 community members participated in the story-telling, while 22 staff participated in interviews. The authors found that food insecurity was a primary concern among community members and was among the contextual factors of deprivation that influenced parents’ and adolescent girls’ decisions around child marriage. Parents often forced their daughters into marriage to relieve the household economic burden. At the same time, adolescents were found to be initiating their own marriages due to limited alternative survival opportunities and within the restraints imposed by food insecurity, poverty, abuse in the home, and parental migration. COVID-19 and climate hazards exacerbated food insecurity and child marriage, while education was assessed to be a modifier that reduces girls’ risk of marriage. The authors suggest that child marriage programming in humanitarian settings should be community-led and address the gender inequality that underpins child marriage. They argues that programming must be responsive to the diverse risks and realities that adolescents face to address intersecting levels of deprivation.
This study explored barriers to access health and nutrition services in drought and food insecurity emergency affected districts in north-east Uganda. The authors interviewed 30 patients and 20 Village Health Teams from 15 districts and used thematic data analysis on the findings. The majority of respondents reported that difficulties in access to health and nutrition services, with various sociocultural, economic, environmental, health system, and individual barriers. The study identified several modifiable barriers that are addressed in proposals for comprehensive interventions in the paper.
This paper explores the impacts of COVID-19 and past pandemics on food security and key strategies that could be put in place to manage these impacts on security. The coronavirus pandemic deepened disruptions in the flow of farm workers and farm operations leading to post-harvest food losses, and diets were affected. The authors recommend future responses to prevent and mitigate the effects of pandemics on food security consider inter-connected pro-active policy, program, and institutional actions.
A broken sewerage system in Bophelong near the Vaal River in Gauteng, forces people to live “like pigs”, says environmental activist Lawrence Majoro. The department of water and sanitation acknowledges the Vaal is “one of the worst polluted rivers in South Africa”, leaving residents exposed to diseases like cholera. In this episode of Bhekisisa’s monthly television show, Health Beat, viewers are taken to see the Emfuleni municipality in Vanderbijlpark’s rundown sewers, with input from an infectious diseases expert and a water scientist on the implications if water treatment services don’t improve.
This study investigated how water and food insecurity were associated in nationally representative samples of individuals from 25 low- and middle-income countries, using data from the Individual Water Insecurity Experiences Scale and the Food Insecurity Experience Scale administered to 31 755 respondents, measuring insecurity in the previous 12 months. The likelihood of experiencing moderate-to-severe food insecurity was higher among respondents also experiencing water insecurity, including in sub-Saharan Africa. The results suggest that water insecurity should be considered when developing food and nutrition policies and interventions and the authors propose research to understand the paths between these insecurities.
This study explored the drivers of child marriage in specific contexts in Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia, combining a household survey among youth with focus group discussions and interviews conducted with youth, parents and community stakeholders. A lack of education was associated with the occurrence of child marriage in Ethiopia, Kenya and Zambia. In all countries, teenage pregnancy was associated with child marriage. In Ethiopia, Kenya and Mozambique, fathers’ education seemed a protective factor for child marriage. In all countries, child marriage was driven by difficult economic circumstances, which were often intertwined with disapproved social circumstances, in particular teenage pregnancy, in case of Kenya, Malawi, Mozambique and Zambia. These circumstances made child marriage an ‘acceptable practice’. The authors found that child marriage is a manifestation of social norms, particularly related to girls’ sexuality, which are intersecting with other factors at individual, social, material, and institutional level – most prominently poverty or economic constraints. The authors argue that efforts to prevent child marriage need to take these realities of girls and their families into account.
This study determined the prevalence of limited handwashing facility and its associated factors in sub-Saharan Africa. Data was obtained from the Demographic and Health Surveys in 29 sub-Saharan African countries since January 1, 2010. The pooled prevalence of limited handwashing facilities was found to be 66%. Having a limited handwashing facility was associated with having a household head aged between 35 and 60, having a mobile type of hand washing facility, unimproved sanitation facility, water access requiring more than a 30 min round trip, living in an urban residential area, having low media exposure, low educational level, low income level and being in a lower middle-income level and having more than three children.
This study was implemented in central Malawi in 2017 to understand the different roles that Malawian men and women play in child nutrition. It involved interviews (76), focus group discussions and in-depth interviews. The authors found that women carried a disproportionate workload in supporting child nutrition compared to men, and that their heavier workloads in other areas often prevented them from being able to meet children’s food needs. There were some shifts in gender roles with men taking up responsibilities typically associated with women, but this did not necessarily increase women’s power within the household. Women continued to be primarily responsible for the food, care, and health of the household. The authors suggest that improving gender equality and child nutrition will require efforts to redistribute gendered work and encourage men to move towards shared power with women over household decision-making and control over income.