Both maternal HIV diagnosis and household food insecurity may increase maternal stress levels, and lead to unhealthy coping behaviours. In this study, researchers examined the independent associations of HIV, persistent household food insecurity and the synergistic effect of both on maternal stress. For 12 months after childbirth, they followed 232 Ghanaian women recruited prenatally from hospitals offering voluntary counselling and testing (VCT). They found that the proportion of HIV-positive women who lived in severe food insecure households increased over time. By contrast, the HIV-negative group living in severely food insecure households experienced a steady decline across time. HIV-infection and persistent household food insecurity were independently associated with high stress. Being both HIV-positive and persistently food insecure strongly and synergistically increased the risk for high maternal perceived stress. Comprehensive multidimensional intervention studies are needed to better understand how to reduce stress among HIV-positive women living in persistently food insecure households and how to reduce the likelihood of food insecurity in HIV-affected households in sub-Saharan Africa.
Poverty and health
This report is a call to action for the world to rediscover the importance of breastfeeding and for a commitment to support mothers to breastfeed their babies, especially in the poorest communities in the poorest countries. It calls for world leaders, international institutions and multinational companies to take action to ensure that every infant is given the life-saving protection that breastfeeding can offer. All countries should put breastfeeding at the centre of efforts to improve infant and child nutrition, and should develop specific breastfeeding strategies as well as including breastfeeding in their nutrition strategies. Developing countries should ensure that they address all of the obstacles identified in this report that deter optimal breastfeeding practices. The four major barriers are community and cultural pressures, the health worker shortage, a lack of maternity legislation and the promotion of formula by big business.
The aim of this study was to assess latrine coverage and the associated factors among the rural communities in district of Bahir Dar Zuria, Ethiopia. A community-based cross-sectional study was conducted on 608 households in district of Bahir Dar Zuria. Data were collected by means of a pretested, standardised questionnaire and observation checklist. Of the 608 households, 355 (58.4%) had pit latrines and only 220 (62%) were functional (providing services during data collection). One hundred and eighty-seven (52.7%) had been constructed two or more years prior to the time of the study and 202 (56.9%) latrines required maintenance. Latrine coverage in District of Bahir Dar Zuria was far from the national target of 100%. The availability of latrines was found to be affected by income level, frequency of visits by health workers, walking time from local health institutions, and distance from the urban area of Bahir Dar. Therefore, it is recommended that the frequency of supportive visits be increased and that special attention be given to households in inaccessible areas.
In order to reduce health inequities, there is a need to address the wider socioeconomic and structural factors that influence how people become sick, what risk factors they are exposed to, how they access services, and how they use those services. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. This joint statement argues that integrated policy approaches are necessary in order to address the complexity of health inequities, including through national social protection floors, which address income security and the goal to establish universal access to health care simultaneously. Health policy generally, and health equity in particular, to a large extent depend on decisions made in sectors other than health, and are fundamentally linked to several interrelated issues such as governance, environment, education, employment, social security, food, housing, water, transport and energy. It means that health outcomes cannot be achieved by taking action in the health sector alone, and that actions in other sectors are critical. Failing to address the social determinants of health has held back progress on existing global health and development goals, including the Millennium Development Goals. The joint statement outlines the actions to be taken to address the social determinants of health, sector by sector.
In this media briefing, Oxfam reveals that investors are targeting the world’s weakest-governed countries to buy land, and it calls on the World Bank to lead the fight against land grabs. It argues that the Bank is in a unique position to act because it sets international standards for land investments, provides finance for land deals and advises developing countries on land investments. Oxfam’s analysis reveals that over three quarters of the 56 countries where land deals were agreed between 2000 and 2011 scored below average on four key governance indicators. The 23 least developed countries account for more than half of the recorded land deals over this period. Researchers assessed a range of factors including voice and accountability (e.g. whether citizens participate in selecting their government), rule of law, the quality of private sector regulation, and control of corruption. They found poor governance is good business for investors looking to secure land quickly and cheaply. Investors seem to be cherry-picking countries with weak rules and regulations. This can spell disaster for communities if these deals result in their homes and livelihoods being snatched away without consent or compensation.
This paper critically analyses the denial of the right of access to safe drinking water and sanitation. In so doing, it engages with the debate about whether access to water is a human right, using the situation in the rural areas of the Eastern Cape Province as a case study. Water in rural areas of the Eastern Cape continues to be regarded as a scarce resource, while at the same time the Constitution asserts that everyone has a right to access sufficient water and sanitation. The author argues that it is the duty of SA’s Government to work effectively for the progressive realisation of the right to access sufficient water and sanitation in rural areas. It should prioritise improvement of access to water in those areas where there is greatest need. Water sources must be as close as possible to households and water should be available on a daily basis. It should be as accessible and affordable as possible, particularly for the most marginalised and vulnerable members of SA society. An adequate policy should also be developed and monitored to prevent pollution of water resources and encourage water conservation.
The South African government has announced it will no longer pursue the willing buyer-willing seller option for land redistribution, citing the process as slowing down the speed of land reform. President Jacob Zuma listed land reform as a priority area for 2013 in his State of the Nation address on 14 February 2013. June 2013 will mark the centenary of the 1913 Land Act, whereby the British dispossessed African people of their land. He argued that the legacy of the Native Land Act still lives, and as a result many native families are still working for white farmers only for their food. Zuma said the land question needs to be resolved amicably within the framework of the Constitution and the law. But he called for the time it takes to finalise a claim to be shortened. In this regard, Government will now pursue the ‘just and equitable’ principle for compensation as set out in the Constitution instead of the willing buyer- willing seller principle, which forces the State to pay more for land than the actual value. Government’s mid-term review in 2012 revealed a number of shortcomings in the land reform implementation programme, which Zuma says will be used to improve implementation. He also pointed out that better incentives need to be provided for commercial farmers that are willing and capable of mentoring smallholder farmers.
According to this paper, development aid and policy discussions often assume that poorer countries have less internal capacity for redistribution in favour of their poorest citizens. The author tested this assumption for 90 developing countries. He found that most countries fall into one of two groups: those with little or no realistic prospect of addressing extreme poverty through redistribution from the wealthy, and those that would appear to have ample scope for such redistribution. He found that increased per capita income tends to move countries from the first group to the second. The author argues that the marginal tax rates needed to fill the poverty gap for the international poverty line of $1.25 a day are clearly prohibitive (marginal tax rates of 100% or more) for the majority of countries with consumption per capita under $2,000 per year at 2005 PPP. Even covering half the poverty gap would require prohibitive marginal tax rates in the majority of poor countries. Yet amongst better-off developing countries—over $4,000 per year (say)—the marginal tax rates needed for substantial pro-poor redistribution are very small—less than 1% on average, and under 6% in all cases. He found that economic growth tends to move countries from the first group to the second, concluding that the appropriate balance between growth and redistribution strategies can be seen to depend on the level of economic development.
Food prices are at their highest since the 2008 global food crisis, according to this report released by the United Nations Food and Agriculture Organization (FAO). In mid-2008, international food prices reached their highest level in 30 years, sparking one of the worst food crises in recent times and pushing more than a billion people into hunger. The global average price of food - including cereals, cooking oil, meat and dairy products - was 25% higher in December 2010 than in December 2009, according to the report. FAO suggests that countries with bumper crops or ample stocks of staple foods should maintain strategic reserves, and food-importing countries should think strategically and negotiate favourable trading terms. Rising fuel prices could also have a negative impact on food production and distribution in 2011. In Kenya and Tanzania, maize prices remained stable and at low levels in December 2010, mostly reflecting the good 2010 main harvests. However, in Uganda prices have risen considerably, driven by demand from Kenya, a traditional importer, as well as from southern Sudan and Rwanda. In Mozambique, maize prices continued their upward trend during December 2010. Madagascar also reported a significant increase in the price of the country’s main staple, rice, which is imported.
According to Vision 2030, the Kenyan government’s strategic plan on how to boost growth and development in Kenya, there are an estimated five million out of an estimated eight million households who depend directly on agriculture, despite the fact that agriculture continues to be one of the most under-budgeted ministries. Under the current financial year, agriculture has only been awarded a meagre 3.6% of the national budget, which a long way off the 10% mark that the government had committed to set aside for the agricultural sector. With an overdependence on agriculture for both subsistence and commercial purposes, a large number of the population is in dire need of food aid. Aid organisations such as the World Food Programme say an estimated 1.6 million Kenyans face starvation. The situation has deteriorated due to drastic climatic changes, whereby the rains are no longer reliable and most Kenyans are yet to adapt to innovative and sustainable means of trapping rainwater. According to the Kenya Food Security Meeting - the main co-ordinating body that brings together food security actors in a forum to map out various strategies to improve food security - while there has been a notable improvement of short rains in severely drought-affected pastoral areas, there have been a general rain failure in the country since 2007, which has resulted in the deterioration in food security. It is against this background that researchers have intensified research on crops that can grow in most parts of the country and that can be used to alleviate food insecurity. This research has led many Kenyans to accommodate traditional vegetables that in past years were dismissed in favour of Western vegetables, including highly nutritious and easy-to-grow indigenous crops like African eggplant, nightshades and cow peas. According to this article, most Western vegetables are unaffordable to poor people, who account for an estimated 60% of the rural population.