With increasing urbanisation in sub-Saharan Africa and poor economic performance, the growth of slums is unavoidable. About 71% of urban residents in Kenya live in slums. Recent research shows that the urban poor fare worse than their rural counterparts on most health indicators, yet much about the health of the urban poor remains unknown. This study aims to quantify the burden of mortality of the residents in two Nairobi slums, using a Burden of Disease approach and data generated from a Demographic Surveillance System. Slum residents in Nairobi have a high mortality burden from preventable and treatable conditions. It is necessary to focus on these vulnerable populations since their health outcomes are comparable to or even worse than the health outcomes of rural dwellers who are often the focus of most interventions.
Poverty and health
This paper describes changes over the past 15-20 years in non-income measures of wellbeing—education and health—in Africa. Results indicate that in the area of health, little progress is being made in terms of reducing pre-school age stunting, a clear manifestation of poor overall health. Likewise, our health inequality measure showed that while there were a few instances of reduced inequality along this dimension, there was, on balance, little evidence of success in improving equality of outcomes. Similar results were found in our examination of underweight women as an indicator of general current health status of adults. The overall picture gives little cause for complacency or optimism that Africa has reaped, or will soon reap the potential benefits of the process of globalisation.
From the vantage point of a rural district in northern Mozambique, the development efforts by government and donors are visible through the enhanced capacity of the local administration and investments in education and health, but not where it really matters for poor people: employment creation and reasonable returns from their agricultural production, which currently are adversely affected by an absent or exploitative private sector. The very poorest are marginalised or excluded from social relationships with the extended family, traditional institutions as well as the state, underlining the need to give special attention to the chronically poor and destitute in rural areas.
Issues of urban poverty have received little attention in Mozambique, even though the urban poverty rate is high and urban inequality is on the rise. In the bairros of Maputo, unemployment, crime and the high costs of food, housing and land inhibit the poor from converting progress in education and health into increased income and consumption. In a context where money is an integral part of most social relationships, the most destitute become marginalised with no one to turn to. Rising poverty and inequality in Maputo also have an adverse impact on vital urban-rural relationships, and may jeopardise political stability.
In this paper we review the associations between maternal and child undernutrition with human capital and risk of adult diseases in low-income and middle-income countries. We analysed data from five long-standing prospective cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa. We conclude that damage suffered in early life leads to permanent impairment, and might also affect future generations. Its prevention will probably bring about important health, educational, and economic benefits. Chronic diseases are especially common in undernourished children who experience rapid weight gain after infancy.
Maternal and child undernutrition is highly prevalent in low-income and middle-income countries, resulting in substantial increases in mortality and overall disease burden. This paper presents new analyses to estimate the effects of the risks related to measures of undernutrition, as well as to suboptimum breastfeeding practices on mortality and disease. The high mortality and disease burden resulting from these nutrition-related factors make a compelling case for the urgent implementation of interventions to reduce their occurrence or ameliorate their consequences.
Lake Victoria supports Africa’s largest inland fishery, and its most valuable product is the Nile perch, much of which is exported. This has given rise to arguments claiming a direct linear relationship between perch exports and disturbingly high rates of malnutrition along the lake’s shores. In this paper, we argue that this argument is seriously flawed for it is unable to explain how it is that the income from the Nile perch fishery fails to translate into a well-fed riparian population. We draw on field work carried out in 2001 that (a) set out to establish exactly how much malnutrition there was on the lake’s shores; and (b) sought to identify what happened to the income the fishery generates. We argue that because men control much of the fishery, and women are held responsible for the upkeep of their families, little of this income makes its way back into the households of the region, giving rise to the levels of malnutrition we observed.
The new Lancet series on nutrition, co-authored and co-financed by the World Bank, depicts the lamentable state of under-nutrition worldwide, and a corresponding negligence on the part of the development community to meet the challenge decisively. Under-nutrition represents the non-income face of poverty. And the world is off track on meeting this goal. Countries with 'higher overall logistics costs are more likely to miss the opportunities of globalization,' say the study’s lead authors Jean Francois Arvis and Monica Alina Mustra of the Bank’s Poverty Reduction and Economic Management (PREM) group.
Malawi hovered for years at the brink of famine. After a disastrous corn harvest in 2005, almost five million of its 13 million people needed emergency food aid. But this year, a nation that has perennially extended a begging bowl to the world is instead feeding its hungry neighbors. It is selling more corn to the World Food Program of the United Nations than any other country in southern Africa and is exporting hundreds of thousands of tons of corn to Zimbabwe. In Malawi itself, the prevalence of acute child hunger has fallen sharply.
In Africa, national governments and international organizations are focusing on rapidly "scaling up" malaria control interventions to at least 60 percent of vulnerable populations. The potential health and economic benefits of "scaling up" will depend on the equitable access to malaria control measures by the poor. This paper analyses the present inequalities in access to malaria interventions in Malawi. The present distribution strategies for ITNs are not addressing the needs of the vulnerable groups, especially the poor. Increasing access to ITNs by the poor will require innovative distribution models which deliberately target the poorest of the poor.
