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.
Poverty and health
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.
There is a growing concern within the international development community that policies aimed at reducing the number of people living below the poverty line could leave the most disadvantaged groups behind. In line with these concerns, this dossier looks at different strategies for reaching the very poor within the health sector, and at the institutional challenges associated with scaling up health-related interventions to cover broader segments of the population. It also highlights the fact that there are ways outside the health sector to improve health or reduce the impoverishing impact of disease, and that in some contexts these may benefit the poor most.
School-based health and nutrition interventions in developing countries aim at improving children’s nutrition and learning ability. In addition to the food and health inputs, children need access to education that is relevant to their lives, of good quality, and effective in its approach. Based on evidence from the Zambia Nutrition Education in Basic Schools (NEBS) project, this article examines whether and to what extent school-based health and nutrition education can contribute directly to improving the health and nutrition behaviors of school children. Initial results suggest that gains in awareness, knowledge and behavior can be achieved among children and their families with an actively implemented classroom program backed by teacher training and parent involvement, even in the absence of school-based nutrition and health services.
Urbanisation can and should be beneficial for health. In general, nations that have high life expectancies and low infant mortality rates are also those where city government leaders and policies address the key social determinants of health. Within developing countries, the best local governance can help produce 75 years or more of life expectancy; with bad urban governance, life expectancy can be as low as 35 years. Better housing and living conditions, access to safe water and good sanitation, efficient waste management systems, safer working environments and neighborhoods, food security, and access to services like education, health, welfare, public transportation and child care are examples of social determinants of health that can be addressed through good urban governance. Failure of governance in today’s cities has resulted in the growth of informal settlements and slums that constitute an unhealthy living and working environment for a billion people. National government institutions need to equip local governments with the mandate, powers, jurisdiction, responsibilities, resources and capacity to undertake “healthy urban governance”. A credible health agenda is one that benefits all people in cities, especially the urban poor who live in informal settlements.
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.
This paper reports the association between food insufficiency (not having enough food to eat over the previous 12 months) and inconsistent condom use, sex exchange, and other measures of risky sex in a cross-sectional population-based study of 1,255 adults in Botswana and 796 adults in Swaziland using a stratified two-stage probability design. Associations were examined using multivariable logistic regression analyses, clustered by country and stratified by gender. Food insufficiency was reported by 32% of women and 22% of men over the previous 12 months. Among 1,050 women in both countries, after controlling for respondent characteristics including income and education, HIV knowledge, and alcohol use, food insufficiency was signficcantly associated with inconsistent condom use with a nonprimary partner, sex exchange, intergenerational sexual relationships and lack of control in sexual relationships. Associations between food insufficiency and risky sex were much attenuated among men.
This paper estimates the reduction in child mortality as a result of interventions related to the environmental and nutritional MDGs (improving child nutrition and providing clean water, sanitation, and fuels) and to estimate how the magnitude and distribution of the effects of interventions vary based on the economic status of intervention recipients.