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.
Poverty and health
Monitoring and Evaluating Poverty Reduction Policies in Mozambique, Study 2
Paulo M, Rosário C, Tvedten I: CMI Brief 7 (3), 2008
Maternal and child undernutrition: consequences for adult health and human capital
Victora CG, Adair L, Fall C, Hallal PC, Martorell R, Richter L, Sachdev HS: The Lancet 371(9609): 340-357, 26 January 2008
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: global and regional exposures and health consequences
Black RE, Allen LH, Bhutta ZA, Caulfield LE, de Onis M, Ezzati M, Mathers C, Rivera J: The Lancet 371(9608): 243-260, 19 January 2008
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.
Nile perch and the hungry of Lake Victoria: Gender, status and food in an East African fishery
Geheb K, Kalloch S, Medard M, Nyapendi A-T, Lwenya C and Kyangwad M: Food Policy 33(1): 85-98, February 2008
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.
Nutrition:The forgotten MDG
The World Bank, 28 January 2008
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.
Ending famine, simply by ignoring the experts
Dugger CW: The New York Times Company, 1 December 2007
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.
Malaria control in Malawi: are the poor being served?
Mathanga DP and Bowie C: International Journal for Equity in Health 6:22, 2 December 2007
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.
Meeting the health-related needs of the very poor
Eldis
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.
Developing a Nutrition and Health Education Program for Primary Schools in Zambia
Sherman J and Muehlhoff E: Journal of Nutrition Education and Behavior 39(6): 335-342, November 2007
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.
Our cities, our health, our future: Acting on social determinants for health equity in urban settings
Kjellstrom T: Report to the WHO Commission on Social Determinants of Health from the Knowledge Network on Urban Settings
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.