Poverty and health

Africa’s political instability hinders maternal health progress
Palitza K: IPS News: 21 March 2012

Health experts have pointed out that African countries with good maternal health statistics are generally those that have long-term political stability, like Botswana, arguing that this shows that stability is a fundamental basis for development. Generally, maternal health is neglected in public health, as most African countries focus on the eradication of poverty and hunger, according to a spokesperson from the United Nations Development Programme (UNDP) in Ivory Coast. The UNDP spokesperson added that few governments seem to be aware of the close link between maternal health and poverty. It takes strong leadership at the country level to shift priorities and spend more on maternal and child health, as well as more effectively implement existing policies and international agreements, he added. One example is the right to family planning, which has not yet been included in public health care provision in many African countries.

Agricultural Outlook 2011-2020
United Nations Food and Agriculture Organisation and the Organisation for Economic Cooperation and Development: 2011

Contrary to popular perception, the current high food prices will not see more money flowing into agriculture in the long term, according to this forecast. Input costs, including that of fuel and fertiliser, have risen significantly and the Food and Agriculture Organisation (FAO) anticipates global agriculture production to slow down in the next decade. The Outlook has forecast in its last three editions that food prices will remain high for the next few decades. Global agricultural production is projected to grow at 1.7% annually until 2020, compared to 2.6% during the previous decade. Slower growth is expected for most crops, especially oilseeds and coarse grains, which face higher production costs and slowing productivity. The FAO estimates that to meet projected demand over the next 40 years, farmers in developing countries need to double production.

Agricultural success from Africa: the case of fertiliser tree systems in southern Africa (Malawi, Tanzania, Mozambique, Zambia and Zimbabwe)
Ajayi OC, Place F, Akinnifesi FK and Sileshi GW: International Journal of Agricultural Sustainability February 2011: 129-136, 1 February 2011

In response to declining soil fertility in southern Africa and the negative effects that this leads to, such as food insecurity, fertiliser tree systems (FTS) were developed as technological innovation to help smallholder farmers to build soil organic matter and fertility in a sustainable manner. In this paper, the authors trace the historical background of FTS and highlight the developmental phases and outcomes of the technology. The synthesis shows that FTS are inexpensive technologies that significantly raise crop yields, reduce food insecurity and enhance environmental services and resilience of agro-ecologies. Many of the achievements recorded with FTS can be traced to some key factors: the availability of a suite of technological options that are appropriate in a range of different household and ecological circumstances, partnership between multiple institutions and disciplines in the development of the technology, active encouragement of farmer innovations in the adaptation process, and proactive engagement of several consortia of partner institutions to scale up the technology in farming communities. It is recommended that smallholder farmers would benefit if rural development planners emphasise the merits of different fertility replenishment approaches and take advantage of the synergy between FTS and mineral fertilisers rather than focusing on `organic vs. inorganic' debates.

Agriculture and trade opportunities for Tanzania: Past volatility and future climate change
Ahmed SA, Diffenbaugh NS, Hertel TW and Martin WJ: WIDER Working Paper 2011/91, December 2011

The authors of this paper argue that Tanzania has the potential to substantially increase its maize exports to other countries, if global maize production falls due to supply shocks in major exporting regions. Tanzania may be able to export more maize at higher prices, even if it also experiences below-trend productivity. Future climate predictions suggest that some of Tanzania’s trading partners will experience severe dry conditions that may reduce agricultural production in years when Tanzania is only mildly affected. Tanzania could thus export grain to countries as climate change increases the likelihood of severe precipitation deficits in other countries while simultaneously decreasing the likelihood of severe precipitation deficits in Tanzania. Trade restrictions, like export bans, prevent Tanzania from taking advantage of these opportunities, foregoing significant economic benefits.

Agro-ecology and the right to food
De Schutter O: United Nations, March 2011

This report explores how States can and must achieve a reorientation of their agricultural systems towards modes of production that are highly productive, highly sustainable and that contribute to the progressive realisation of the human right to adequate food. Drawing on an extensive review of the scientific literature published in the last five years, de Schutter identifies agro-ecology as a mode of agricultural development with strong conceptual connections with the right to food. Moreover, agro-ecology delivers advantages that are complementary to better known conventional approaches such as breeding high-yielding varieties. In the report, de Schutter argues that the scaling up of these experiences is the main challenge today. Appropriate public policies can create an enabling environment for such sustainable modes of production, such as: prioritising the procurement of public goods in public spending rather than solely providing input subsidies; investing in knowledge by reinvesting in agricultural research and extension services; investing in forms of social organisation that encourage partnerships, including farmer field schools and farmers’ movements innovation networks; investing in agricultural research and extension systems; empowering women; and creating a macro-economic enabling environment, including connecting sustainable farms to fair markets.

Air pollution and child health: prescribing clean air
World Health Organisation: WHO, Geneva, 2018

This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to air pollution, a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013. This public health crisis is receiving more attention, but one critical aspect is often overlooked: how air pollution affects children in uniquely damaging ways. Recent data released by the World Health Organization (WHO) show that air pollution has a vast and terrible impact on child health and survival. Globally, 93% of all children live in environments with air pollution levels above the WHO guidelines. More than one in every four deaths of children under 5 years is directly or indirectly related to environmental risks. Both ambient air pollution and household air pollution contribute to respiratory tract infections that resulted in 543 000 deaths in children under 5 years in 2016.

Alcohol consumption in relation to maternal deaths from induced-abortions in Ghana
Asamoah BO and Agardh A: Reproductive Health 9:10, 6 August 2012

According to this paper, in Ghana, alcohol consumption and unwanted pregnancies are on the ascendancy. The authors examined the association between alcohol consumption and maternal mortality from induced-abortion, as well as the factors that lie behind the alcohol consumption patterns in the study population. They extracted data from the Ghana Maternal Health Survey 2007, identifying 4,203 female deaths through verbal autopsy, among which 605 were maternal deaths in the 12 to 49 year-old age group. Alcohol consumption was significantly associated with abortion-related maternal deaths. Women who had ever consumed alcohol, frequent consumers and occasional consumers were about three times as likely to die from abortion-related causes compared to those who abstained from alcohol. Maternal age, marital status and educational level were found to have a confounding effect on the observed association. The authors recommend that policy actions directed toward reducing abortion-related deaths should consider alcohol consumption, especially among younger women. Policy makers in Ghana should also consider increasing the legal age for alcohol consumption. In addition, information on the health risks posed by alcohol and abortion be disseminated to communities in the informal sector where vulnerable groups can best be reached.

Alternatives to the food crisis
Angus I: Pambazuka News, 15 May 2008

The regressive food policies imposed on poor countries by the World Bank and IMF are codified and enforced by the World Trade Organization's Agreement on Agriculture (AoA). The AoA, as Afsar Jafri of Focus on the Global South writes, is "biased in favour of capital-intensive, corporate agribusiness-driven and export-oriented agriculture." AoA should be abolished, and Third World countries should have the right to unilaterally cancel liberalization policies imposed through the World Bank, IMF, and WTO, as well as through bilateral free trade agreements such as NAFTA and CAFTA.

Ambient pollution and respiratory outcomes among schoolchildren in Durban, South Africa
Naidoo RN, Robins TG, Batterman S, Mentz G and Jack C: South African Journal of Child Health 7(4), 127-134, November 2013

The author examines associations between ambient air pollutants and respiratory outcomes among schoolchildren in Durban, South Africa, in a cross sectional survey of primary schools from within each of seven communities in two regions of Durban (the highly industrialised south compared with the non-industrial north) and measurement of particulate matter (PM), sulphur dioxide (SO2) and carbon monoxide at each school, and nitrogen oxides (NOx) at other sites. Children had a prevalence of asthma symptoms of any severity of 32%, higher in schools with higher SO2 levels. Schoolchildren from industrially exposed communities experienced higher covariate-adjusted prevalences of persistent asthma than children from communities distant from industrial sources. The authors indicate that the findings are strongly suggestive of industrial pollution-related adverse respiratory health effects among these children.

An assessment of current support strategies for patients with TB in KwaZulu-Natal
Lutge E, Ndlela Z and Friedman I: Health Systems Trust, November 2009

In order to ameliorate poverty among tuberculosis (TB) sufferers, a few initiatives to support patients with TB have been made in KwaZulu-Natal, South Africa, including free treatment at government hospitals and clinics, and nutritional supplementation and social grants. Although these programmes have been functioning for a number of years, they have never been formally assessed in terms of the costs involved, the effects on the target populations, and the responses of patients. A recent study in Brazil (Belo et al, 2006) investigated a range of support strategies for patients with TB that included material and financial assistance, improved health services support and better administrative organisation – from the patient's perspective. Such a study has not been undertaken in South Africa, however, and given the large amount of money spent on support to TB patients, this is necessary to better inform such programmes.