Poverty and health

USDA’s Food Security Assessment for 2008–2009
United States Department of Agriculture: June 2009

The number of poor and food-insecure people in developing countries is increasing more quickly in urban areas than in rural areas, and could be dropping off the policy radar, according to new research by the US Department of Agriculture (USDA). By 2030 the majority of people in all developing countries will live in urban areas, and UNFPA estimates that about 60 percent of the urban slum population will be under the age of 18. Sub-Saharan African countries have the world's highest rates of urban growth and highest levels of urban poverty – the slum population in these countries doubled from 1990 to 2005, when it reached 200 million. Health hazards emanating from food in urban areas are a critical concern: buying pre-cooked food from street vendors, close contact between humans and poultry and other domestic animals for slaughter, and generally unhygienic conditions in urban markets can have significant health consequences.

Viability of commercially available bleach for water treatment in developing countries
Lantagne DS: American Journal of Public Health 99(11): 1975–1978, November 2009

Treating household water with low-cost, widely available commercial bleach is recommended by some organisations to improve water quality and reduce disease in developing countries. This study analysed the chlorine concentration of 32 bleaches from twelve developing countries. The average error between advertised and measured concentration was 35% (range = -45%–100%; standard deviation = 40%). Because of disparities between advertised and actual concentration, the use of commercial bleach for water treatment in developing countries is not recommended without ongoing quality control testing.

Violence and injuries in South Africa: Prioritising an agenda for prevention
Seedat M, van Niekerk A, Jewkes R, Suffla S and Ratele K: The Lancet 374(9692): 1011–1022, 5 September 2009

Violence and injuries are the second leading cause of death and lost disability-adjusted life years in South Africa. With a focus on homicide, and violence against women and children, this paper reviews the magnitude, contexts of occurrence, and patterns of violence, and refer to traffic-related and other unintentional injuries. The social dynamics that support violence are widespread poverty, unemployment, and income inequality; patriarchal notions of masculinity that valourise toughness, risk-taking and defence of honour; exposure to abuse in childhood and weak parenting; access to firearms; widespread alcohol misuse; and weaknesses in the mechanisms of law enforcement. So far, there has been a conspicuous absence of government stewardship and leadership. Successful prevention of violence and injury is contingent on identification by the government of violence as a strategic priority and development of an intersectoral plan based on empirically driven programmes and policies.

Water and power: Are public services still public?
Municipal Services Project, February 2015

Public water and electricity are back in vogue! Yet many state-owned utilities are now undergoing “corporatization”: they have legal autonomy and manage their own finances. Is this a positive development in the struggle for equitable public services? Or a slippery slope toward privatisation? This video draws from in-depth research on corporatization cases from around the world.

Water sector governance in Africa
African Development Bank: November 2010

This report was launched during the Third African Water Week in Addis Ababa on 23 November 2010. About 350 million Africans still do not have access to water, according to the report. The author investigates whether poor governance has been a major contributory factor in the lack of sustainability in the African water sector. The report identifies numerous but common governance risks, and shows that these are easily identifiable and preventable. The main challenges and issues in the water sector are identified as sustainability, capacity and finance. The report also finds that substantial gains would be made if government assessments became standard procedure and if governance criteria were introduced in donor project approval procedures. While local and national institutions have the most visible role to play in governing the water sector, the report notes that it is the sector’s underlying policies, legislation and regulations that provide the foundation for overall governance. To meet the Millennium Development Goals by 2015, an enormous annual investment is required, probably more than four to five times current investment rate in the water sector.

WFP and UNICEF sign deal to reduce child stunting in ESA
Langa L: Health-e News, 20 January 2011

The United Nations World Food Programme (WFP) and the United Nations Children’s Fund (UNICEF) have signed an agreement to work together to reduce child stunting in Eastern and Southern Africa in an effort to reach the UN Millennium Development Goals by 2015. UNICEF and WFP acknowledged the progress that had been made to address the nutritional factors hampering children’s health. UNICEF said that the prevalence of stunting in the developing world declined from 40% to 29% between 1990 and 2008. Stunting in Africa only fell from 38% to 34% in the same period. Of the 24 countries that make up 80% of the world’s stunting burden, at least seven are in Eastern and Southern Africa. UNICEF argues that investing in child nutrition pays high dividends for a country’s social and national development. National nutrition strategies need to tackle not only the root causes of stunting, but also to target the most vulnerable children and their families, including those in remote areas, or from the poorest and most marginalised communities. Only 11 African countries are on track to reaching the Millennium Development Goals to halve hunger by 2015, four of which are from the eastern and southern African (ESA) region: Mozambique, Botswana, Swaziland and Angola.

WFP bought R600m food from Southern Africa

The United Nations' World Food Programme (WFP) in Southern Africa on Tuesday announced that it spent nearly R600-million ($100-million) in 2005, double the amount in 2004, buying more than half a million tonnes of food in the region to support vulnerable people across Africa. About 337 000 tonnes of food, worth R372-million ($62-million) was purchased in South Africa by WFP's regional headquarters in Johannesburg.

WFP urges doctors to join fight against malnutrition
WFP: 26 February 2010

World Food Programme (WFP) Executive Director Josette Sheeran has urged doctors and medical experts to put their knowledge to work to support the battle against malnutrition, a factor in 10,000 child deaths every day. Speaking at the Royal Society of Medicine in London, Sheeran said that the world already had the ability and knowledge to tackle the challenge of malnutrition. What was lacking was the coordinated focus and political will, she said. 'We need to harness what we know – take the knowledge that we have right now and put it into action. We cannot wait,' she said in remarks to a breakfast meeting with a group of eminent doctors and medical experts. If a child under two is deprived of the nutrition needed for mental and physical growth, the damage is irreversible, Sheeran noted. 'For the world's bottom billion, can we take the technology and what we know, and ensure that there is access to nutrition? And can we stand with those under two year olds and at least make sure they are getting a shot at life?' The costs of undernutrition are high. Without adequate nutrition children cannot learn in school, HIV and AIDS drugs don’t work, populations are more vulnerable to disease and economic growth is undermined, she added.

What could infant and young child nutrition learn from sweatshops?
Singer PA, Ansett S and Sagoe-Moses I: BMC Public Health 11(276), May 2011

Adequate infant and young child nutrition demands high rates of breastfeeding and good access to nutrient rich complementary foods, requiring public sector action to promote breastfeeding and home based complementary feeding, and private sector action to refrain from undermining breastfeeding and to provide affordable, nutrient rich complementary foods. The authors argue, however, that public and private sectors do not work well together in improving infant and young child nutrition. The authors argue that there are lessons to learn in managing public and private interactions on nutrition from the actions taken around sweatshops. One example is the Ethical Trading Initiative, in which companies, trade unions, and civil society organisations work together to enhance implementation of labour standards and address alleged allegations of abuse.

What does Access to Maternal Care Mean Among the Urban Poor? Factors Associated with Use of Appropriate Maternal Health Services in the Slum Settlements of Nairobi, Kenya
Fotso J-C, Ezeh A, Madise N, Ziraba A and Ogollah R: Maternal and Child Health Journal 13(1), January 2009

The study seeks to improve understanding of maternity health seeking behaviors in resource-deprived urban settings by identifying factors which influence the choice of place of delivery among the urban poor, with a distinction between sub-standard and “appropriate” health facilities. Methods The data are from a maternal health project carried out in two slums of Nairobi, Kenya. A total of 1,927 women were interviewed, and 25 health facilities where they delivered, were assessed. Facilities were classified as either “inappropriate” or “appropriate”. Although 70% of women reported that they delivered in a health facility, only 48% delivered in a facility with skilled attendant. Besides education and wealth, the main predictors of place of delivery included being advised during antenatal care to deliver at a health facility, pregnancy 'wantedness', and parity. The influence of health promotion (i.e., being advised during antenatal care visits) was significantly higher among the poorest women. Interventions to improve the health of urban poor women should include improvements in the provision of, and access to, quality obstetric health services. Women should be encouraged to attend antenatal care where they can be given advice on delivery care and other pregnancy-related issues. Target groups should include poorest, less educated and higher parity women.

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