Poverty and health

Sugarcane outgrower schemes are central to several policy and donor strategies for driving agricultural growth and reducing poverty, including the Southern Agricultural Growth Corridor project in Tanzania (SAGCOT). But field research into the outgrower component of Kilombero Sugar Company, Tanzania’s largest and best regarded sugar producer, demonstrates a pressing need for change. Sugarcane production in Kilombero has had benefits for farming households as well as the local and national economy. However, unsustainable expansion and governance issues in the outgrower scheme have created new risks. There are pressures on food security as a result of a decline in land for food crops, and on incomes, particularly when outgrowers’ cane remains unharvested and farmers’ payments are delayed. These problems have been aggravated by the importation of foreign sugar into the country. For this industry to provide its maximum benefits to the economy and to the household, a policy, legal and institutional framework is needed that provides greater efficiency, accountability and transparency, as well as greater security for all participating stakeholders. There are lessons for the sugar industry, as well as donors and investors of ongoing and future agribusiness developments in Tanzania.

Hypertension is neither unique nor novel to South Africa (SA), but the legislative actions undertaken by the South African government reflect a new approach to addressing this growing burden. Research has shown that a significant portion of hypertension is linked to sodium consumption, and a major proportion of sodium consumption in SA comes from bread--part of the staple diet. Aware of the burden of hypertension and the high levels of sodium in processed foods, Minister of Health Aaron Motsoaledi and the National Department of Health (NDOH) spearheaded legislative action to regulate sodium in food products at the manufacturing level. Based on the mixed results of voluntary regulation in other countries, the NDOH decided to initiate mandatory regulation to effectively curb sodium consumption. Answers to a questionnaire distributed to food industry members showed that about half of the groups who answered preferred to have regulated rather than voluntary sodium, because they believed this could even the playing field. The government devoted a significant amount of time and effort to understanding the industry's concerns, many of which were considered in negotiations. Years of South African research and inter-sectoral interactions between government, academia, and industry culminated in successfully signed regulations. Even with this first successful step, the hypertension problem is far from solved. This report concludes with a discussion on plausible recommendations that calls for international collaboration across the African continent, in order to further address the growing prevalence of hypertension.

Increasing urbanization will be one of the defining features of the 21st century. This produces particular environmental challenges, but also creates opportunities for urban development that can contribute to broader goals of improving the quality of life for urban residents while achieving greater levels of global sustainability. Focusing on the City Development Strategy (CDS), the report draws on two main sets to determine the effectiveness of using the CDS to integrate environmental issues into city planning processes. Firstly, it draws on an analysis of documentation from 15 cities in Africa, Asia and Latin America that have engaged in the process of developing a City Development Strategy under the auspices of Cities Alliance. Secondly, it incorporates insights from in-depth Learning and Leadership Groups conducted with three additional cities (Metro Manila [Philippines] [specifically Makati City and Quezon City], Kampala [Uganda] and Accra [Ghana]) that have engaged in this process. The report does not present the results of these workshops directly, but rather uses the insights from these to contribute to a broader understanding of the potential for the incorporation of environmental concerns in urban planning and management, the barriers to this, and the opportunities to overcome these. This report is intended primarily to encourage and support urban decision-makers to integrate environmental concerns more centrally in their planning and management activities.

Globally, 2.8 billion people rely on household solid fuels. Reducing the resulting adverse health, environmental, and development consequences will involve transitioning through a mix of clean fuels and improved solid fuel stoves (IS) of demonstrable effectiveness. To date, achieving uptake of IS has presented significant challenges. the authors performed a systematic review of factors that enable or limit large-scale uptake of IS in low- and middle-income countries. The authors conducted systematic searches through multidisciplinary databases, specialist websites, and consulting experts. The review drew on qualitative, quantitative, and case studies and used standardized methods for screening, data extraction, critical appraisal, and synthesis. They identified 31 factors influencing uptake from 57 studies conducted in Asia, Africa, and Latin America. All domains matter. Although factors such as offering technologies that meet household needs and save fuel, user training and support, effective financing, and facilitative government action appear to be critical, none guarantee success: All factors can be influential, depending on context. The nature of available evidence did not permit further prioritization. Achieving adoption and sustained use of IS at a large scale requires that all factors, spanning household/community and program/societal levels, be assessed and supported by policy.