Poverty and health

Getting out of the food crisis
Biodiversity, Rights and Livelihood, 2-6 July 2008

While there has been widespread reporting of the riots that have broken out around the world as a result of the global food crisis, little attention has been paid to the way forward. The solution is a radical shift in power away from the international financial institutions and global development agencies, so that small-scale farmers, still responsible for most food consumed throughout the world, set agricultural policy. Three interrelated issues need to be tackled: land, markets and farming itself.

Governments and donors must do more to improve nutrition of women and children
Woods T, Jones M and Mahendra S: Institute of Development Studies, Sussex, UK, 2008

Current high world food prices serve as a reminder of the vulnerability of large parts of sub-Saharan Africa and South Asia to hunger and undernutrition. Good nutrition status for children and adolescent girls is fundamental to attaining many of the Millennium Development Goals. Despite this, donors and governments underinvest in interventions to improve nutrition. Underinvestment is due to a lack of incentives for donors; few take a strategic approach to investments that have the potential to improve nutrition and they have little idea whether current investments are making a difference. Furthermore, their ‘critical friends’ – research institutes and non-governmental organisations – lack the leadership to engage with donors strategically on this issue. The authors suggest that this desperate cycle can only be broken by a new alliance between donors, governments and critical friends. This will require new leaders to come forward and develop politically aware strategies that raise public consciousness and put human and financial resources, both public and private, to effective use.

Perceptions of poverty
Witteveen A, Ludi E, Felber G: poverty-wellbeing.net, June 2008

This document is the second of a series addressing issues surrounding poverty and poverty reduction. It explains perceptions of poverty of the poor, well off and development practitioners to give a more complete picture of poverty. The briefing emphasises the need for poor people’s involvement in defining and exploring multiple dimensions of poverty. This points out the drawbacks of relying on understanding and interpretations of researchers and development practitioners. Providing examples from previous studies in Tanzania, Ghana, Bangladesh, India and Pakistan, the document admits that understanding of poverty varied greatly. Therefore the process of arriving at a shared understanding of poverty can be challenging but important.

Rapid urbanisation, employment crisis and poverty in African LDCs: A new development strategy and aid policy
Herrmann M and Khan H: Munich Personal RePEc Archive, 2008

Rapid urbanisation is a fact of life even in the least developed countries where the lion’s share of the population presently lives in rural areas and will continue to do so for decades to come. This paper examines the causes, consequences and policy implications of ongoing urbanisation in Africa’s less-developed countries (LDCs). The authors find that the employment opportunities in both the rural or urban sectors are not growing adequately. The emerging trends and patterns of urbanisation in the African LDCs are analysed, with a strong emphasis on rural-urban migration and the informal sectors. The paper argues that it is necessary to reverse the trends in aid and provide a much larger share of aid for productive sector development, including the development of rural and urban areas. Also the development of agricultural and non-agricultural sectors is needed, in line with the perspective of the dual-dual model. Although urban centres mostly host non-agricultural industries, sustainable urbanisation also strongly depends on what happens in the agricultural sectors. Productive employment opportunities in rural areas are important in order to combat an unsustainable migration from rural areas to urban centres, and productive employment opportunities in urban centres are essential to absorb the rapidly increasing labour force in the non-agricultural sector. Authors recommend building up productive capacities to create adequate employment and incomes for the rapidly growing population, particularly in the urban areas.

Improving the nutrition status of children and women
id21 insights 73, July 2008

The high world food prices currently being experienced provide a chilling reminder of the vulnerability of large parts of sub-Saharan Africa and South Asia to hunger and undernutrition. Many children in these regions are vulnerable to poor growth, poor development and death. Topics covered in this paper include: child undernutrition in Africa; nutrition for mothers and children; the cost of hunger; why undernutrition is not a higher priority for donors; and public-private sector partnerships in responding to undernutrition.

Nutrition for mothers and children
id21 Health News 131, July 2008

Article 25.2 of the Universal Declaration of Human Rights establishes that motherhood and childhood are entitled to special care and assistance. Yet maternal and child undernutrition are still highly prevalent in most developing countries. This article outlines the role of the World Food Programme (WFP) in tackling undernutrition. It concludes that WFP programmes can contribute to breaking traditional gender barriers, such as the view that caring for children is the sole responsibility of women. It can bring communities together around a common goal of improving maternal and child nutrition for the benefit of society. In communities where the WFP also operates School Feeding programmes, there are opportunities to link school feeding to wider nutrition issues and advocate the importance of nutrition throughout a person's lifecycle.

The Chronic Poverty Report 2008-2009
Chronic Poverty Research Centre CPRC - UK's Department for International Development (DFID)

Widespread chronic poverty occurs in a world that has the knowledge and resources to eradicate it. This report argues that tackling chronic poverty is the global priority for our generation. There are robust ethical grounds for arguing that chronically poor people merit the greatest international, national and personal attention and effort. Tackling chronic poverty is vital if our world is to achieve an acceptable level of justice and fairness. Currently, development research is mainly assessed in terms of its contribution to meeting the Millennium Development Goals, in particular MDG1: to halve absolute poverty by 2015. However, achieving the first MDG would still leave some 800 million people living in absolute poverty and deprivation – many of whom will be chronically poor. Their lives are extremely difficult and, being marginalised, their story is rarely told. This report tries to tell parts of their story. It does so through the lives of seven chronically poor people:Maymana, Mofizul, Bakyt, Vuyiswa, Txab, Moses and Angel. Chronic poverty is a varied and complex phenomenon, but at its root is powerlessness. Poor people expend enormous energy in trying to do better for themselves and for their children. But with few assets, little education, and chronic ill health, their struggle is often futile.

Why have donors committed so few direct investments to eliminate child undernutrition?
id21HealthNews 131, July 2008

The mandate of most international donors is to reduce poverty, suffering and inequity. Addressing child undernutrition falls within this. However, current donor investment to directly address undernutrition is estimated to be well under half of the resources required. Encouragingly, some new initiatives to increase investment and improve coordination are already underway. Several international agencies are working together to develop a Ten Year Strategy to reduce vitamin and mineral deficiencies. These include the United Nations Children's Fund (UNICEF), the Academy for Educational Development and the Global Alliance for Improved Nutrition (GAIN). They have completed a technical situation analysis (published in the Food and Nutrition Bulletin) and formed working groups to better coordinate their actions, including monitoring and evaluation activities.

Malnutrition among women in sub-Saharan Africa: rural-urban disparity
Uthman OA, Aremu O: Rural and Remote Health 8(931), 2008

Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity among women. To provide a reliable source of information for policy-makers, the current study used nationally representative data from 26 countries in sub-Saharan Africa to update knowledge about the prevalence malnutrition and its rural-urban disparities among women. The data sources were the demographic and health surveys of 26 countries conducted between 1995 and 2006.Overall, rural women were 68% more likely to be malnourished compared with their urban counterparts.

The burden of disease profile of residents of Nairobi's slums: Results from a Demographic Surveillance System
Kyobutungi C, Ziraba AK, Ezeh A and Yé Y: Population Health Metrics 6(1), 10 March 2008

With increasing urbanization in sub-Saharan Africa and poor economic performance, the growth of slums is unavoidable. About 71% of urban residents in Kenya live in slums. Slums are characteristically unplanned, underserved by social services, and their residents are largely underemployed and poor. Recent research shows that the urban poor fare worse than their rural counterparts on most health indicators, yet much about the health of the urban poor remains unknown. This study aims to quantify the burden of mortality of the residents in two Nairobi slums, using a Burden of Disease approach and data generated from a Demographic Surveillance System. Data from the Nairobi Urban Health and Demographic Surveillance System (NUHDSS) collected between January 2003 and December 2005 were analysed. Core demographic events in the NUHDSS including deaths are updated three times a year; cause of death is ascertained by verbal autopsy and cause of death is assigned according to the ICD 10 classification. Years of Life Lost due to premature mortality (YLL) were calculated by multiplying deaths in each subcategory of sex, age group and cause of death, by the Global Burden of Disease standard life expectancy at that age. The overall mortality burden per capita was 205 YLL/1,000 person years. Children under the age of five years had more than four times the mortality burden of the rest of the population, mostly due to pneumonia and diarrhoeal diseases. Among the population aged five years and above, HIV/AIDS and tuberculosis accounted for about 50% of the mortality burden. Slum residents in Nairobi have a high mortality burden from preventable and treatable conditions. It is necessary to focus on these vulnerable populations since their health outcomes are comparable to or even worse than the health outcomes of rural dwellers who are often the focus of most interventions.

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