Urban farming in the Democratic Republic of Congo (DRC) is providing a livelihood for thousands of city dwellers, with vegetables bringing in good money for small growers and helping to alleviate high levels of malnutrition, according to this article. The Food and Agricultural Organisation (FAO) has noted that the demand for vegetables and the high prices they command in DRC cities has pushed many jobless residents into becoming small-scale growers. Most of the green spaces along the roadsides of the capital, Kinshasa, have been transformed into small farms. City farmers now grow 122% more produce than they did five years ago, according to the FAO, which is supporting gardeners in five main DRC cities with a US$10.4 million urban horticulture project. Although the project has contributed to improving nutrition in urban areas, the project manager cautions that there is still a lot of work to be done and malnutrition levels remain high: 24% of children in the DRC under five are underweight, 43% are stunted, and 9% are wasted.
Poverty and health
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.
Despite increased research interest on the social and economic determinants of health (SEDH), the vast majority of studies on this issue are from developed countries. The authors of this study set out to determine whether there are specific social determinants of health in the world's poorest countries, and if so, how they could be better identified and researched in Africa in order to promote and support universal health coverage. They conducted a literature review of existing papers on the social and economic determinants of health, finding that most of the existing studies on the SEDH studies did not provide adequate explanation on the historical and contemporary realities of SEDHs in the world's poorest countries. As these factors vary from one country to another, the authors argue that it is necessary for researchers and policy makers to understand country-specific conditions and design appropriate policies that take due cognisance of these country-specific circumstances. They call for further research in the world's poorest countries, especially in Africa.
Since April 2011, the humanitarian community has been gearing up to deploy a new mechanism aimed at combining expertise on food aid and agricultural assistance to boost food security and make food insecure communities hit by a disaster more resilient. The tool, which is deployed by aid workers in emergency responses, is the "cluster approach", first implemented in 2005. A "cluster" consists of groupings of UN agencies, NGOs and other international organisations around a sector or service provided during a humanitarian crisis. The cluster approach currently encompasses 11 clusters or sectors such as logistics, water and sanitation, early recovery and nutrition. Agriculture as a separate cluster will cease to exist under the new scheme. The new cluster is led jointly by the UN Food and Agriculture Organization (FAO) and the World Food Programme (WFP). The tool is aimed at implementing a proper `early recovery' approach by introducing recovery and development aspects into relief work as early as possible and strengthening transition.
Global Call to Action Against Poverty (GCAP) has proposed seven major issues that must be tackled by the G8 if it is serious about alleviating poverty. Public accountability, just governance and human rights should be enshrined in programmes financed by G8, with reporting that takes into account real prices (after inflation) and is based on consistent year-on-year calculations. The G8 must also place gender equality and empowerment at the heart of its development policies. It should reaffirm the Gleneagles, L’Aquila and Muskoka commitments in the G8 communiqué and set out an emergency plan to deliver the US$19 billion shortfall against commitments by 2012. In terms of debt cancellation, the G8 should endorse the formation of an International Debt Court to ensure a fair and transparent process that is independent of borrowers and lenders, based on clear rules, legally enforceable, comprehensive and mandated to assess the validity and legitimacy of all debt cancellation claims. The G8-Africa Declaration and related agreements must be based on fairness to both Northern and Southern countries, ensuring equitable trade conditions. Justice in terms of climate change agreements should be secured for developing countries, and peace and security should also be taken into account by the G8, as democracy is currently being undermined in Africa by continual armed conflict.
Poverty is the state of having little or no money and few or no material possessions. Poverty can be caused by unemployment, low education, deprivation and homelessness. This study assessed the relationship between poverty and patient abandonment (PA) in hospitals, and the attitude of health care professionals (HCPs) towards the patient. The study targeted all patients who were abandoned at MNH and who voluntarily accepted to participate in this study under informed consent and strict confidentiality. This is the first study to be conducted in Dar es Salaam with respect to PA in hospital. Results revealed unnecessary overcrowding in wards and overwhelmingly heavy burden of patient care on the HCPs. The study also observed a correlation between poverty and PA, which was to a great extent related to the patient's level of education. The respondents strongly condemned PA immoral. The authors propose that government re-introduce subsidies on services to alleviate the burden of medical expenses incurred by the low income citizens, particularly the unemployed and farmers. The study also recommends that the government should improve services in regional hospitals to reduce travel and patients care expenses.
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.
The number of people requiring humanitarian assistance in the Horn of Africa could increase sharply in coming months due to below-average rainfall and high food and fuel prices, say aid workers. According to the World Food Programme, the Horn of Africa drought, which began with the failure of the short rains in December 2010, is the first since a two-year regional drought in 2007-2009 that saw the number of people needing humanitarian assistance in the region rise to more than 20 million. Conflict over rising food prices could further increase the number of people requiring help. While governments of the affected countries have already started interventions, short- and long-term international assistance is needed to help address critical needs but also underlying structural causes and chronic vulnerabilities. What is needed, according to this article, is a set of interventions which strengthens people's own resilience capacity and coping mechanisms to survive such severe conditions while at the same time responding to their current humanitarian needs and protecting their livelihoods. It is crucial that people can feed themselves through their own means instead of being dependent on food distributions.
The thirteen case studies contained in this publication – including studies from Tanzania and South Africa - were commissioned by the research node of the Knowledge Network on Priority Public Health Conditions (PPHC-KN), a WHO-based interdepartmental working group associated with the WHO Commission on Social Determinants of Health. The publication is a joint product of the Department of Ethics, Equity, Trade and Human Rights (ETH), Special Programme for Research and Training in Tropical Diseases (TDR), Special Programme of Research, Development and Research Training in Human Reproduction (HRP), and Alliance for Health Policy and Systems Research (AHPSR). The case studies describe a wealth of experiences with implementing public health programmes that intend to address social determinants and to have a great impact on health equity. They also document the real-life challenges in implementing such programmes, including the challenges in scaling up, managing policy changes, managing intersectoral processes, adjusting design and ensuring sustainability.
The objectives of this study were to measure inequalities in child mortality, HIV transmission and vaccination coverage within a cohort of infants in South Africa. The researchers observed disparities in the availability of infrastructure between least poor and most poor families, and inequalities in all measured child health outcomes. Overall, 75 (8.5%) infants died between birth and 36 weeks. Infant mortality and HIV transmission was higher among the poorest families within the sample. Immunisation coverage was higher among the least poor. The inequalities were mainly due to the area of residence and socio-economic position. This study provides evidence that socio-economic inequalities are highly prevalent within the relatively poor black population. Poor socio-economic position exposes infants to ill health. In addition, the use of immunisation services was lower in the poor households. These inequalities need to be explicitly addressed in future programme planning to improve child health for all South Africans.