This study’s objective was to evaluate mortality and morbidity among internally displaced persons (IDPs) who relocated in a demographic surveillance system (DSS) area in western Kenya following post-election violence. In 2007, 204 000 individuals lived in the DSS area, where field workers visited households every four months to record migrations, births and deaths. Between December 2007 and May 2008, 16,428 IDPs migrated into the DSS, and over half of them stayed six months or longer. In 2008, IDPs aged 15–49 years died at higher rates than regular residents of the DSS. A greater percentage of deaths from HIV infection occurred among IDPs aged ≥ 5 years (53%) than among regular DSS residents (25–29%). Internally displaced children < 5 years of age did not die at higher rates than resident children but were hospitalised at higher rates. In conclusion, HIV-infected internally displaced adults in conflict-ridden parts of Africa were found to be at increased risk of HIV-related death. Relief efforts should extend to IDPs who have relocated outside IDP camps, particularly if afflicted with HIV infection or other chronic conditions.
Poverty and health
New data on the nutritional status of Zimbabwe’s children reveals that more than one third of Zimbabwe’s children under the age of five are chronically malnourished and consequently stunted. Zimbabwe’s current food production remains too low to meet national requirements. Years of persistent droughts and the downturn of the Zimbabwean economy over the past decade have adversely affected food availability in many homes in Zimbabwe. The report calls for accelerated action to reverse chronic malnutrition and maintain the low levels of acute malnutrition highlighted by the report. Chronic malnutrition poses long-term survival and development challenges for Zimbabwe. The survey also shows plummeting exclusive breastfeeding rates. However, the low and stable rates of severe acute malnutrition that were found are a sign that the food security programmes supported by the international community are reaping benefits. The report also acknowledges the tremendous coping mechanisms of the Zimbabwean people at a time of great difficulty.
The different explanations given for Africa’s current food crisis seem to miss the real causes of the problem, according to this article. The crisis is not of an economic nature. Rather, it is the endpoint of the dismantling of Africa’s agricultural sector and its linking to the international market and brutal liberalism. The article cautions that there are huge risks associated with linking African agriculture to global markets dominated by subsidised produce from the United States and the European Union. There is also the threat of genetically modified organisms and other industrial hybrids that could wipe out tradition systems. Radical measures are necessary to safeguard local production and producers, who make up close to 80% of the population in some countries. Based on an analysis of the political choices that have contributed to the current situation, notably the structural adjustment programmes of the 1980s, the article proposes solutions and decisions that need to be taken to achieve food sovereignty in Africa, such as re-nationalising agri-food industries that are strategic to agricultural development and setting in place agricultural policies that are based on food sovereignty and that make all issues related to food human rights issues.
Though global progress in sanitation has been poor, some low income countries have achieved a reduction of up to 60% in the proportion of people without improved sanitation. This article argues that it is likely that this progress was not simply due to installing infrastructure, but also due to political support, modest financing cleverly applied and a focus on changing behaviour and social norms. Building demand for toilets, especially among those people who have practiced open defecation all their lives, helps trigger household investments. Evidence that these approaches are effective suggests that accelerated progress is possible. Barriers in providing drinking-water can also be overcome using innovations like low-cost drilling techniques and cheaper hand pumps, the use of locally-managed, small-scale systems and civil society intermediation between poor communities and service providers. Providing water, sanitation and hygiene in schools is increasingly a priority for ministries of education in developing countries. Emerging designs for toilets that incorporate privacy and facilities for menstrual hygiene provide a multitude of benefits. Water, sanitation and hygiene also enable women to play roles in their community’s development, including decision-making and management of water and sanitation systems.
The objective of this paper was to investigate the relationships between the prevalence of HIV infection and underlying structural factors of poverty and wealth in several African countries. A retrospective ecological comparison and trend analysis was conducted by reviewing data from demographic and health surveys, AIDS indicator surveys and national sero-behavioural surveys in twelve sub-Saharan African countries with different estimated national incomes. The relationship between the prevalence of HIV infection and household wealth quintile did not show consistent trends in all countries. In particular, rates of HIV infection in higher-income countries did not increase with wealth. The Tanzanian data illustrated that the relationship between wealth and HIV infection can change over time in a given setting, with declining prevalence in wealthy groups occurring simultaneously with increasing prevalence in poorer women. In conclusion, both wealth and poverty can lead to potentially risky or protective behaviours. To develop better-targeted HIV prevention interventions, the paper urges the HIV community to recognise the multiple ways in which underlying structural factors can manifest themselves as risk in different settings and at different times. Context-specific risks should be the targets of HIV prevention initiatives tailored to local factors.
This paper examines the South African government’s mandate to halve unemployment and poverty by 2014, noting the growing evidence of the unlikelihood of this happening. The paper found that disagreements among academics on the severity of poverty can be traced to the failure by Statistics South Africa to conduct adequate surveys on poverty, while unemployment rates have undermined the progress of poverty-elevation made since 2006. It estimates that, in 2014, there will still be between three and five million unemployed lacking any kind of income protection. The impact of AIDS on mortality also means that the number of poor has been significantly reducing, also impacting on unemployment rates. The paper attempts to explain the reasons behind the offhand rejection of the 'Basic Income Grant' (BIG) by government, concluding that the political bargains were behind scrapping the proposal of BIG.
This book aims to give a bird’s eye view of the situation of child poverty in Africa. It highlights the paradox of countries that have an abundance of natural resources, especially oil and diamonds, yet whose populations largely suffer from poverty, such as Angola, Equatorial Guinea and Nigeria. The book points to a symbiotic relationship between poverty and armed conflicts as Africa is slowly extricating itself from the intertwined problems of conflict, poverty, hunger and illiteracy. The book argues that improved governance and increased investments in key social sectors have created an unprecedented sense of optimism. Nevertheless, millions of African children still struggle on the margins. At least 600 million children under the age of 18 are surviving on less than US$1 a day worldwide and 40% of these children live in developing countries.
This is a synthesis report of eight case studies conducted across South Africa to investigate sanitation and the delivery of clean water. The findings and conclusions have been captured under four cross-cutting issues: public participation and politics; accountability and regulation; service levels, financing and affordability; and institutional approaches. The research showed that finding workable solutions and taking appropriate decisions can only be achieved through a thorough understanding of the local context and realities. There is no one-size-fits-all best-approach, and institutional models work best when they are developed on the basis of robust, comprehensive local assessment of what the key challenges are and how best to meet them. The author argues for a multi-jurisdictional water utility model, across more than one municipality, as having the potential to make the best use of available skills and resources and achieve economies of scale. Sufficient municipal capacity, consolidation of services, clear organisational objectives, and staff commitment and capability are identified as critical to success. The studies indicate that, internationally and nationally, there is a need to shift away from an excessive preoccupation with institutional approaches, which tend to rely on layers of capacity and governance that are generally quite rare or undeveloped, and rather focus on the basics of good operational practice.
A resolution at the 63rd World Health Assembly states that food-borne diseases continue to represent a serious threat to the health of millions of people in the world, particularly those in developing countries with poor nutritional status. It refers to the links between food safety, nutrition and food security, and acknowledges the instrumental role of food safety in eradicating hunger and malnutrition, in particular in low-income and food-deficit countries, while also acknowledging increasing evidence that many communicable diseases are transmitted through food, a risk that is increased by the growing global trade in food. It calls for closer collaboration between the health sector and other sectors, and increased action on food safety at international and national levels, across the full length of the food-production chain, to reduce significantly the incidence of food-borne disease.
With 87% of the world’s population or approximately 5.9 billion people using safe drinking water sources, the world is on track to meet or even exceed the drinking water target of the Millennium Development Goals (MDGs), according to this new report. The report confirms that advances continue to be made towards greater access to safe drinking water. In contrast, progress in relation to access to basic sanitation is insufficient to achieve the Millennium Development Goal (MDG) target to halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation.