Poverty and health

The social and economic impacts of South Africa’s child support grant
Williams MJ: Economic Policy Research Institute Working Paper 40, November 2007

Evidence from this South African study indicates that cash transfers achieve positive education, health and nutrition outcomes. South Africa's child support grant (CSG) is the country's largest social cash transfer programme and is regarded as one of the government's most successful social protection interventions. This study analysed panel data constructed from general household surveys (2002 to 2004), and compared eligible children who received the CSG in 2003 and 2004 with those who did not receive it. It found robust evidence that the CSG is improving nutrition and education outcomes for children. Hunger, as defined by the lack of food in a household, fell among both CSG recipients and non-recipients over the study period, but the reduction was found to be two to three times larger for children receiving the grant. Children under seven years of age who were eligible for the CSG were significantly less likely to be attending school in 2002 than those not receiving the CSG, but after receiving the CSG for two years there was a 6% increase in their pre-school and early grades enrolment by 2004. The study concludes that these effects are likely to be sustained over time among households receiving the CSG, with cumulative improvements in children’s nutrition and educational attainment in the future.

The story of bottled water
The Story of Stuff: March 2010

This short video about the story and challenges to local communities of production of bottled water was launched as part of World Water Day on 22 March 2010.

The end of poverty?
Diaz P: 2009

According to this film, global poverty did not just happen. It began with military conquest, slavery and colonisation that resulted in the seizure of land, minerals and forced labour. Today, the problem persists because of unfair debt, trade and tax policies – in other words, wealthy countries taking advantage of poor, developing countries. Actor and activist, Martin Sheen, narrates the film, a feature-length documentary directed by award-winning director, Philippe Diaz, which explains how today's financial crisis is a direct consequence of these unchallenged policies that have lasted centuries. It considers that 20% of the planet's population uses 80% of its resources and consumes 30% more than the planet can regenerate. At this rate, to maintain our lifestyle means more and more people will sink below the poverty line. Filmed in the slums of Africa and the barrios of Latin America, ‘The end of poverty?’ features expert insights from: Nobel prize winners in Economics, Amartya Sen and Joseph Stiglitz; authors Susan George, Eric Toussaint, John Perkins, Chalmers Johnson; university professors William Easterly and Michael Watts; government ministers such as Bolivia's Vice President Alvaro Garcia Linera and the leaders of social movements in Brazil, Venezuela, Kenya and Tanzania.

The MDGS and beyond:Pro-poor policy in a changing world
Sumner A And Melamed C (eds): Poverty In Focus 19, January 2010

This issue of Poverty in Focus reviews the Millennium Development Goals (MDGs) to date and asks what can be done to accelerate MDG progress in the years 2010–2015 and beyond. There have been numerous calls for a new development narrative/paradigm from developing countries, international civil society organisations and development agencies. The contributing authors believe this changing context will affect the debate on the MDGs, past and future, in ways that perhaps only now are starting to become clear. They also believe that impact of the current financial crisis is likely to continue to frame debates over the next five years, and will be critical in determining the economic and social environment. Economic uncertainty in donor countries is also leading to declining public support for aid budgets. They predict the coming period is likely to be much less certain as developing countries, especially in sub-Saharan Africa, face several interconnected crises to which climate change is central, and which will change the context for achieving the MDGs.

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.

Hospitalisation and mortality among primarily non-breastfed children during a large outbreak of diarrhoea and malnutrition in Botswana, 2006
Creek TL, Kim A, Lu L, Bowen A, Masunge J, Arvelo W, Smit M, Mach O, Legwaila K, Motswere C, Zaks L, Finkbeiner T, Povinelli L, Maruping M, Ngwaru G, Tebele G, Bopp C, Puhr N, Johnston SP, Dasilva AJ, Bern C, Beard RS, Davis MK: Journal of Acquired Immune

In 2006, a paediatric diarrhoea outbreak occurred in Botswana, coinciding with heavy rains. Surveillance recorded a three-times increase in cases and a 25-fold increase in deaths between January and March. Botswana has high HIV prevalence among pregnant women (33.4% in 2005), and an estimated 35% of all infants under the age of six months are not breastfed. This study followed all children <5 years old with diarrhoea in the country's second largest referral hospital at the peak of the outbreak by chart review, interviewed mothers and conducted laboratory testing for HIV and enteric pathogens. Of 153 hospitalised children with diarrhoea, 97% were <2 years old; 88% of these were not breastfeeding. HIV was diagnosed in 18% of children and 64% of mothers. Many children who died had been undersupplied with formula. Most of the severe morbidity and mortality in this outbreak occurred in children who were HIV negative and not breastfed. Feeding and nutritional factors were the most important determinants of severe illness and death. Breastfeeding is critical to infant survival in the developing world, and support for breastfeeding among HIV-negative women, and HIV-positive women who cannot formula feed safely, may prevent further high-mortality outbreaks.

Kampala faces sanitation and water crisis
IRIN News: 8 January 2010

The lack of adequate sanitation facilities in the Ugandan capital, Kampala, has led to increased use of polythene bags – known as 'flying toilets' – for human waste disposal, local officials said. The situation is worse in slums where infrastructure is basic. The few private and public facilities that exist charge up to USh200 [US 10 cents] per use of a toilet. 'These areas are characterised by poor drainage systems and, in the rainy season, the problem becomes worse,' said Bernard Luyiga, a councillor in Kampala district. 'We have not invested enough in this area.' About 6.2% of households in the city have no toilet facilities at all. Most, according to chief health inspector Mohammed Kirumira, are in the slums. And only about 65% of Kampala’s two million residents have access to clean water. The rest use water that is sometimes contaminated by pit latrines. According to Uganda's Lands, Housing and Urban Development Ministry, the high cost of piped water has forced some city dwellers to rely on springs and wells. 'Over 50% of household occupants in Kampala are hospitalised every three months due to malaria while contamination of water by prevalence of micro-organisms is evident in the water sources of the city,' it said.

The MDGs and beyond: Pro-poor policy in a changing world
Sumner A and Melamed C (eds): Poverty in Focus 19, January 2010

This issue of Poverty in Focus reviews the Millennium Development Goals (MDGs) to date and asks what can be done to accelerate MDG progress in the years 2010–2015 and beyond. There have been numerous calls for a new development narrative/paradigm from developing countries, international civil society organisations and development agencies. The contributing authors believe this changing context will affect the debate on the MDGs, past and future, in ways that perhaps only now are starting to become clear. They also believe that impact of the current financial crisis is likely to continue to frame debates over the next five years, and will be critical in determining the economic and social environment. Economic uncertainty in donor countries is also leading to declining public support for aid budgets. They predict the coming period is likely to be much less certain as developing countries, especially in sub-Saharan Africa, face several interconnected crises to which climate change is central, and which will change the context for achieving the MDGs.

Urban poverty and vulnerability in Kenya: The urgent need for co-ordinated action to reduce urban poverty
Oxfam: Oxfam GB Briefing Note, 10 September 2009

Even if, in terms of income, there are still today a higher number of poor people in the countryside than in Kenya’s cities, poor urban-dwellers face an alarming (and growing) range of vulnerabilities. Oxfam GB Kenya’s report highlights the mutually reinforcing dimensions of vulnerability in Nairobi’s slums. It launched a new Urban Programme Strategy in 2009 that aims to build on the organisation’s strategic comparative advantages, bringing its experience elsewhere into the urban sector in Kenya. These advantages include: coordinating partnerships with key stakeholders, bringing Oxfam GB’s experience in peace and conflict transformation in other parts of rural Kenya into the urban arena; capitalising on its international status in terms of resource mobilisation; and utilising its expertise on water, sanitation and food security to support local organisations in delivering basic urban services. The strategy will be implemented on a phased basis over a fifteen-year period, and will focus on three strategic priority areas: urban governance, sustainable livelihoods, and disaster preparedness and risk reduction.

An assessment of current support strategies for patients with TB in KwaZulu-Natal
Lutge E, Ndlela Z and Friedman I: Health Systems Trust, November 2009

In order to ameliorate poverty among tuberculosis (TB) sufferers, a few initiatives to support patients with TB have been made in KwaZulu-Natal, South Africa, including free treatment at government hospitals and clinics, and nutritional supplementation and social grants. Although these programmes have been functioning for a number of years, they have never been formally assessed in terms of the costs involved, the effects on the target populations, and the responses of patients. A recent study in Brazil (Belo et al, 2006) investigated a range of support strategies for patients with TB that included material and financial assistance, improved health services support and better administrative organisation – from the patient's perspective. Such a study has not been undertaken in South Africa, however, and given the large amount of money spent on support to TB patients, this is necessary to better inform such programmes.

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