This article provides evidence on the link between poverty and risky sexual behaviour. It examines the effect of wealth status on age at first sex, condom use, and multiple partners using data from more than 19,000 adolescents from Burkina Faso, Ghana, Malawi and Uganda. The results show that the wealthiest girls in Burkina Faso, Ghana and Malawi have later sexual debut compared with poorer adolescents, but this association was not significant in Uganda. Wealth status is weaker among males and significant only in Malawi, where those in the middle income group had earlier sexual debut. Wealthier adolescents were most likely to use condoms, but wealth status was not associated with the number of sexual partners. The authors conclude that understanding patterns and motivations of early sexual debut, non-use of condoms, and multiple partnerships is an important contribution to HIV prevention strategies. From this study poverty appears to influence early sexual debut, especially among females, and the poor are less likely to be using condoms. Therefore, poverty, by influencing sexual behaviour and access to services, can influence the transmission of HIV infection.
Poverty and health
The seventh Millennium Development Goal (MDGs) commits the international community to halving, by 2015, the proportion of people without sustainable access to safe drinking water. The baseline set for most of the MDG targets, including that on water and sanitation, is 1990. As 2002 is the last year for which comprehensive data is available it can be considered the halfway mark towards achieving the 2015 MDG deadline. Based on 2002 data, is the world on course for achieving this goal? A report prepared by the World Health Organization/UNICEF Joint Monitoring Programme (JMP) presents a report on progress made towards fulfilling the MDG commitment. Encouragingly, with 83 percent coverage, the world is set to meet the drinking water MDG. This progress is tempered, however, by slow progress in sub-Saharan Africa.
Poverty reduction efforts in Malawi pivot on the twin strategies of the Poverty Reduction Strategy Paper (PRSP) and decentralisation. Yet researchers argue that the Malawi PRSP represents a mixture of policies and generalities that could equally well have appeared in any strategic document of the past 30 years. A paper from the University of East Anglia’s Overseas Development Group takes a sceptical view of the PRSP and decentralisation processes in Malawi. The authors argue that PRSP-generated poverty indicators cannot reveal causes and effects regarding the opportunities and constraints experienced by citizens. The report shows that creating an enabling environment for people to construct their own routes out of poverty may be prevalent in many PRSPs, but the nature of public sector roles and modes of conduct required to build such an enabling environment are poorly articulated by both donors and governments.
This article reports on a qualitative study of 20 married girls aged 12-17 years' experiences of sexual violence in the Shinyanga Region, Tanzania where there is high prevalence (59%) of child marriage. The study identified four analytical themes regarding the experience of sexual violence, namely: forced sex; rape; struggling against unpleasant and painful sex; and inculcation of the culture of tolerance of sexual violence. The study found that married adolescent girls suffer sexual coercion in silence, increasing their risk of acquiring sexually transmitted infections and or unwanted pregnancies. The authors make recommendations for sexual violence prevention strategies .
Health aid advocates are gearing up to lobby for more, and better, aid at the Fourth High Level Forum on Aid Effectiveness in Busan, South Korea, in November 2011. And like many others, health aid advocates seem to be missing the bigger picture, according to this paper. While it is vital to improve aid procedures to get more aid flowing for health, this is not the only important issue: continuously overlooked are problems with the whole development model. Part of the problem is an epistemological one involving the discourse about "poverty reduction" that has seemingly supplanted earlier understandings of development. It seems, somehow, short-term "poverty reduction" has become a stand-in for actual long-term development. The author argues that, while aid advocates lobby external funders in one arena, the advocates' own representatives to the IMF executive board push a conservative monetary policy within another arena that exacerbates the ability of the aid recipients to develop. The same goes for the arena of trade policy, where the donor countries give aid with one hand while pushing for rapid and premature trade liberalisation in poor countries with the other.
This brief notes some developments in the provision of water to poor Kenyans since the enactment of the 2002 Water Act. These include increased government spending for further water provision and policy reforms that separated asset ownership from service provision, regulation and policy formulation. Yet it found that at least 16 million Kenyans do not receive clean, piped water and remain at risk for water-borne diseases. It also noted that urban water kiosks provide an inadequate service, with many users forced to use minimal quantities of water as distance, waiting times and cost make water inaccessible. Poor people in urban areas appear to pay much more for water than those with piped water, while urban coverage of the piped system is declining. Large inequities exist in access to water as the struggle for water by the excluded sections of Kenya’s population contrasts sharply with the privileged, who benefit from water delivered to their homes, often at very low prices. At the current pace of expansion, the author argues that it will take unacceptably long to cover populations that urgently need water. It estimates that it will take at least 30 years for rural areas to have acceptable water supplies. The government’s budgets allocated to water provision, the author argues, do not reflect need. To address existing inequalities, the government should urgently develop and implement a needs-based budget allocation formula.
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.
In the run up to the 2011 United Nations climate conference – hosted in Durban, South Africa, from 28 November to 1 December – Oxfam supported communities to speak out about the impact that climate change is having on their lives. In drought-prone areas of Kenya, Oxfam worked with communities to organise climate hearings. This document reports that at time of writing four million Kenyans faced hunger as a result of failed rains. The northern regions of Turkana and Wajir experienced chronic drought, leaving over half the population dependant on food aid. The hearings were seen as a vital opportunity for communities to speak out about the dramatic impact that climate change is having on their lives. Testimony from the hearings painted a devastating picture of lives and livelihoods that have been severely disrupted by what communities see as a changing climate. Feedback from the hearings indicate that cattle are crucially important to pastoralists, but with changing weather patterns, cattle-rearing is more and more difficult, and livestock are reduced to feeding on polythene paper and human waste. Women in particular were found to suffer from the consequences of a changing climate, with livestock death leading to food insecurity, falling household incomes and child school drop out. The findings of the hearings were taken to the United Nations Climate Change Summit in Durban in end November 2011.
In the run up to the 2011 United Nations climate conference – hosted in Durban, South Africa, from 28 November to 1 December – Oxfam is supporting communities to speak out about the impact that climate change is having on their lives. In drought-prone areas of Kenya, Oxfam has worked with communities to organise climate hearings. This document reports that at time of writing four million Kenyans faced hunger as a result of failed rains. The northern regions of Turkana and Wajir experienced chronic drought, leaving over half the population dependant on food aid. The hearings are seen as a vital opportunity for communities to speak out about the dramatic impact that climate change is having on their lives. Testimony from the hearings paints a devastating picture of lives and livelihoods that have been severely disrupted by what communities see as a changing climate. Feedback from the hearings indicate that cattle are crucially important to pastoralists, but with changing weather patterns, cattle-rearing is more and more difficult, and livestock are reduced to feeding on polythene paper and human waste. Women in particular are found to suffer from the consequences of a changing climate, with livestock death leading to food insecurity, falling household incomes and child school drop out. The findings of the hearings were taken to the United Nations Climate Change Summit in Durban in end November 2011.
According to this report, malnutrition levels in pastoralist districts of northeastern Kenya have remained high, despite recent rains that boosted livestock productivity, the mainstay of the local economy. Improvements in household food security have not translated into a decisive reduction in rates of child malnutrition in the northeastern districts, suggesting that causal factors of the unacceptably high rates go beyond availability of food at the household level. The Ministry of Health and its partners found Global Acute Malnutrition (GAM) levels above the World Health Organization's 15% emergency threshold in Mandera Central Districts, Wajir South and Wajir East. Mandera West recorded GAM rates above 25%. High illiteracy levels may mean that parents do not ensure their children receive a balanced diet, resulting in malnutrition. The report also emphasises the growing problem of urban poverty, with an estimated 3.5‐4.1 million (or up to 20%) out of 13.5 million urban households situated in high-density areas that are suffering various degrees of food insecurity. Further assessment of urban poverty in Kenya is already underway, according to the Ministry.