This paper uses Demographic and Health Survey (DHS) data to analyse the evolution and determinants of children’s nutritional status in Kenya using descriptive and econometric methods. Our findings suggest that if Kenya is to reduce the current high rates of malnutrition as stipulated in the strategic health objectives and the millennium development goals, policies and strategies for poverty alleviation, promotion of post secondary education for women and provision of basic preventive health care are critical issues which need to be pursued because they have a big impact on children’s nutritional status. Decomposition results indicate that there are significant unexplained differentials in chronic malnutrition between the two years.
Poverty and health
Evolution and determinants of non-monetary indicators of poverty in Kenya: Children's nutritional status 1998-2003
Kabubo-Mariara J, Ndenge GK, Mwabu DK: World Institute for Development Economic Research (WIDER)
Exclusive breastfeeding promotion by peer counsellors in sub-Saharan Africa (PROMISE-EBF): a cluster-randomised trial
Tylleskär T, Jackson D, Meda N, Engebretsen IMS, Chopra M, Diallo AH et al: The Lancet 378(9789): pp 420-427, 30 July 2011
Exclusive breastfeeding (EBF) is reported to be a life-saving intervention in low-income settings. In this study, researchers evaluated the effectiveness of breastfeeding counselling by peer counsellors in Africa. Twenty-four communities in Burkina Faso, 24 in Uganda and 34 in South Africa were included in the study. Of the 2,579 mother-infant pairs assigned to the intervention or control clusters in the three countries, EBF prevalences were recorded along with prevalence of diarrhea. The researchers found that, although it does not affect diarrhoea prevalence, low-intensity individual breastfeeding peer counselling is an achievable target and they urge governments in low-income countries in sub-Saharan Africa to scale up EBF counseling to increase the prevalence of EBF.
Explaining household socio-economic related child health inequalities using multiple methods in three diverse settings in South Africa
Nkonki LL, Chopra M, Doherty TM, Jackson D and Robberstad B: International Journal for Equity in Health 10(13), 4 April 2011
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.
Exploring the paradox: double burden of malnutrition in rural South Africa
Kimani-Murage EW: Global Health Action 6(100), 24 January 2013
This paper explores the double burden of malnutrition in rural South Africa, to understand the profiles of malnutrition among children and adolescents in a poor, high HIV prevalent context. A cross-sectional survey was conducted in 2007 of 4,000 children and adolescents aged 1–20 years. The study found stunting at an early age and adolescent obesity, particularly among girls, co-existing in the same socio-geographic population. HIV is a risk factor for poor nutritional outcomes. Significant predictors of undernutrition at an early age include child's HIV status, age and birth weight, maternal age, age of household head, and area of residence. Significant predictors of overweight/obesity and risk for metabolic disease during adolescence include child's age, sex, and pubertal development, household-level food security, socio-economic status, and household head's highest education level. The combination of early stunting and adolescent obesity raises concerns as paediatric obesity and adult short stature are risk factors for metabolic syndrome and metabolic diseases in adulthood.
Extreme Poverty Spreading In Sub-Saharan Africa, says UN
Sub-Saharan Africa is the only region in the world where the proportion of people living in extreme poverty has continued to grow for 20 years, Reuters reports. In its annual Industrial Development Report released on Tuesday, the United Nations Industrial Development Organization (UNIDO) described the region as "the last frontier in the fight against abject poverty" and said the international community and the countries concerned needed to step up efforts to promote economic growth there. The rate of absolute poverty - people living on one dollar a day or less - in Sub-Saharan Africa is nearing 50 percent.
Facilitators and Obstacles in Youth Saving: Perspectives from Ghana and Kenya
Zou L; Tlapek S; Njenga G; Appiah E; Opai-Tetteh D; Sherraden M: Global Social Welfare 2(2) 65-74, 2015
Youth are a rapidly growing percentage of the Sub-Saharan African population, and many are economically vulnerable. Financial inclusion for youth, particularly the promotion of savings behaviour, is associated with a number of positive social and economic outcomes and is an international priority. However, the majority of youth in Sub-Saharan Africa are not saving, and limited qualitative research exists to aid understanding of the possible explanations. This paper aims to increase the understanding of factors that facilitate and obstruct youth saving by exploring the savings behaviour of youth participating in the YouthSave Project in Ghana and Kenya. The authors conducted in-depth interviews with four triads comprised of youth, a parent or caregiver, and a school stakeholder in each country to develop case studies for the YouthSave Project. Findings indicate that support from parents, school staff, and financial institutions is conducive to youth participation in saving, even though youth participants struggle with limited financial resources and conflicting demands for money.
Factors associated with household food insecurity and depression in pregnant South African women from a low socio-economic setting: a cross-sectional study
Abrahams Z; Lund C; Field S; et al: Social Psychiatry and Psychiatric Epidemiology, doi: https://doi.org/10.1007/s00127-018-1497-y, 2018
This study aimed to assess factors associated with food insecurity and depression in a sample of pregnant South African women in a low-income suburb in Cape Town. Pregnant women attending a local clinic for their first antenatal visit were invited to participate. The shortened form of the US Household Food Security Survey Module was used to measure food insecurity. The Expanded Mini-International Neuropsychiatric Interview was used to diagnose depression, anxiety, alcohol and drug dependence, and assess for suicidal ideation and behaviour. Logistic regression modelling was conducted to explore factors associated with food insecurity and depression in separate models. The authors found that 42% of households were food insecure and that 21% of participants were depressed. The odds of being food insecure were increased in women with suicidal behaviour, with depression and in those with three or more children. The odds of depression was greater in women who were food insecure, substance dependent or diagnosed with an anxiety disorder. Food insecurity and depression are strongly associated in pregnant women. The relationship between food insecurity and depression is complex and requires further investigation. Interventions that improve both food security and mental health during the perinatal period are likely to benefit the physical and mental well-being of mothers and children.
Factors influencing men’s involvement in antenatal care services: a cross-sectional study in a low resource setting, Central Tanzania
Gibore N; Bali T; Kibusi S: Reproductive Health 16(52)1-10, 2019
In this paper the authors sought to determine the level of men’s involvement in antenatal care and the factors influencing their involvement in these services. A cross sectional study of 966 randomly selected men aged 18 years or older was conducted in Dodoma Region, from June 2014 to November 2015. Face to face interviews were conducted using a pretested structured questionnaire. The level of men’s involvement in antenatal care was high and 89% of respondents made joint decisions on seeking antenatal care. More than half of respondents accompanied their partners to the antenatal clinic at least once. Less than a quarter of men were able to discuss issues related to pregnancy with their partner’s health care providers, although 77% of respondents provided physical support to their partners during the antenatal period. Factors influencing men’s involvement in antenatal care were occupation, ethnicity, religion, waiting time, information regarding men’s involvement in antenatal care and men’s perception about the attitude of health care providers. Overall, more than half of respondents reported high involvement in antenatal care services. Access to information on men’s involvement, religion, occupation, ethnicity, waiting time and men’s perception about the attitude of care providers were significant factors influencing men’s involvement in antenatal care services in this study. The authors observe that health promotion is needed to empower men with essential information for meaningful involvement in antenatal care services.
Fair shares: Is CAADP working?
Howell J, Curtis M and Ross S: ActionAid, May 2013
The Comprehensive Africa Agriculture Development Programme (CAADP), launched by African heads of state in 2003, offered the prospect of a new, intensified focus on agriculture throughout the continent. Ten years on, how successful has CAADP been? This paper offers a brief assessment, with its authors examining if agricultural budgets have increased, if the focus of spending has improved, and if CAADP is providing ‘fair shares’ to the millions of smallholder farmers who do most of Africa’s farming and produce most of its food. The key CAADP commitment made by African states was to allocate 10% of public expenditure to agriculture. Yet, as of 2010, only eight countries have exceeded the 10% target. Although the adoption of CAADP-aligned national strategies has played a role in increasing agricultural investment in some (though not all) countries, there are serious problems with the focus of spending, especially in the lack of adequate support to the needs of smallholder farmers, notably women farmers. The authors note that CAADP is promoting a farming model associated with the Green Revolution, which promotes the use of expensive external inputs such as chemical fertilisers, pesticides and genetically modified or hybrid seeds bought from agribusiness companies; they argue this comes at the expense of promoting sustainable agriculture approaches that are likely to benefit poor farmers much more. One of the biggest failures for CAADP-aligned national investments is that they have not recognised the potential of smallholders’ own investments or their potential to build on their ‘fair share’, the authors conclude.
Famine in east Africa caused by human actions not drought
Answerman A: Pambazuka News 543: 4 August 2011
The famine spreading across the Horn of Africa is not principally the result of drought, but due to political and social circumstances that urgently need to be addressed, the author of this article argues. Global media reports attribute the main cause for the famine to successive seasons of failed rains, yet the author notes here that there has been only one failed rainy season in the Horn so far. The primary cause of the famine is war, the author argues, which has disrupted farmers in Somalia from their normal routines. In the past, a single rainy season failure was easily augmented by relying on stored food from surplus harvests, or from importing food from further south, but violence and fighting has kept farmers from their fields, even if the rains are good, as they were this year. And while there is surplus food, it isn’t getting to the famine area due to lack of infrastructure and local disruption of services. Tanzania, which has had a bumper harvest so far this year, has also banned agricultural sales to the north, for fear it will deplete its own surpluses.