Carol E. Levin

Good Care Practices Can Mitigate the Negative Effects of Poverty and Low Maternal Schooling on Children’s Nutritional Status: Evidence from Accra

This study uses data from a representative survey of households with preschoolers in Accra, Ghana to (1) examine the importance of care practices for childrens height-for-age z-scores (HAZ); and (2) identify subgroups of children for whom good maternal care practices may be particularly important. Good caregiving practices related to child feeding and use of preventive health services were a strong determinant of childrens HAZ, specially among children from the two lower income terciles and children whose mothers had less than secondary schooling. In this population, good care practices could compensate for the negative effects of poverty and low maternal schooling on childrens HAZ. Thus, effective targeting of specific education messages to improve child feeding practices and use of preventive health care could have a major impact on reducing childhood malnutrition in Accra.

Working Women in an Urban Setting: Traders, Vendors and Food Security in Accra

Data collected from a 1997 household survey carried out in Accra, Ghana, are used to look at the crucial role that women play as income earners and in securing access to food in urban areas. The high number of female-headed households and the large percent of working women in the sample provide a good backdrop for looking at how women earn and spend income differently than men in an urban area. Livelihood strategies for both men and women are predominantly labor based and dependent on social networks. For all households in the sample, food is still the single most important item in the total budget. Yet, important and striking differences between men and womens livelihoods and expenditure patterns exist. Compared to men, women are less likely to be employed as wage earners, and more likely to work as street food vendors or petty traders. Women earn lower incomes, but tend to allocate more of their budget to basic goods for themselves and their children, while men spend more on entertainment for themselves only. Despite lower incomes and additional demands on their time as housewives and mothers, female-headed households, petty traders, and street food vendors have the largest percentage of food secure households. This paper explores differences in income, expenditure, and consumption patterns in an effort to answer this question, and suggests ways that urban planners and policymakers can address special concerns of working women in urban areas.

Alternative food-security indicators: revisiting the frequency and severity of `coping strategies'

Abstract Recent research on the multi-factorial nature of food security has provided a wealth of analytical insight, but measurement problems remain a major challenge, not only for research, but particularly for targeting, program management, monitoring and evaluation. Building on an approach suggested in a 1996 article, this paper constructs a series of alternative food-security indicators based on the frequency and severity of consumption-related coping strategies. These alternative indicators are then compared with more standard measures, including a consumption benchmark, a poverty benchmark and a nutritional benchmark using data from the 1997 Accra Urban Food and Nutrition Study. Against these more traditional indicators, the coping strategy indicators are best at ruling out cases—that is, minimizing the risk of classifying a food-insecure household as food-secure. They also help to identify sources of vulnerability and the trade-offs made with other basic needs to acquire sufficient food. The measures outlined here are much less time-consuming and less expensive in terms of data collection and analysis, and therefore perhaps offer a pragmatic alternative to food and livelihood program managers. However, the comparative analysis of conventional benchmarks with the coping strategies indicator reveals some shortcomings with the benchmark indicators as well—a sign that perhaps the indicators of food security proposed here are both alternative and complementary measures.

Does Geographic Targeting of Nutrition Interventions Make Sense in Cities? Evidence from Abidjan and Accra

Although most developing country cities are characterized by pockets of substandard housing and inadequate service provision, it is not known to what degree low incomes and malnutrition are confined to specific neighborhoods. This analysis uses representative household surveys of Abidjan and Accra to quantify small-area clustering in service provision, demographic characteristics, consumption, and nutrition. Both cities showed significant clustering in housing conditions but not in nutrition, while income was clustered in Abidjan, but less so in Accra. This suggests that neighborhood targeting of poverty-alleviation or nutrition interventions in these and similar cities could lead to undercoverage of the truly needy.

Does urban agriculture help prevent malnutrition? Evidence from Kampala

Abstract Previous research has suggested that urban agriculture has a positive impact on the household food security and nutritional status of low-income status groups in cities in Sub-Saharan Africa, but a formal test of the link between semi-subsistence urban food production and nutritional status has not accompanied these claims. This paper seeks to redress this gap in the growing literature on urban agriculture through an analysis of the determinants of the nutritional status of children under five in Kampala, Uganda, where roughly one third of all households in the sample engage in some form of urban agriculture. When controlling for other individual child, maternal, and household characteristics, these data indicate that urban agriculture has a positive, significant association with higher nutritional status of children, particularly height for age. Several pathways by which this relationship is manifested are suggested, and the implications of these results for urban food and nutrition policy and urban management are briefly discussed.

Discussion Paper 92. Assessing the Potential for Food-Based Strategies to Reduce Vitamin A and Iron Deficiencies: A Review of Recent Evidence

Balanced diets are not accessible to a large proportion of the world’s population, particularly those who live in developing countries. Many populations subsist on staple plant-based diets that often lack diversity (and sometimes also quantities), which may result in micronutrient deficiencies. Vitamin A and iron deficiencies are among the nutritional deficiencies of greatest public health significance in the world today. Because they disproportionately affect children and women during their reproductive years, they hinder both the development of individual human potential and national social and economic development. The most popular approaches to address vitamin A and iron deficiencies include the distribution of vitamin supplements, food fortification, nutrition education, and food-based strategies. Also referred to as dietary modification, food-based approaches use a combination of agricultural, educational, and nutritional strategies to increase the production of, availability of, access to, and consumption of micronutrient-rich foods.