James L. Garrett

Are Determinants of Rural and Urban Food Security and Nutritional Status Different? Some Insights from Mozambique

Undernutrition of children 0-60 months old in Mozambique is much higher in rural than in urban areas. Food security is about the same, although substantial regional differences exist. Given these outcomes, we hypothesized that the determinants of food security and nutritional status in rural and urban areas of Mozambique would differ as well. Yet we find that the determinants of food insecurity and malnutrition, and the magnitudes of their effects, are very nearly the same. The difference in observed outcomes appears primarily due to differences in the levels of critical determinants rather than in the nature of the determinants themselves.

Some Urban Facts of Life: Implications for Research and Policy

Abstract This review of recent literature explores the challenges to urban food and nutrition security in the rapidly urbanizing developing world. The premise of the manuscript is that the causes of malnutrition and food insecurity in urban and rural areas are different due primarily to a number of phenomena that are unique to or exacerbated by urban living. These areas include: (a) a greater dependence on cash income; (b) weaker informal safety nets; (c) greater labor force participation of women and its consequences for child care; (d) lifestyle changes, particularly diet and exercise patterns; (e) greater availability of public services, but questionable access by the poor; (f) greater exposure to environmental contamination; and (g) governance by a new, possibly nonexistent, set of property rights. The main focus is on identifying what is different about urban areas, so as to better frame the program and policy responses.

The Food, Fuel, and Financial Crises Affect the Urban and Rural Poor Disproportionately: A Review of the Evidence

The vulnerability of the urban poor to the recent food and fuel price crisis has been widely acknowledged. The unfolding global financial crisis, which brings higher unemployment and underemployment, is likely to further intensify this vulnerability. This paper reviews the evidence concerning the disproportionate vulnerability of the urban compared with the rural poor to these types of shocks. It reviews some of the unique characteristics of urban life that could make the urban poor particularly susceptible to price and financial shocks and summarizes the evidence regarding the disproportionate vulnerability of the urban poor. The focus is on impacts on poverty, food insecurity, and malnutrition. The review shows that although the urban poor are clearly one of the population groups most affected by the current (and previous) crises, the rural poor, landless, and net buyers are in no better position to confront the crisis without significant suffering. The poorest of the poor are the ones who will be most affected, irrespective of the continent, country, or urban or rural area where they live. The magnitude and severity of their suffering depends on their ability to adapt and on the specific nature, extent, and duration of the coping strategies they adopt. A better understanding of how these coping strategies are used and staggered is critical to help design triggers for action that can prevent households from moving to more desperate measures. Using these early coping strategies as early warning indicators could help prevent dramatic losses in welfare.

The food price crisis and urban food (in)security

Both national and international policy responses to the rapid food price increases in 2007 and the first half of 2008 did little to address the very serious impacts on low-income urban dwellers. The speeches, declarations, plans and pledges duly noted the vulnerability of poor urban dwellers to food price rises, as they rely primarily on market purchases for their food (much more so than rural dwellers) and food purchases account for the bulk of their expenditure. Yet most policy prescriptions focused on addressing constraints to rural-based food production. This paper discusses why policy makers should pay greater attention to urban dwellers and describes the multiple pathways through which food price increases have impacts on urban people. It also highlights the evidence on how these impacts have played out during this crisis and discusses how current policy responses could be adjusted and improved to better protect the urban poor in the short and longer term.

Stunted child-overweight mother pairs: prevalence and association with economic development and urbanization.

This paper explores the prevalence of the coexistence of a stunted child and an overweight mother in the same household (SCOWT), a somewhat paradoxical phenomenon when found in the developing world. It tests whether this phenomenon is associated with a countrys level of economic development and urbanization and, by implication, the nutrition transition. It then highlights policy directions for public nutrition. Data from 42 Demographic and Health Surveys in Africa, Asia, and Latin America were used. Stunting was defined as height-for-age < −2 SD of the reference population, and maternal overweight as a body-mass index > 25 kg/m2. World Bank and United Nations figures were used for gross domestic product (GDP) per capita (an indicator of economic development) and for level of urbanization. Descriptive statistics were derived, and regression analysis was used to model the association between economic development, urbanization, and the prevalence of pairs of stunted children and overweight mothers. The prevalence of this phenomenon is generally below 10%, except in four countries, three of them in Latin America. The phenomenon is generally more prevalent in Latin America than in Africa, though not necessarily more prevalent in urban than in rural areas. The analysis finds that the phenomenon is associated with economic development, but not urbanization, and that it does differ between urban and rural areas and regions. The association with GDP per capita supports the hypothesis that SCOWT increases with economic development, up to a point. SCOWT appears to be most prevalent, as expected, in those countries in the midst of the nutrition transition. Recognizing this phenomenon is important for delineating strategies that respond to the differential needs of individuals within the household and do not just affect the household as a whole. This may become especially important with future economic development and, potentially, urbanization.

Urbanization and caregiving: a framework for analysis and examples from southern and eastern Africa

This paper considers the role of caregiving on childrens health and development with a special focus on identifying the constraints on effective caregiving in urban areas, and the potential solutions. It uses the extended UNICEF framework for nutrition which suggests that there are six major types of care behaviour: feeding and breast-feeding, food preparation and handling, hygiene behaviour, psycho-social care, care for women and home health practices. To ensure adequate care for the child, the caregiver needs adequate knowledge and education, physical and mental health, autonomy in decision-making, time, and social support from the family and community. This paper describes each of these resources and constraints, and two of the behaviour types (breast-feeding and health care utilization) in the urban areas of eight countries in eastern and southern Africa. It also presents a matrix highlighting critical constraints on caregiving behaviours in urban areas, and potential solutions, and identifies areas where further research is needed.

Value Chains and Nutrition: A Framework to Support the Identification, Design, and Evaluation of Interventions

In this paper we explore how a value chain framework can inform the design of interventions for achieving improved nutrition. Conceptually, there are three main channels for value chains to improve nutrition: (1) through increased consumption of nutritious foods (a demand side pathway); or (2) through increased incomes from value chain transactions (a supply side pathway) or (3) through increased nutrition value-addition in the chain transactions. These three pathways are interlinked and involve complex dynamics that are not straightforward to understand.

Rapid Urbanization and the Challenges of Obtaining Food and Nutrition Security

Over the period 2000–2025, the urban population of the developing world is projected to double—from 2.02 billion to 4.03 billion, and the rural population is projected to increase from 2.95 billion to 3.03 billion (1). Caveats to these projections abound,1 nevertheless, the numbers are striking As Figure 1 indicates, 47% of the population, some 2.9 billion people, now lives in urban areas. About 75% of Latin American lives in cities, and a little more than one-third of Africans and Asians live in cities (2). The urban population in developing countries is growing three times faster (3% annually) than the rural population (less than 1% annually). Over the period 2000–2025, the urban population of Africa is expected to increase from 310 million to 804 million (the rural population is projected to increase from 521 to 692 million); for Asia, the urban population will increase from 1.4 billion to 2.7 billion (the rural population is pfojected to decline from 2.3 to 2.2 billion); and for Latin America, the corresponding numbers show an increase in the urban population from 401 million to 601 million (and a decline of the rural population from 123 to 109 million).

Nutrition change strategies: the new frontier

OBJECTIVE To advance understanding of nutrition change dynamics and strategies needed to tackle complex global nutrition challenges. DESIGN Two frameworks, a descriptive framework of orders of change and a change model (Theory U), are introduced to advance understanding of how to promote effective action on a complex social problem like nutrition. The descriptive framework explores the types of change pursued by four current global nutrition initiatives and the strategies they use to achieve their goals. Theory U provides a conceptual model to help understand breakthrough or transformative change, i.e. change that shifts the entire system. SETTING The focus is on global and regional nutrition initiatives. RESULTS Using the criteria of desired outcomes, purpose, participation and process, the orders of change framework categorizes programme strategies according to the levels of change likely to be achieved. Such a framework can help to structure conversations among actors about prerequisites for, and the likelihood of, transformative change. Theory U provides a conceptual framework to facilitate transformative change by providing insight into change processes and levers for action. CONCLUSIONS Nutrition is a complex social issue, and not only a biological or technical challenge. But nutritionists seldom inquire into the nature of changes required to achieve goals or the processes through which change occurs. Lack of understanding and failure to address such change processes directly mean that nutrition policies and programmes continue to fall short. There is a need to understand the dynamics of change in nutrition; to learn from current change experiences; and to create dynamic learning communities.

Incorporating crime in household surveys: a research note

This paper discusses how to incorporate questions about crime into household surveys, drawing on the authors’ experience of designing and implementing a module on crime, violence and physical insecurity in a household survey in the city of Dinajpur in Bangladesh in 2002. The paper discusses issues of design, such as determining survey objectives and the questions that follow from these, involving knowledgeable local partners, determining sample size and designing the questionnaire (and the role of consultations and focus group discussions as well as pre-testing). Then it reports on the findings which highlight the multifaceted nature of crime, the number of people affected (one in six interviewees had been a victim of crime in the 12 months preceding the interview), the role of mastaans (local strong-men) in crime, people’s lack of confidence in the police and the legal system (in part because of the lack of official action against perpetrators), and crime’s direct and indirect costs.