Patrick Mutuo

The African Millennium Villages

We describe the concept, strategy, and initial results of the Millennium Villages Project and implications regarding sustainability and scalability. Our underlying hypothesis is that the interacting crises of agriculture, health, and infrastructure in rural Africa can be overcome through targeted public-sector investments to raise rural productivity and, thereby, to increased private-sector saving and investments. This is carried out by empowering impoverished communities with science-based interventions. Seventy-eight Millennium Villages have been initiated in 12 sites in 10 African countries, each representing a major agroecological zone. In early results, the research villages in Kenya, Ethiopia, and Malawi have reduced malaria prevalence, met caloric requirements, generated crop surpluses, enabled school feeding programs, and provided cash earnings for farm families.

Feasibility, acceptability and cost of home-based HIV testing in rural Kenya

Objective  To demonstrate the feasibility, acceptability and cost of home‐based HIV testing and to examine the applicability of the model to high HIV prevalence settings.

Identifying potential synergies and trade-offs for meeting food security and climate change objectives in sub-Saharan Africa

Potential interactions between food production and climate mitigation are explored for two situations in sub-Saharan Africa, where deforestation and land degradation overlap with hunger and poverty. Three agriculture intensification scenarios for supplying nitrogen to increase crop production (mineral fertilizer, herbaceous legume cover crops—green manures—and agroforestry—legume improved tree fallows) are compared to baseline food production, land requirements to meet basic caloric requirements, and greenhouse gas emissions. At low population densities and high land availability, food security and climate mitigation goals are met with all intensification scenarios, resulting in surplus crop area for reforestation. In contrast, for high population density and small farm sizes, attaining food security and reducing greenhouse gas emissions require mineral fertilizers to make land available for reforestation; green manure or improved tree fallows do not provide sufficient increases in yields to permit reforestation. Tree fallows sequester significant carbon on cropland, but green manures result in net carbon dioxide equivalent emissions because of nitrogen additions. Although these results are encouraging, agricultural intensification in sub-Saharan Africa with mineral fertilizers, green manures, or improved tree fallows will remain low without policies that address access, costs, and lack of incentives. Carbon financing for small-holder agriculture could increase the likelihood of success of Reducing Emissions from Deforestation and Forest Degradation in Developing Countries programs and climate change mitigation but also promote food security in the region.

Assessing Nutritional Diversity of Cropping Systems in African Villages

Background In Sub-Saharan Africa, 40% of children under five years in age are chronically undernourished. As new investments and attention galvanize action on African agriculture to reduce hunger, there is an urgent need for metrics that monitor agricultural progress beyond calories produced per capita and address nutritional diversity essential for human health. In this study we demonstrate how an ecological tool, functional diversity (FD), has potential to address this need and provide new insights on nutritional diversity of cropping systems in rural Africa. Methods and Findings Data on edible plant species diversity, food security and diet diversity were collected for 170 farms in three rural settings in Sub-Saharan Africa. Nutritional FD metrics were calculated based on farm species composition and species nutritional composition. Iron and vitamin A deficiency were determined from blood samples of 90 adult women. Nutritional FD metrics summarized the diversity of nutrients provided by the farm and showed variability between farms and villages. Regression of nutritional FD against species richness and expected FD enabled identification of key species that add nutrient diversity to the system and assessed the degree of redundancy for nutrient traits. Nutritional FD analysis demonstrated that depending on the original composition of species on farm or village, adding or removing individual species can have radically different outcomes for nutritional diversity. While correlations between nutritional FD, food and nutrition indicators were not significant at household level, associations between these variables were observed at village level. Conclusion This study provides novel metrics to address nutritional diversity in farming systems and examples of how these metrics can help guide agricultural interventions towards adequate nutrient diversity. New hypotheses on the link between agro-diversity, food security and human nutrition are generated and strategies for future research are suggested calling for integration of agriculture, ecology, nutrition, and socio-economics.

Nitrogen fertilizer equivalencies of organics of differing quality and optimum combination with inorganic nitrogen source in Central Kenya

Decline in crop yields is a major problem facing smallholder farmers in Kenya and the entire Sub-Saharan region. This is attributed mainly to the mining of major nutrients due to continuous cropping without addition of adequate external nutrients. In most cases inorganic fertilizers are expensive, hence unaffordable to most smallholder farmers. Although organic nutrient sources are available, information about their potential use is scanty. A field experiment was set up in the sub-humid highlands of Kenya to establish the chemical fertilizer equivalency values of different organic materials based on their quality. The experiment consisted of maize plots to which freshly collected leaves of Tithonia diversifolia (tithonia), Senna spectabilis (senna) and Calliandra calothyrsus (calliandra) (all with %N>3) obtained from hedgerows grown ex situ (biomass transfer) and urea (inorganic nitrogen source) were applied. Results obtained for the cumulative above ground biomass yield for three seasons indicated that a combination of both organic and inorganic nutrient source gave higher maize biomass yield than when each was applied separately. Above ground biomass yield production in maize (t ha−1) from organic and inorganic fertilization was in the order of senna+urea (31.2), tithonia+urea (29.4), calliandra+urea (29.3), tithonia (28.6), senna (27.9), urea (27.4), calliandra (25.9), and control (22.5) for three cumulative seasons. On average, the three organic materials (calliandra, senna and tithonia) gave fertilizer equivalency values for the nitrogen contained in them of 50, 87 and 118%, respectively. It is therefore recommended that tithonia biomass be used in place of mineral fertilizer as a source of nitrogen. The high equivalency values can be attributed to the synergetic effects of nutrient supply, and improved moisture and soil physical conditions of the mulch. However, for sustainable agricultural production, combination with mineral fertilizer would be the best option.

Econutrition: Implementation Models from the Millennium Villages Project in Africa

Econutrition integrates environmental health and human health, with a particular focus on the interactions among the fields of agriculture, ecology, and human nutrition. Soil loss and degradation and human undernutrition are major barriers to economic development in Africa. A primary aim of the Millennium Villages Project in Africa is to meet the Millennium Development Goals by integrated multisectoral interventions in health and nutrition, agriculture, and environmental sustainability in hunger and poverty hot spots in Africa. Econutrition is only one example of how interdisciplinary approaches are not only critical to alleviating extreme poverty but also fundamental to linking basic science understanding in multiple areas. Human health and agricultural productivity gain, and the costs of the gains are lowered, when we take the opportunity to apply different disciplines through cross-sectoral, thematically linked interventions.

High rates of AIDS-related mortality among older adults in rural Kenya.

Background:Health challenges faced by older people in developing countries are often neglected amidst a wide range of competing priorities. This is evident in the HIV field where the upper age limit for reporting HIV prevalence remains 49 years. However, the long latency period for HIV infection, and the fact that older people continue to be sexually active, suggests that HIV and AIDS are likely to affect older people. To better understand this, we studied mortality due to AIDS in people aged 50 and older in an area of rural Kenya with high rates of HIV infection. Methods:A community health worker-administered verbal autopsy system was introduced in Nyanza Province, encompassing 63,500 people. Algorithms were used to determine cause of death. Results:A total of 1228 deaths were recorded during the study period; 368 deaths occurred in people aged 50 years and older. AIDS was the single most common cause of death, causing 27% of all deaths. AIDS continued to be the main cause of death up to age 70 years, causing 34% of deaths in people aged 50-59 years and 23% of deaths in people aged 60-69 years. Conclusions:AIDS remains the principle cause of death among older people in Nyanza Province in western Kenya up until the age of 70 years. Greater efforts are needed to integrate older people into the HIV response and to better understand the specific vulnerabilities and challenges faced by this group.

A 3-year cohort study to assess the impact of an integrated food- and livelihood-based model on undernutrition in rural western Kenya.

76 (eds B. Thompson and L. Amoroso) Abstract Reducing extreme poverty and hunger is the first Millennium Development Goal (MDG). With undernutrition contributing to nearly half of all child deaths, improving nutrition is a precondition for accelerating progress towards other MDG targets. While the role of technical interventions such as micronutrient fortification and supplementation in reducing morbidity and mortality has been well documented, evidence to support more comprehensive multi-sectoral approaches remains inconclusive. This chapter aims to evaluate the impact of an integrated foodand livelihood-based model on nutrition-related outcomes in rural western Kenya. A 3-year prospective cohort study was undertaken among 300 randomly selected wealth-stratified households. Detailed socio-economic and health surveys were conducted. A nutrition module assessed household levels of food security, food consumption frequency and diet diversity. This was complemented by anthropometric measurement and assessments of serum levels of vitamin A among children under 5 years old. The average food insecurity score decreased from 5.21 at baseline to 4.13 at follow-up (P < 0.0001). Average diet diversity scores for daily, weekly and monthly time periods increased from 6.7 to 7.3; from 10.7 to 11.2; and from 12.4 to 12.6, respectively (P < 0.0001). Daily consumption for 14 out of 16 food groups increased significantly. For children under 2 years of age, underweight and stunting decreased from 26.2% to 3.9% (P = 0.002) and from 62.3% to 38.3% (P = 0.014), respectively. Vitamin A deficiency as measured by serum vitamin A levels decreased from 70.0% to 33.3% (P = 0.007) for children under 5 years old. This study presents encouraging evidence that a multi-sectoral foodand livelihood-based model can improve diet quality, enhance food security and positively affect childhood nutritional outcomes. The wider application of this approach to a diversity of agro-ecological zones in sub-Saharan Africa is currently being assessed.