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Reducing undernutrition requires improving access to goods and services from a wide range of economic and social sectors, including agriculture, education and health. Yet despite broad agreement on the multisectoral nature of the global burden of undernutrition, relatively little research has analyzed how different dimensions of accessibility, such as urbanization and travel times to urban centers, affect child nutrition and dietary outcomes. In this paper we study these relationships in sub-Saharan Africa, a highly rural continent still severely hindered by remoteness problems. We link spatial data on travel times to 20,000 person cities to survey data from 10,900 communities in 23 countries. We document strong negative associations between nutrition indicators and rural livelihoods, but only moderately strong associations with remoteness to cities. Moreover, the harmful effects of remoteness and rural living largely disappear once education, wealth, and social/infrastructural services indicators are added to the model. This implies that the key nutritional disadvantage of rural populations stems chiefly from social and economic poverty. Combating these problems requires either an acceleration of urbanization processes, or finding innovative cost-effective mechanisms for extending basic services to isolated rural communities.
Africa is experiencing a rapid growth in urban population with a billion more people expected to live in cities by 2050. The extent to which urbanization contributes to improvements in the welfare of households and individuals depends on whether it is accompanied by the creation of remunerative employment opportunities and investments on essential infrastructure and services. Specific to child nutrition, urbanization can improve nutrition through its effects on the immediate and underlying determinants that include dietary and nutrient intake, diseases, household food security, environmental sanitation, and access to health services. The direction and strength of the association between urbanization and child undernutrition is therefore an empirical matter that largely depends on the type of urban settlements. This study examines linkages between urbanization and child undernutrition in Burkina Faso. Nutrition data are obtained from the Burkina Faso Demographic and Health Surveys (DHS) con-ducted in 1998/99, 2003, and 2010. Nutritional outcomes of children 0-59 months old are measured using height-for-age z-score (HAZ), weight-for-height z-score (WHZ), and weight-for-age z-score (WAZ). Instead of relying on a binary urban-rural classification available in the DHS data, we construct two continuous indicators of urbanization based on remotely sensed data ‒ the size of urban area within 10 kilometers radius around the DHS cluster (urban extent) and the distance between the child’s DHS cluster and the boundary of the nearest urban settlement (remoteness).
Reviews the World Bank's experience in industrial restructuring in 46 countries during the past 14 years. The study finds that for most completed public enterprise restructuring operations, sustainability of benefits was a large problem, mainly because of fragile sector reforms and inadequate governance and management. Those completed for the private sector experienced poor outcomes from inadequate attention to country economic conditions and policy distortions. To overcome such problems, the study recommends that future restructuring operations be designed and implemented to have an impact at the firm level.
In Sub-Saharan Africa, the scale of undernutrition is staggering; 58 million children under the age of five are too short for their age (stunted), and 14 million weigh too little for their height (wasted). Poor diets in terms of diversity, quality, and quantity, combined with illness and poor water and sanitation facilities, are linked with deficiencies of micronutrients—such as iodine, vitamin A, and iron—associated with growth, development, and immune function. In the short term, inequities in access to the determinants of nutrition increase the incidence of undernutrition and diarrheal disease. In the long term, the chronic undernutrition of children has important consequences for individuals and societies: a high risk of stunting, impaired cognitive development, lower school attendance rates, reduced human capital attainment, and a higher risk of chronic disease and health problems in adulthood. Inequities in access to services early in life contribute to the intergenerational transmission of poverty. Recent World Bank estimates suggest that the income penalty a country incurs for not having eliminated stunting when today’s workers were children is about 9†“10 percent of gross domestic product per capita in Sub-Saharan Africa. Much of the effort to date has focused on the costing, financing, and impact of nutrition-specific interventions delivered mainly through the health sector to reach the global nutrition targets for stunting, anemia, and breastfeeding, and interventions for treating wasting. However, the determinants of undernutrition are multisectoral, and the solution to undernutrition requires multisectoral approaches. An acceleration of the progress to reduce stunting in Sub-Saharan Africa requires engaging additional sectors—such as agriculture; education; social protection; and water, sanitation, and hygiene (WASH)—to improve nutrition. This book lays the groundwork for more effective multisectoral action by analyzing and generating empirical evidence to inform the joint targeting of nutrition-sensitive interventions. Using information from 33 recent Demographic and Health Surveys (DHS), measures are constructed to capture a child’s access to food security, care practices, health care, and WASH, to identify gaps in access among different socioeconomic groups; and to relate access to these nutrition drivers to nutrition outcomes. All Hands on Deck: Reducing Stunting through Multisectoral Efforts in Sub-Saharan Africa addresses three main questions: • Do children have inadequate access to the underlying determinants of nutrition? • What is the association between stunting and inadequate food, care practices, health, and WASH access? • Can the sectors that have the greatest impact on stunting be identified? This book provides country authorities with a holistic picture of the gaps in access to the drivers of nutrition within countries to assist them in the formulation of a more informed, evidence-based, and balanced multisectoral strategy against undernutrition.
Nutrition is the number one health concern in Africa - and nutrition programs can be a magnet for attracting community support to the health system, especially maternal-child health programs. But nutrition is often a secondary concern of health policy, often ignored in food policy, and too often left out of training programs and work plans.
Undernutrition remains a major source of human suffering and an obstacle to national economic and human development in many African countries. This report investigates undernutrition's persistence, drawing on case studies of the public response to the problem in Ghana, Mozambique, Nigeria, and Uganda. Analyzing each nation's policymaking structures, political actors, understanding of undernutrition, and the timing of public responses, the author explains why none of these four nations has mounted an effective campaign to eliminate undernutrition. The author identifes several different causes of this shortcoming, with one underlying flaw in the various public responses standing out: a fundamental failure on the part of political leaders to see undernutrition as a grave problem that undermines development efforts in their nations. The author concludes that an effective response to undernutrition in these countries requires the formation of national advocacy coalitions that can raise public awareness of the problem, highlight policymakers' duty to ensure the nutrition of their citizens, and link proper nutrition to general national development. This report should serve as a resource for advocates, researchers, and others concerned with undernutrition in Africa.
In this paper, we investigate the implications of urbanization on child nutritional outcomes using satellite-based nighttime light intensity data as a proxy for urbanization and urban growth. We employ two rounds (2008 and 2013) of geo-referenced and nationally representative Demographic and Health Survey (DHS) data from Nigeria. The DHS data provide detailed anthropometric measures of child nutritional outcomes along with a series of control variables. We merge these geo-referenced DHS data with nighttime light intensity data for the survey clusters in which the DHS sample households reside. This nighttime light introduces a continuous gradient of urbanization permitting investigation of the implications of urbanization on child nutritional outcomes along an urbanization continuum. The longitudinal nature of the nighttime data allows us to examine the dynamics of urbanization and its implication on child nutrition.
Research Paper (postgraduate) from the year 2016 in the subject Health - Public Health, Northumbria University (Social Health and Wellbeing), course: Public Health Fundamentals, language: English, abstract: Malnutrition is a serious challenge posing tremendous negative impact in sub-Saharan Africa and the world in general. In view of this, the United Nations (UN) proposed the Sustainable Development Goals (SDG2) which hopes to “End hunger, achieve food security and improved nutrition and ensure sustainable food production by 2030”. Several socio-economic factors have been identified as the principal causes of malnutrition; some of these include poverty, lack of education, poor government policies, poor access to healthcare, poor access to hygienic water supply and environmental sanitation, lack of toilet facilities as well as gender inequality and corruption. However, it is important to note that all of these factors are related to each other in one way or another. Thus, in order to mitigate the continued rise in the level of malnutrition in sub-Saharan Africa, a multifocal approach is needed. These factors should not be approached individually in the process of finding a viable solution to the scourge of malnutrition, rather they should be approached as a collective entity in the planning and implementation of government policies.