Browsing by Author "Mpiana, Bukasa Andy."
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Item Children's anthropometric indices as proxies for measuring household food security.(2013) Mpiana, Bukasa Andy.; Mudhara, Maxwell.; Kolanisi, Unathi.Food security is a complex concept with no definite measure. Measures of household food security are needed for many different applications in situations where households are chronically vulnerable due to deepening poverty, environmental and climatic shocks, rapid economic change and conflict. Indeed, measurement problems remain a major challenge, not only for research, but particularly for targeting, programme management, monitoring and evaluation. The objective of the study was to develop a specific analytical approach for measuring food security, by making a comparison of approaches that use children’s anthropometric indices (CAI) and Household Food Insecurity Access Scale (HFIAS). The study was specifically aimed at determining the relationship between children’s anthropometric indices and household food security. The pros and cons of using children’s anthropometric indices as indicators of food security were then assessed. The study area was Msunduzi Municipality in Pietermaritzburg, KwaZulu-Natal Province, South Africa. A total of 180 children, aged between 0 and 60 months, took part in the study and the sample was geographically broken down equally between two clusters: Edendale and Northdale Hospitals. The study found that using univariate analysis, “overweight” in “weight-for-height” was statistically significantly associated with HFIAS categories (p<0.05). From the bivariate, multiple linear regressions were conducted and the result was that “height-for-age” index was statistically significantly associated with “mild household food insecurity” (p<0.05). On the other hand, “weight-for-age” and “weight-for-height” were not statistically significantly associated with categories of HFIAS. The lack of significant association between household food insecurity and these two indices was not expected, because of the substantial evidence that a household’s access to food is one of the key determinants of the nutritional status of children. Alternative indicators were used to make up for the established weak association, so that proxies indicators of poverty, including “households which are continuously using wood fuel for cooking”, “households without clean water”, “households with access to the child grant” were ii statistically significantly associated with children’s anthropometric indices. Indeed, It was found that “height-for-age” (≤-2SD) and “weight-for-height” (≤-2SD) indices were statistically significantly associated with “households which are continuously using wood fuel for cooking (p<0.1) and (p<0.1), respectively. “Weight-for-age”, “height-for-age” and “weight-for-height” were statistically significantly associated with “households without clean water” (p<0.01, p<0.1 and p<0.01), respectively, and all these three indices were statistically significantly associated with “households with access to the child grant (p<0.01, p = 0.1 and p<0.01), respectively. The relationship found between anthropometric indices, especially “overweight” in the “height-for-age” and “weight-for-height” index, proxy indicators of poverty and HFIAS categories suggest that children’s anthropometric indices can be good indicators for household food security measurement. However, they have to be used in combination with other indicators. It is concluded that food security strategies should consider socio-economic characteristics of households in order to achieve more than a marginal reduction in the number of chronically undernourished people. Policy recommendations should focus on addressing overweight children whose anthropometric measures are associated with the physical environment and the accompanying levels of physical activity. Further research may need to assess the relationship between food security and quality of life.Item Right to food for women and children: a critical analysis and review of the implementation indicators in a South African context.(2018) Mpiana, Bukasa Andy.; Kolanisi, Unathi.; Van Onselen, Annette.; Obi, Ajuruchukwu.The “right to food” is a fundamental human right firmly enshrined in international law, including the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Rights of the Child (CRC). Its realization is essential to the fulfilment of other human rights, such as the “right to life” and the “right to health”. Subsequently, the none-realization of the right to food can be perceived as a deviation or reject to recognize the state obligations to respect, protection and fulfilment of the right to food. This study brings forth an argument that hunger and children undernourishment are a direct and indirect outcomes of inadequate right to food implementation. The aim of this study was to provide a comprehensive analysis of structural, process and outcome indicators in right to food by demonstrating the severity and the magnitude of women and children vulnerability to food and nutrition at the community based (household) as well as factors affecting the right to food realization. A cross-sectional survey was carried out in Umlazi Township, KwaZulu-Natal Province. Mixed research methods that is a combination of quantitative and qualitative approaches including convergent parallel mixed designs were used to provide a comprehensive analysis of the research problem. In data collection, structured and unstructured questionnaires in English with translated in IsiZulu were used to obtain quantitative data in selected townships and a consent form was made available for signature from each woman and child’s mother or caregivers. Portable scale and digital weight balance were used to take the measurement for both women and children. The household dietary diversity score was also performed using 12 of the following food groups: G/1: Cereals, G/2: Root and tubers, G/3: Vegetables, G/4: Fruits, G/5. Meat, poultry, offal: G/6. Eggs: G/7. Pulses/legumes/nuts, G/8: Fish and seafood, G/9: Milk and milk products, G/10: Oil/fats, G/11: Sugar/honey and G/12: Miscellaneous. Interview guide for key informant interview and focus group discussion was used to facilitate complementary focus group discussions in the selected townships. The key informant interview was held with provincial government officials who were working in the Food Security section, in the Department of Agriculture (DAFF). So, the data obtained from the questionnaires and other interviews were analyzed using the Statistical Package for Social Sciences (SPSS) version 24.0 (SPSS, 2016). The choosing of a statistical test is critical in data analysis and practical to address the issue of whether the data are parametric or nonparametric and finally the nonparametric method was adopted. The overall thesis was organized in chapter but chapter regarding result was divided in case study useful for paper manuscript. The findings in the first study showed that the children underweight prevalence was 79.2%, stunting 71.6%, wasting 57.5% and overweight and obese were respectively 6.7% and 2.5%. An Independent t-test provided means weight (-2.595 SD) and (-2.500 SD) respectively for children <-2SD Z scores with “food supplement” intervention versus of those without “food supplement” intervention. Interestingly, about 30% of mothers were HIV positive and the breastfeeding initiative prevalence was 92% with only 37% practicing exclusive breastfeeding and 80% practicing mix breastfeeding. Rising prevalence of obesity and a high risk of contracting cardiovascular diseases among young female-headed households in majority (93%) in Umlazi Township. The mother’s body mass index (BMI) prevalence for obesity were: class III 4.2%, class II 13.3%, class I 30.8%, whilst 25.8 % showed to be overweight with 2.5% underweight. With regards to children vulnerability, the study shows that ‘stunting” was among children’s anthropometric indices with a strong association with the persisting childhood diseases especially diarrhea, respiratory infection, and fever. It was also associated with mother feeding practices, weight birth of the child and household dietary diversity, as a proxy to household food security. The most frequent, “height-for-age’ index or children stunting was statistically and significantly associated with child’s respiratory infection (p=0.001), diarrhea (p=0.001) and fever (p=0.001) as well as household dietary diversity scores (correlation coefficient r = 0.227 and p=0.006), among which protein food items such as meat and poultry had a p-value of p=0.020. Children growth retardation was also associated with weight birth of the child (a positive correlation of r=0.288 and a strong p-value of p=0.001). In addition, “height-for-age” and “weight- for-height” index were statistically and significantly associated with “exclusive breastfeed”, “continued breastfeeding”, “complementary foods”, “dietary diversity” and “mix breastfeeding” all with a strong p-value ranged between p = 0.001 and p =0.009. But “weight-for-age” index was statistically and significantly associated with only “exclusive breastfeed”, “continued breastfeeding” and “mix breastfeeding” with p=0.012, p=0.040, p=0.012 respectively. Household Dietary Diversity (cereal and sugar/homey groups) was statistically and significantly associated with mother’s body mass index (BMI) category as provided by the independent sample t-test (p=0.001) for cereal group and (p=0.001) for sugar/honey food groups. All these outcome indicators are showing the inadequacy in the right to food policies development and implementation. By exploring the perception aspect of the right to food, it was found that there is a minimal understanding of the right to food concept and especially how it links to the concepts of food-nutrition security. The experts consulted in this study as key informants, confirmed that the right to food tends to be assumed as ‘affiliating somehow’ to the food security programmes. There was limited clarity of whether the right to food was better understood or it was maybe understood and interpreted as ‘just one of the used terminologies that do not mean anything’ and at times the concept was understood to be the same as food security, thus agreed that it could be used interchangeably. So, at grass root level 25 % of caregivers stated that they had never heard about right to food and 75% interpreted it as food quality, food poverty and food insecurity or food that can boost the immune system to work properly etc. With regards to food security causes, 67.7% of caregivers, stated that the main cause of food insecurity was unemployment, when 13.8% though it was an “economic powerlessness” or lack of income. However, causes such as cultural practices, food high prices, lack of education and family size were also cited by (7.7%), (7.7%), (1.5%) and (1.5%) of caregivers respectively. In keeping with the question “who is vulnerable or most affected by food-nutrition insecurity (right to food)”, it was found that children were the most affected by the right to food’s inadequate “implementation” (54%), when “old persons’ were cited by 23.5% of caregivers. However, “women” and “persons with disability” were considered as the most vulnerable group by 11% but 10% of caregivers respectively. The right to food has a legal aspect however, it is a concept that is less known and understood by many government officials or policymakers. A critical review of the food and nutrition security policies over the past decade shows that little has been achieved by leaving NFNSP largely to a government department with insufficient legal capacities building to deal with the interlinked priorities of poverty and hunger. However, in the ground, the number of people with inadequate or severe inadequate access to food was increased from 13, 8 million (26%) in 2013 to 14, 1 million (26, 2%) in 2014. The review suggests that while the extended argument on alignment to NDP or vision 2030 of Sustainable Development Goals has provided, valuable critiques of the National Food and Nutrition Security Policy in terms of meeting its human right to food, as well as other general insights, it allows only for very little tentative. So, this diagnostic raises deeply worrying questions about the continued pursuit of policies that fail to bring about change. The outcome of the review suggests that a more holistic view of the policy is needed with a better pro-poor programme and intervention development and with a larger participation of all stakeholders in the policy design to improve inclusive and efficient implementation. In general, the thesis found that despite a positive evolution by South Africa government in national food and nutritional security agendas, there remain gaps and challenges to be addressed in regards to the implementation of the right to food. Significant work is still required to fill in the gaps resonating with the discourse that proves to hinder the efforts to progressively realize this valuable human right.