2014 Kenya Demographic and Health Survey; Inching closer towards meeting MDG 1

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The Kenya Demographic Health Survey (KDHS) of 2014 has finally been released. Considering that this was the first under the new constitution, its release was anticipated with much interest. It has not disappointed. Apart from interesting findings on fertility rates across the counties which the media presented with a tongue-in-cheek, the survey shows the gains made by directing resources towards ending hunger.

The national prevalence of stunting (too short for age showing chronic malnutrition) is 26%, wasting (too thin for height showing acute malnutrition) is 4 %, and underweight (too thin for age showing acute and chronic malnutrition) is 11%.

Stunting

Stunting is noted to be highest (36 %) in children aged 18-23 months and lowest (10%) in children aged less than 6 months. This is a clear indicator that there needs to be more nutrition education on complementary feeding and the 1000 days (conception to two years of age) window of opportunity  needs to be fully utilised to avert malnutrition.

Stunting is also noted to be higher among boys (30 %) than girls (22 percent) and higher among rural children (29 %) than urban children (20 %). While this difference between rural and urban children may be true nationally, it is not necessarily true from one county to another.

Consider Trans Nzoia County, Kenya’s maize basket. In a study I carried out therein among children under five years from resource poor households, I found a significantly higher proportion (P=0.047) of urban children were stunted (40%) compared to rural children (19%).The prevalence rate of stunting in Trans Nzoia County according to the KDHS 2014 is 29.2 %. This is believable considering that this figure comprises of all children (urban and rural) and does not take into account the resources owned by a household.

In the KDHS, education of the care givers was also taken into account. It was found that children of mothers with secondary or higher education are less likely to be stunted (17%) compared with children whose mothers did not complete primary school (34 %) or have no education (31%). This shows that efforts directed towards the improvement of girl-child education should be encouraged and not downplayed as is usually done by groups such as Maendeleo ya Wanaume (MAWE) and the numerous heavily paternalistic communities across Kenya.

At the county level, West Pokot and Kitui have the highest proportions (46 percent) of stunted children. Others reporting high proportions of stunting include Kilifi (39 percent), Mandera (36 percent), and Bomet (36 percent). Nyeri, Garissa, and Kiambu counties have the lowest proportion of stunted children, each less than 16 percent.

Wasting

Wasting is highest among children in the age groups 6-8 months and 9-11 months (each 7 percent). This shows there is a gap in the manner in which complementary feeds are introduced. Furthermore, children at this age are quite vulnerable to infections accompanied by diarrhoea, vomiting, high fever and loss of appetite. This consequently leads to acute weight loss.

The survey further reveals that children whose mothers have no education have a higher chance of wasting (10 percent) compared with children of educated mothers. Wasting in children is inversely related to household wealth.

Garissa, Wajir, Mandera, Marsabit, Turkana, West Pokot, and Samburu Counties exhibited the highest proportions of wasting (>11%) while Siaya and Kisumu exhibited the least (<1%)

 Underweight

Children aged 24-35 months were found to have the highest levels of underweight with boys showing higher levels (12 percent) than girls (10 percent), and rural children exhibiting higher percentage (13 percent) than urban children (7 percent). It is important remember that these are national figures but the nutrition status at the county level may be far much different. Once again consider Trans Nzoia County where I found urban preschoolers exhibited slightly higher rates (22%) as compared to their rural counterparts, (17%). This shows that perhaps in high potential agricultural areas, it is the urban poor who are more vulnerable to malnutrition than the rural poor. The survey reports underweight levels in Trans Nzoia being 15.3%.

The survey correctly noted that proportion underweight decreases as mother’s education level increases or household wealth quintile increases.

In Mandera, Marsabit, Turkana, West Pokot, and Samburu, more than 25% of children are underweight while in Nyeri and Nairobi counties this figure stands at less than 4%.

All in all, the survey brings some good news; there is a marked reduction in malnutrition since 2008/9; Stunting has decreased from 35 percent to 26 percent, wasting from 7 percent to 4 percent, and underweight from 16 percent to 11 percent. Furthermore, the proportion of children younger than age 6 months who are exclusively breastfed has increased significantly from 32 percent in the 2008-09 KDHS to the current 61 percent

It is such evidence that gives us hope. Our efforts are not in vain. Perhaps we are closer towards meeting MDG 1, eradicating extreme poverty and hunger, than we think.

A Tale of Two Governors; Mwangi Wa Iria and Alfred Mutua

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It goes without saying that the promulgation of the new constitution in August, 2010 marked the beginning of a new era in Kenya . The impact of this constitution was to be felt in all sectors of the economy. This is especially so since many of the functions that were previously handled by the national government were to be devolved to the County government. Chief among these were agriculture, health and education. The fourth estate has so far done a wonderful job in highlighting the progress made my various county governments. Time and time again, two governors have caught the media’s eye. They have proven themselves developmental and unlike most governors in the country, they have given political shenanigans a wide berth and sought to deliver the pledges they made to their people. It is these two, Mwangi Wa Iria and Alfred Mutua that I shall attempt to profile especially in matters food and nutrition security.

Mwangi Wa Iria, the governor of Murang’a County rode into power on two pledges; to put money into people’s pockets and to better the grade of students in the County.

To meet these pledges, he sourced the expertise of Deloitte and Touch firm who drew a 1 year strategic plan. This plan was fed into the County’s 5-year strategic plan. Agriculture and Education were given highest priority.

In agriculture, the governor has invested Ksh 50 million in fertiliser and seed subsidy. This is in addition to the fertiliser subsidy offered by the national government. The county subsidy targets 6,500 farmers. It is also used in the acquisition of several drought resistant crops such as Soya, sweet potato and Katumani beans to be planted in the semi-arid areas of the county.

He has also invested Ksh 200 million in an irrigation scheme covering 1000 acres that is to benefit 10,000 farmers. This scheme will focus on growing of rice and horticultural crops. It is envisioned that the county shall be able to produce enough for its own consumption but more importantly for sale to other counties.

In April, this year, Mwangi Wa Iria invested Ksh 500 million in the purchase of 35 milk coolers for every ward. Youth and women were encouraged to form groups wherein they would be given a heifer with which to start a dairy herd. I suppose, as a former managing director of the New Kenya Cooperative Creameries, investment in the dairy sector was in the offing.

Perhaps the most innovative investment strategy that the governor has employed is the formation of Murang’a Investment Cooperative Sacco (MICS). The Sacco aims to raise funds from the county residents for investment in real estate, energy and agro-processing. It seems to have been borrowed from Rwanda’s Agaciro fund whose main function is to lessen the country’s dependence on foreign aid. To their credit, members of the county assembly seem to be the only ones in Kenya who have drawn lessons from those expensive learning trips to Rwanda.

In education, the governor has invested Ksh 70 million in a bursary for bright and needy students in the County. Furthermore, he has entered into a Memorandum of Understanding with Kenyatta University to advance agribusiness initiatives in the County.

On the other hand, Alfred Mutua seems to pick his development agenda from a handbook of trickledown economics.

He has made several investments in recreational infrastructure such as the Machakos People’s park and the Machakos stadium. These investments, combined with flamboyant public relations machinery, have seen Machakos be the darling of Nairobi’s middle class. The hosting of several music concerts and rugby tournaments in Machakos town is a testament to this fact.

In recent times, he has flaunted the Kitumani-Makutano ma Mwala road as the ‘fastest built highway in Kenya and possibly in Africa’. Built at a cost of Ksh 650 million instead of the proposed Ksh 1.6 billion, Alfred Mutua has publicised the infrastructure as an African lesson in austerity. However, doubts have been raised about the quality and durability of the road and his ‘Maendeleo Chap Chap’ philosophy. It is because of this that many political pundits question his long term commitment to the people of Machakos County. They view his handling of Machakos County as a convenient stepping stone to a higher political office. But I digress.

Other investments in the pipeline by my Mutua include digging of boreholes (800), dams and pans (820) and raised water tanks (896).

He has also set aside money (figures not provided) for provision of free tractors, subsidised fertilisers, free chicks, seeds and greenhouses for 20 women groups in each of the 40 wards in the county. However, the actualisation of these investments remains to be seen.

To his credit, education in primary schools in the County have received a boost due to a Ksh 250 million in the supplementary budget allocated for School Feeding Programs and other food relief programs in the county.

Perhaps the most significant investment undertaken by Alfred Mutua is the purchasing of 80 ambulances (70 vans and 10 motorcycles) and upgrading the 40 community health centres in each ward to community hospitals. Considering that 360 women per 100,000 live births died in Kenya in 2013 and 73 children out of 1000 births die before the age of five, any investment to reduce the maternal and infant mortality rate in Kenya is very much welcome. Indeed as the governor stated in his speech during the launch of the ambulances (in flamboyance of course), perhaps Machakos county (or the Government of Machakos as the Dr prefers) would see an end to the naming of children as ‘Nzia’ meaning one born by the roadside.

So there is the brief profile of the soft spoken Mwangi Wa Iria and the stylish Alfred Mutua (Dr I should add). Come 2017 the scorecard of governors will be in the offing. I bet that residents of Murang’a County will have more money in their pockets (Ksh 200/day up from the current Ksh 63/day) and her children would record higher grades. I also bet that the living standards in Machakos County will have improved immensely. However, much of this will be evident in Machakos town and other peri-urban areas rather than the rural areas. Thus, if given a choice, I would rather be a resident in Murang’a County.

Neymar and Maize: The Peculiar Similarities

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I truly empathise with Brazil and her fans all over the world. Although I am no doctor, it seems to me that a fractured vertebra is no small matter. So much so that Neymar would have to miss out on the rest of World Cup. Brazil Coach Luis Felipe Scolari and the Brazilian team laid a lot of hope on the young man.

It was obvious right from the start that the game revolved around Neymar’s performance. Balls were fed to him from both flanks of the field. It seemed all players were under strict instruction to look out for the boy whenever they obtained possession of the ball. The coach has tried to lay the blame of Neymar’s injury on the Spanish referee Carlos Velasco Carballo, who allowed several rugged challenges from both sides to go unpunished throughout the match between Brazil and Colombia. However, I think the referee was just trying to allow the game flow without many stoppages. Neymar’s injury should fall squarely on the Brazil Coach. He is the one who thrust the boy into the limelight, and allowed him to take centre stage; even when there was clear indication of his being increasingly fouled throughout the world Cup matches. The pressure to perform was clearly weighing heavy on Neymar. He is without a doubt the poster boy of the Brazil team. However, placing too much importance on one individual, no matter how good, is bound to have its consequences.

This phenomenon is not restricted to soccer talent management only. It is also true in matters food and nutrition security.

During my studies in Uganda, it was often quipped that the availability of a wide array of staples in Uganda was the key factor that prevented the occurrence of famine during Idi Amin’s presidency. Plantains, sweet potatoes, arrowroots, cassava, and maize are just but some of the many staples widely consumed by Ugandans. It is not uncommon for one to order a little bit of each, along with a desired stew such as groundnuts, beans and the like. It is true, without a single shadow of doubt, that Ugandans’ dietary diversity score is way up there. Cross over to Kenya, my beloved country, and the situation is the exact opposite. Our obsession with maize is unbridled.

In order to understand how maize came to take center stage in matters agriculture, a sneak peek into the past is helpful.

The maize crop was introduced to Kenya by the Portuguese in the 16th and 17th Century. However, it became an important commercial crop when adopted by the European settlers in the 18th century. The latter did away with the Portuguese variety that did well in the coastal areas and introduced varieties sought from South Africa which had higher yields.

Many European large scale farmers gravitated towards maize over cash crops like tea, coffee, sisal and pyrethrum. This was largely attributed to the lower initial financial costs required to engage in maize farming and the quicker returns. Moreover, maize did not require a high level of technical skills and management as did other crops.

The European famers were encouraged to grow maize by the then colonial government which offered them such incentives as special railway transport rebates and protection from vagaries of the world market. Furthermore, maize offered an easy means of feeding the African labour force employed in the vast farms. In the 1st and 2nd world war, the colonial government encouraged and supported the farmers to produce even more in the name of supporting British war efforts.

Such steps taken by the colonial government laid the foundation for a radical change in the tastes and preferences of Africans. Overtime, plantation workers and world war veterans preferred maize to traditional staples such as sorghum and millet. In Nyanza, stories were told of young men offering to work in European plantations not only earn money but also enjoy free rations of Ugali maize meal. And as they say, the rest is history.

Maize is now grown even in arid and semi-arid lands, areas which do not support the agronomical requirements of the crop. Agricultural research institutes are burning the midnight oil to develop drought resistant maize varieties. Although, these efforts are laudable it makes more sense to promote the adoption of crops such as sorghum and millet which have significantly lower water requirements than maize.

In peculiar similarity to the popular Neymar, the popular maize crop is beginning to give in. Farmers in the South Rift are beginning to shy away from the crop after incurring heavy losses attributed to necrosis disease. Yields have dwindled over the years due to declining soil fertility while human population has increased and consequently the per capita consumption of maize. Hence, farmers in Trans Nzoia and Uasin Gishu County, the major maize production areas, are also beginning to look to other high value crops owing to declining profits in maize production. Due to climate change, rain fed maize yields are expected to fall drastically. Consequently, it is predicted that come 2050, world prices for maize would increase by 52-55%.

In order to avert food insecurity in the long term, I suggest a three-pronged solution. There should be a national nutrition education programme. This campaign should be sustained over a considerable period of time say five years. During this period, behaviour change regarding food choice especially of staples ought to be monitored and evaluated at previously agreed intervals. Perhaps, consumer research firms devoted to political polls that more often than not are of little public benefit can be put to good use. Secondly, protectionism around the maize crop should be completely removed. In its stead, incentives should be given to farmers to grow other staples such as millet, potatoes, sorghum and the like. Thirdly, research institutes should channel their time and energies to developing varieties of the aforementioned crops that are high yielding, disease and pest-resistant.

Contrary to taking the suggested measures, it will only be a matter of time before the maize crop completely gives in. Then, we will be left wondering why we did not heed the warnings the crop tried to give us that it was under too much pressure to perform.

NB: Historical information on maize largely obtained from Professor Mark Ollunga Odhiambo’s inaugural lecture: ‘The Kenyan Maize Sub-Sector Performance and Its Implications for Food Security Policy Dialogue.

 

 

 

 

The Role of Youths In Agriculture in the EAC

On the 4th of November, I, among other youths from the East African Community (EAC) gathered in Kampala, Uganda, to deliberate on our involvement in agriculture. The outcomes of this pre-symposium were designed to feed into the International Symposium and Exhibition on Agricultural Development in the EAC partner states. All the EAC member states will have attained 50 years of independence by the end of the year. It was thus pivotal that progress made in agriculture in the past be evaluated and forge plans for the future. In doing this, our role in agriculture could not be overlooked. We shared our experiences in production, value addition, agribusiness, inputs supply and innovations in agriculture. It was evident that youths involved in agriculture were making considerable strides despite the numerous challenges we faced. Some of the major challenges discussed included access to credit, competition from larger companies for start-ups, market access and bureaucracies in licensing and obtaining information.

Nonetheless, the pre-symposium begged the question, why should more youth be involved in agriculture and secondly, why were they shying away from the trade? Several attempts were made to answer these questions.

It was noted that the East African region boasts of the youngest population in the world. More than 60% of the population consists of persons between 0-24 years. Uganda leads the pack with this age group consisting of 73 % of its population. It is this bulging youth population that necessitates changes in the way development is approached. This change is further made crucial by projections showing population growth in the next 30 years in all EAC member states will occur in the urban areas. Hence, the need to increase food supply to these areas is inevitable. Given that all the member states hope to achieve middle income status by the year 2040, it is reasonable to assume that the demand for animal protein will increase as the middle class increases.

In order to feed the growing population in the cities, there is need to focus on the rural youth. The rural youth have the golden opportunity of supplying urban areas with food given the availability of large tracts of arable land in the rural areas as opposed to the cities. However, much of this land is owned by the older population. The average age of arable land tenure in the member states is between 50 and 60 years. Kenya leads the pack with the average farmer being 57 years old. It is these dynamics that need due consideration in planning food and nutrition security programmes.

It was also duly noted that development in the region highly favoured urban development as opposed to rural development. This was seen as the major driver of rural-urban migration. A dwindling able-bodied population in the rural areas poses a great barrier to production of food. Furthermore, there is only a 20% chance of the youth gaining meaningful employment in the cities. It is thus crucial that the youth be more involved in agriculture not only for their welfare but for the food security of EAC inhabitants, especially in the city. However, in order to achieve this, there is need to focus on rural development. Improving the state of the roads and networks in the rural areas would greatly improve food distribution channels and mechanisms. Furthermore, efforts in infrastructure developments such as rural electrification would attract agro-based industries to the rural areas as the proximity to raw materials would greatly reduce costs of production. Such improvements would inevitably reduce rural-urban migration and furthermore, attract and retain the youth in agriculture.

All in all, on the podium, the pre-symposium concluded that it is no longer important that the youth be involved in Food and Nutrition security programmes. It is imperative. However, off the podium, there was general scepticism among the youth participants as to whether this would be realized in the near future.

NB: A taste of Uganda’s Hospitality

India’s Food Security bill and what Kenya can learn from it

India is going through what many may call ”interesting times”. In December 2011, the ruling party, United Progressive Alliance (UPA) introduced the National Food Security Bill in parliament. It consolidated several food programs that had proved successful in the country. However, the part that drew public attention was the grain distribution program which is arguably the most ambitious food program to be undertaken singly by any government in the world. It seeks to provide food (5kg grain/person/month) at subsidised prices to 800 million people at a cost of $22 billion annually. The identification of these 800 million people will be done by government officials. In a country where a quarter of the world’s hungry live in and has the second highest percentage of malnourished children, one might be forgiven for thinking this bill was going to be welcomed with open arms. Its reception has been quite the opposite. The opposition has claimed that the ruling party has just repackaged existing food programs and hurriedly introduced it to parliament. Furthermore, they are irked by the fact that the Prime Minister chose to use an ordinance to ensure the bill passed through the lower house. ”Ordinances are to be employed only in cases of emergency. What was so urgent that the bill could not wait 30 days to be discussed?” the opposition protested. All in all, it is the view of the opposition that this bill is UPA’s re-election strategy, designed to hoodwink India’s majority, the rural poor into electing UPA back to government come 2014.

In spite of all the dust this bill has raised, there remains a few voices that have chose to rise above it and offer sober judgment of the bill.

Jean Drèze, the co-author with Amartya Sen, of “An Uncertain Glory: India and Its Contradictions.” acknowledges that the bill might do some good only if there is sufficient political backing for it. However, he asserts that the battle for the right to food in India is far from over. Arvind Virmani, a former chief economic advisor to the government believes the bill will have little or no effect on malnutrition, poverty and hunger. This is because the most important cause of malnutrition in India is its abysmal state of public health, sanitation and hygiene. Most Indians do not have access to proper lavatories. This fact was wittingly captured by Amartya Sen during an interview by the Guardian when he remarked that the Indian government is more concerned with putting a mobile phone in an Indian’s hand than providing the same individual with a lavatory. Moreover, public knowledge on nutrition is wanting with the majority not possessing basic knowledge on nutrition matters.

While the debate rages on and the bill has been pruned first by the National Advisory Council and later by the government, the eastern state of Chhattisgarh has adopted the bill in its original form and is doing a commendable job in its implementation. Unlike the national food distribution system which is riddled with corruption and inefficiency, the new distribution system in Chhattisgarh state is regular, efficient and has a markedly lower leakage as compared to the national which stands at about 40 %. Majority of the poor households in Chhattisgarh are entitled to 34 kg of rice every month. The success of the system at the ground goes to show the extent to which the National Food Security bill can significantly reduce malnutrition levels in the country if implemented well. Ironically, Chhattisgarh state is ruled by the main opposition party, Bharatiya Janata.

I have always believed that developing nations such as Kenya can borrow a few lessons from India. For instance, the new form of governance in Kenya offers citizens opportunities to come up with solutions to problems that have bedeviled them since time immemorial. This a radical shift from the recent past where waiting for the central government to take action was the only option (Naomba Serikali Syndrome-NSS). Turkana County seems to lead the way by ensuring that the concept of food and nutrition security has been institutionalized. The county government has created a department whose sole mandate is to ensure that the inhabitants of Turkana County are food and nutrition secure.

In addition to developments at the county level, it is prudent to note that politics will always be closely linked with development. Whichever election period it is, there is always that one promise or proposed law that draws public attention; free Primary Education, free laptops for standard one students (the lowest class in Primary schooling in Kenya), etc. However, there is usually that promise concerning food and nutrition security that is often overlooked. In its manifesto, the ruling alliance, Jubilee, promised to put one million acres under irrigation to counter food insecurity in the country. Although faulted to only consider the supply side of food insecurity, it was a breakthrough of sorts. Efforts are being made to deliver on this promise but more remains to be done. The civil society, Non-governmental Organizations, the opposition, the media and the public at large need to keep the incumbent government on its toes thus ensuring that such noble programs are not drowned in political shenanigans.

The bill has now been passed by the Upper house in India. It now awaits accent by President Pranab Mukherjee before it becomes law. The global development players are watching India closely. If India succeeds in its implementation, it goes without saying that the program will be replicated elsewhere as well.

A Jittery leadership might be good for prevention of famine

The JKIA inferno brought to the fore the age-old debate about our country’s ineptitude in dealing with disasters. In an attempt to add a voice to this debate, I feel strongly that a jittery leadership is a pivotal factor in disaster management. And to defend this position, I call to mind the 1982 coup d’état attempt and the 1984/85 food emergency.

100 soldiers and more than 200 civilians are recorded to have died during the putshe attempt. However, in a curious twist of events, this failed attempt might have aided to avert what might have been a more fatal disaster-famine.

The 1984/85 food emergency was the worst to hit Kenya in the 20th Century. Livestock losses of up to 70% were recorded and production of major food security crops such as maize, wheat and potato dropped by 50%, 70% and 70% respectively. These very low yields and loss of livestock was caused by a drought that began with the failure of the short rains in northern and north-eastern Kenya in 1983. Only the central and western highlands received enough rain to produce maize. However, in 1984, the long rains almost completely failed, except in the narrow strip along the coast and in the western highlands. Hence, the drought was felt heavily in the Central highlands where a majority of natives were not enthusiastic about Moi’s presidency.

The failed coup d’état jolted President Moi to the realization that all was not well. Although, it was primarily planned by persons loyal to the late Jaramogi Oginga Odinga, rumours have it that a few Kikuyus within the disciplined forces were warming up for a coup but the Luos beat them to it. Hence, with this background in mind, President Moi acted fast to mitigate the effects of the drought as he feared deterioration of the drought into famine might result in discontent and political instability.

His government established an inter-ministerial drought response coordinating committee chaired by the Chief Secretary in his office. The committee moved swiftly to assess the situation, establish a government response policy, begin commercial imports of food, negotiate with the donor community for food assistance, and establish a Task Force to manage the food import and distribution program. The first shipment of yellow maize arrived in September 1984. It was 30% less costly than white maize and had a secondary positive effect of encouraging informal rationing by those consumers who had access to alternative food supplies.

The Planning Department of the Ministry of Finance and Planning collected information on the school feeding programs, commodity prices in various local markets, domestic commodity transport costs, livestock conditions, nutritional status of selected low income communities, voluntary organization programs and the status of the railway rolling stock. These were analysed and made available at all levels of personnel involved in the drought response. Unconditional relief in the form of free food rations were given out to vulnerable households in the affected areas. The identification of such households was carried out by the provincial administration which relied on relief committees and local chiefs. In 1985, the long rains were about average and drought emergency was considered over.

The government response to the 1984/85 food emergency was pivotal in the prevention of a famine and it was lauded the world over. However, an often overlooked fact is that a jittery presidency was fundamental to its success.