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.

My Apathy towards Galana/Kulalu Irrigation Project

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President Kenyatta during launch of the irrigation project

Source: http://jamhurimagazine.com

I shudder every time I hear food insecurity and Galana/Kulalu mentioned in the same breath. For those not in the know, Galana/Kulalu is the new irrigation project in Kenya. During the campaigning period, Jubilee coalition promised to put one million acres under irrigation. This was seen as the silver bullet needed to stem increasing levels of food insecurity in the country. This, among other significant promises such as one laptop for every standard one pupil, saw the Jubilee coalition win the elections albeit with accusations of malpractice by the main opposition, CORD coalition. Now the Jubilee government has hit the ground running. And Galana/Kulalu irrigation scheme is one of its pet projects. A few details of the project are in order.

Firstly, how are the million acres divided between the various crops of food security concern?

  • 500,000 acres to grow maize and other rotational crops i.e. beans, sorghum…
  • 200,000 acres, sugarcane
  • 150,000 acres, beef and game animals and finishing
  • 50,000 acres, Horticulture production including potatoes, groundnuts, etc
  • 50,000 acres, dairy animals and value added products
  • 50,000 acres, orchards, mangoes, guavas, etc

 

Well, it is no surprise that maize takes the lion share. According to the latest government reports on the country’s food security, we have a shortfall of 10 million bags of maize (Food security in Kenya is equated to maize availability). This deficit should begin to bite in May, 2014. Considering that the first crop in Galana/Kulalu was expected to be planted in March, this shortfall cannot be met by the project. Hence, come May the government would be forced to remove duty on maize thus allowing for its cheap importation. Enter maize cartels, connected individuals and the politician out to make a kill and you have all the hallmarks of a scandal in the making. It is this that makes a good majority of the citizenry doubt the government’s figures on actual number of bags shortfall. Furthermore, if I have my intelligence correct, the Galana/Kulalu project would be leased out to potential individuals/organisations to grow the crops on behalf of the government. Going by how recent contracts have been handled, I am not quite sure that the irrigation project would not attract its fair share of political shenanigans. However, there are much more fundamental issues that make me sceptical of the project altogether.

To begin with, Galana/Kulalu straddles the Tana River and Kilifi Counties of the Coastal region of Kenya. The area is predominantly semi-arid except for the eastern edge which receives annual mean rainfall of 625mm. The rest of the area receives approximately 250mm of rainfall annually. Furthermore, the area sits at an average altitude of 270m above sea level. Soils in the area are mostly sandy loams although some parts have red clay and black cotton soils. Considering that half of project area would be allocated to maize production, it is prudent to consider the basic requirements for growing of maize. Maize requires copious amounts of water (500-800mm). This would not be a problem since water can easily be sourced from Galana/Sabaki river or alternatively from River Tana. Despite maize doing well in various soils, it does not do so much well in sandy soils and it is prone to water logging. Hence, great care would be required during irrigation especially during flowering and yield formation periods. Water logging during flowering can reduce grain yields by 50 percent or more. All in all, let us suppose, for argument’s sake that yields in Galana/Kulalu would be slightly lower than Trans Nzoia’s (20-30 bags/ acre) which is Kenya’s maize basket. Never mind that this has greatly reduced in recent times due to increasing soil acidity. Suppose that an optimistic view of Galana/Kulalu is taken, say 15-20 bags/acre. This would give a yield of 7.5-10 million bags tops. Suppose that 5% of this yield is lost post-harvest (substantial maize losses in semi-arid environments range from 10-20%, 5-10% and 0-5% due to pest, poor storage and disease respectively) we are looking at 7.125-9.5 million bags. This leaves a minimum shortfall of 500,000 bags only. Not bad, one might say. Nonetheless, the “ifs” are too big to ignore.

Secondly, it is crucial to consider the complexity and various facets of food security as captured in the 2009 World Summit on Food Security: “ Food Security exists when all people at all times have physical, social and economical access to sufficient, safe and nutritious food which meets their dietary needs and food preferences for an active  and healthy life”. Four pillars of food security have been identified. These are Food Availability, Food Access, Food Stability and Food Utilisation.

four_pillars_of_food_security

Source: http://www.newsustainabilityinc.com/2014/01/14/can-rural-agriculture-solve-global-food-insecurity/

These pillars, along with dimensions such as vulnerability and shocks are adequately used as indicators of food security as shown below

Food Security Indicators

Click for a larger view

Source: http://www.surveymonkey.com/s/ESS_FSN_Indicator_1

Judging from the definition and suite of indicators of food security, it is quite evident that much emphasis is being put on availability at the expense of other pillars such as physical access and utilisation. All you have to consider is the state of the roads and networks, access to improved water sources and sanitation facilities, as well as availability of thriving markets and you will find that areas lacking in such are notorious for cases of acute food insecurity even when other parts of the country enjoy bountiful harvests.

The above scenario is corroborated by UNICEF’s conceptual framework on the causes of malnutrition.

 

malnutrition causes

Source: http://www.foodsecurity.gov.kh/conceptual-framework-malnutrition

It is appreciated that inadequate dietary intake and disease are the immediate causes of malnutrition. However, the basic causes of malnutrition are political, economic, social and cultural structures. Hence, any endeavour to prevent malnutrition by addressing its immediate or underlying causes without giving adequate attention to its basic causes is treating the symptom rather than the cause of the disease. The areas notorious for food insecurity are the very same that have been politically, economically and socially marginalised since colonial times. They have been least represented in national governance, denied equal opportunities of pursuing education, least empowered to grow economically and continually denied their political freedom to air their grievances. This chronic marginalisation has been made evident through glaring inequalities, cries for secession and of course, chronic food insecurity. Unless they are resolved, efforts such as Galana/Kulalu irrigation project, no matter how noble the intentions behind them, will be gone with the wind.