contribute to the alleviation of poverty and hunger through
possibly improved nutrition and better health conditions,
thus giving the community the tools to take action for
change.
In SSA millions of people succumb to diseases such as
malaria, tuberculosis and HIV/AIDS that exacerbate and
worsen the nutrition status of the population. In many SSA
nations, basic nutrition is not fulfilled. Some countries suffer
from recurrent drought, forced migration due to conflicts
and political instabilities. Malnourished children and the labor
available for agriculture are heavily affected due to these
unique problems.
In severely AIDS-affected communities of SSA there has
been a change in the volume and kinds of crops produced in
farming systems. Partly as a result of this, levels of nutrition
are falling due to the reliance on starchy staples like cassava
and sweet potatoes in Eastern Africa, compared with
other more nutritious but labor-intensive traditional crops
or protein from animal products. In addition there is lack of
understanding of the nutritional value of foods. Lower levels
of nutrition result in the increased vulnerability of people
to disease and thus to an overall decline in health.
Studies indicate that better nutrition could play a role
in prolonging life following HIV infection, and the nutritional
status of people living with AIDS plays a large part in
determining their current welfare with respect to morbidity
(Haddad and Gillespie, 2001). People with endemic diseases
such as malaria and tuberculosis also benefit from better
nutrition.
At the crop and ecosystem level, nutritional intake is a
function of the array of crop and livestock species available
in the community basket. For example, researchers are increasingly
curious about an apparent geographical convergence
of the use of aflatoxin-vulnerable crops, groundnut
and maize, and the severity of both malaria and HIV/AIDS
in East and Southern Africa. Aflatoxins confer a short-term
advantage on people through increased resistance to malaria,
but can induce immuno-suppression, which may be
linked to a weakening of the immune system even before
infection by HIV (CORAF/WECARD, 2003). Therefore, a
cautious approach to adopting food items is important (Box
5-5).
In working to assess the nutritional status of a community,
it is important to decide on the objectives of the
assessment, how the analyses will be done and what actions
are feasible. It is important to draw from experience and to
design the most appropriate data collection exercise. For example,
in an assessment in a large, newly established refugee
camp, it might be advisable to collect more than just anthropometric
data; in the past, when nutritional status in refugee
camps was judged only on anthropometry, deficiency diseases
such as scurvy and pellagra were missed.
In many countries, large and expensive surveys, in
which a wide variety of nutrition-related data are collected,
have been carried out and little action has followed. It has
been suggested that ten times the amount spent on a survey
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Box 5-5. Applying an HIV lens.
An HIV lens would, for example, cause an agricultural
commercialization policy to take account of the extra risks
posed by evening markets and the need for people to travel
far to sell their produce. In another example, in Lesotho,
instead of pursuing an add-on activity such as distributing
condoms along with agricultural extension messages,
the Ministry of Agriculture and CARE are now focusing on
improving the food and nutrition security of HIV-affected
households and those struggling with other shocks and
stresses of poverty. Another interesting example is Swaziland’s
Indlunkhulu initiative. Indlunkhulu refers to the tradition
of distributing food from the chief’s fields to members
of the community who are unable to support themselves.
In Swazi law and custom, chiefs are responsible for the
welfare of orphans within their area. Agricultural policy has
built on this practice to provide a sustainable mechanism
for delivering food to orphans and vulnerable children, providing
initial agricultural inputs for the Indlunkhulu fields,
and developing the agricultural skills of older children who
work in them. Agricultural knowledge can also be preserved
through the development of HIV-aware and genderproactive
agricultural extension capacity. Farmer life
schools, as pioneered in Cambodia and adapted in Kenya
and Mozambique, can be developed to bridge gaps in intergenerational
knowledge transfer. Capacity constraints
may be bypassed through better communications, such
as rural radio. There is clearly tremendous scope for agricultural
policy to become more HIV-responsive, both to
further AIDS-related objectives and to help achieve agricultural
objectives. Yet there are no magic bullets. Land-labor
ratios and the relative degree of substitutability between
household resources, among other factors, will determine
the possible responses to HIV/AIDS. If policy becomes
more HIV responsive, it will stay relevant and effective. By
mainstreaming HIV/AIDS into the policy process and carefully
monitoring the results, policymakers will help build
up evidence of what works in different contexts, enhance
learning, and ultimately leave people better equipped to
address the multiple threats of the pandemic.
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should be available for programs aimed at overcoming the
deficiencies identified by it. It is important that the information
collected be kept to the minimum required to assess or
monitor the situation and that surveys be simplified as much
as possible. Some information used for the assessment of the
nutritional status of a community can also be used for evaluation
of programs and for nutritional surveillance.
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