Wealthiest Is Not Always Healthiest: What Explains Differences in Child Mortality in West Africa?

Ghana has the lowest under-five mortality rate in West Africa. Understanding why Ghana’s child mortality rate is lower than in neighboring countries may offer useful insights for other developing countries that are trying to improve child health. This paper explores whether Ghana’s lower mortality rate is mostly a result of greater household wealth, better implementation of national health policies, or more favorable geography. The paper uses micro level data for children under five to examine relative child mortality risk between Ghana and each of its three immediate neighbors -- Burkina Faso, Côte d’Ivoire, and Togo. A Cox proportional hazards model is used to test which of the three ‘contenders’ – health policy, wealth, or geography – best explains Ghana’s mortality advantage. The results of the analysis indicate that wealth variables are not able to explain any of the child mortality variation between Ghana and its neighbors. Geography and health policy variables each explain about 40% of the mortality gap between Ghana and Burkina Faso. Health policy differences alone are able to explain about 70% of the child mortality gap between Ghana and Côte d’Ivoire. These results suggest that even poor countries that have been ‘cursed’ by bad geography can potentially improve development outcomes and save children’s lives

Wealthiest Is Not Always Healthiest: What Explains Differences in Child Mortality in West Africa?

Ghana has the lowest under-five mortality rate in West Africa. Understanding why Ghana’s child mortality rate is lower than in neighboring countries may offer useful insights for other developing countries that are trying to improve child health. This paper explores whether Ghana’s lower mortality rate is mostly a result of greater household wealth, better implementation of national health policies, or more favorable geography. The paper uses micro level data for children under five to examine relative child mortality risk between Ghana and each of its three immediate neighbors -- Burkina Faso, Côte d’Ivoire, and Togo. A Cox proportional hazards model is used to test which of the three ‘contenders’ – health policy, wealth, or geography – best explains Ghana’s mortality advantage. The results of the analysis indicate that wealth variables are not able to explain any of the child mortality variation between Ghana and its neighbors. Geography and health policy variables each explain about 40% of the mortality gap between Ghana and Burkina Faso. Health policy differences alone are able to explain about 70% of the child mortality gap between Ghana and Côte d’Ivoire. These results suggest that even poor countries that have been ‘cursed’ by bad geography can potentially improve development outcomes and save children’s lives

Shifting cultivation and forest pressure in Cameroon

Shifting cultivation is often blamed as a principal cause of deforestation in tropical Africa. It is claimed that the practice is unsustainable because shortened fallow lengths result in soils too degraded to support forest vegetation. The decline in fallow lengths is often attributed to increases in population density and greater market participation. The conventional wisdom makes several claims that are as yet unsubstantiated. This paper investigates whether there is evidence to support two of these claims in southern Cameroon. First, using both cross-sectional and panel data, I find that there is indeed a robust negative association between fallow lengths and population density in the study area and weaker evidence for a negative relationship between fallow lengths and market participation. Second, a stochastic frontier production function approach is used to investigate the marginal contribution of fallow to output. Results indicate that fallow lengths are not low enough to be affecting yields and therefore do not appear to be resulting in declines in soil fertility. Thus overall, while some of the assumptions of the conventional wisdom appear to be true, there is little evidence to support its dramatic conclusion that shifting cultivators are causing deforestation in the forested region of Cameroon

Shifting cultivation and forest pressure in Cameroon

Shifting cultivation is often blamed as a principal cause of deforestation in tropical Africa. It is claimed that the practice is unsustainable because shortened fallow lengths result in soils too degraded to support forest vegetation. The decline in fallow lengths is often attributed to increases in population density and greater market participation. The conventional wisdom makes several claims that are as yet unsubstantiated. This paper investigates whether there is evidence to support two of these claims in southern Cameroon. First, using both cross-sectional and panel data, I find that there is indeed a robust negative association between fallow lengths and population density in the study area and weaker evidence for a negative relationship between fallow lengths and market participation. Second, a stochastic frontier production function approach is used to investigate the marginal contribution of fallow to output. Results indicate that fallow lengths are not low enough to be affecting yields and therefore do not appear to be resulting in declines in soil fertility. Thus overall, while some of the assumptions of the conventional wisdom appear to be true, there is little evidence to support its dramatic conclusion that shifting cultivators are causing deforestation in the forested region of Cameroon

Wild food plants and trends in their use: from knowledge and perceptions to drivers of change in West Sumatra, Indonesia

Wild food plants (WFPs) are often highly nutritious but under-consumed at the same time. This study aimed to document the diversity of WFPs, and assess perceptions, attitudes, and drivers of change in their consumption among Minangkabau and Mandailing women farmers in West Sumatra. We applied a mixed-method approach consisting of interviews with 200 women and focus group discussions with 68 participants. The study documented 106 WFPs (85 species), and Minangkabau were found to steward richer traditional knowledge than Mandailing. Although both communities perceived WFPs positively, consumption has declined over the last generation. The main reasons perceived by respondents were due to the decreased availability of WFPs and changes in lifestyle. The contemporary barriers to consuming WFPs were low availability, time constraints, and a limited knowledge of their nutritional value. The key motivations for their use were that they are free and “unpolluted” natural foods. The main drivers of change were socio-economic factors and changes in agriculture and markets. However, the persistence of a strong culture appears to slow dietary changes. The communities, government and NGOs should work together to optimize the use of this food biodiversity in a sustainable way. This integrated approach could improve nutrition while conserving biological and cultural diversity

Dietary quality and tree cover in Africa

The relationship between forests and human nutrition is not yet well understood. A better understanding of this relationship is vital at a time when the majority of new land for agriculture is being cleared from forests. We use Demographic Health Survey food consumption data for over 93,000 children from 21 African countries and Global Land Cover Facility tree cover data to examine the relationship between tree cover and three key indicators of the nutritional quality of children’s diets: dietary diversity, fruit and vegetable consumption, and animal source food consumption. Our main findings can be summarized as follows: there is a statistically significant positive relationship between tree cover and dietary diversity; fruit and vegetable consumption increases with tree cover until a peak of 45% tree cover and then declines; and there is no relationship between animal source food consumption and tree cover. Overall our findings suggest that children in Africa who live in areas with more tree cover have more diverse and nutritious diets

Challenging perceptions about men, women, and forest product use : a global comparative study

This study uses a multi-case dataset to question current assumptions about the gender differentiation of forest product use. We test some of the commonly held ideas on how men and women access, manage, and use different forest products. Overall, we found significant gender differentiation in the collection of forest products, which seems to support the claim that there are distinctive "male" and "female" roles associated with the collection of forest products. However, we also found that men play a much more important and diverse role in the contribution of forest products to rural livelihoods than previously reported, with strong differences across tropical Asia, Africa, and Latin America

Quantifying the contribution of mangroves to local fish consumption in Indonesia: a cross-sectional spatial analysis

Indonesia has lost more mangroves than any other country. The importance of mangroves for carbon storage and biodiversity is well recognised, but much less is known about what they contribute to the communities living near them who are called on to protect them. Malnutrition in Indonesia is high, with more than a third of children stunted, partly due to poor diets. Fish are nutrient-rich and are the most widely consumed animal source food in Indonesia, making the relationship between mangroves and fish consumption of great importance. Aquaculture is also tremendously important for fish production in Indonesia and has replaced large areas of mangroves over the last two decades. We performed a cross-sectional, spatial analysis in this study. We combined data on fish consumption for rural Indonesian coastal households from the Indonesian National Socioeconomic Survey with spatial data on mangrove forest and aquaculture area from the Indonesian Ministry of Environment and Forestry to create a cross-sectional spatial dataset. Using a mixed-effects regression model, we estimated to what extent living in proximity to different densities of mangroves and aquaculture was associated with fresh fish consumption for rural coastal households. Our sample included 6741 villages with 107 486 households in 2008. The results showed that rural coastal households residing near high-density mangroves consumed 28% (134/477) more fresh fish and other aquatic animals, and those residing near medium-density mangroves consumed 19% (90/477) more fresh fish and other aquatic animals, than coastal households who did not live near mangroves. Coastal households that lived near high-density aquaculture consumed 2% (9/536) more fresh fish, and those that lived near medium-density aquaculture consumed 1% (3/536) less, than other rural coastal households. Mangroves contribute substantially to the food security and nutrition of coastal communities in Indonesia. This finding means that the conservation of mangroves is important not only for carbon storage and biodiversity, but also for the communities living near them. Aquaculture does not appear to offer similar food security benefits. Bureau for Economic Growth, Education, and Environment, United States Agency for International Development. [Abstract copyright: Copyright © 2023 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

Increasing fruit and vegetables consumption among children: a systematic review of animated nutrition interventions

Background: Low consumption of fruits and vegetables among children can lead to deprivation of micronutrients necessary for growth and development and predispose them to NCDs later in life. Low consumption of these nutrient-rich foods is related to high consumption of nutrient-poor, high-energy foods, which leads to childhood overweight and obesity. Many children do not consume enough fruits and vegetables to meet recommendations. This review aims to assess the effectiveness of animated interventions in increasing children's fruit and vegetable consumption. Methods: Articles on animated interventions for increasing fruit and vegetable consumption among children were systematically reviewed from Web of Science, PubMed, and Google Scholar. For the literature searches, inclusion and exclusion criteria were established, and the methodology followed the PRISMA recommendations. Extracted data were synthesized to show the effectiveness of interventions. Results: Thirteen studies (2003-2017) of animated interventions targeting children (3-12 years) designed to increase their consumption of fruits and vegetables met the criteria for inclusion in the systematic review. Most of the studies (69.2%) were in the United States, with no studies in LMICs identified. The animation interventions used games (46.2%), characters (23.1%), adventures (23.1%), and comic books (7.7 %). 11 of the analysed studies revealed positive or neutral effects of interventions on fruit and vegetable consumption. Parental participation, goal setting, and rewards were identified as facilitators of success. Identified interventions were effective in the short term (follow-up <12months). The games and adventure interventions had the greatest effect, with multi-component interventions most effective in increasing fruit and vegetable intake. Conclusion: There is a need for more research to determine the effectiveness of such interventions over extended periods. Multi-component interventions especially including parental involvement, goal setting, and rewards should be leveraged in designing similar interventions in LMICs since there was a conspicuous absence of such studies found in the literature