Relationship Between Household Food Insecurity and Health in the Upper West Region of Ghana

Although the importance of food as a social determinant of health has been elucidated, it remains underexplored in Sub-Saharan Africa (SSA), where a significant population is faced with challenges of accessing food, largely from a combination many factors including low economic power, poor livelihoods, political instability and policy gaps. Despite tremendous improvement on food security in Ghana, the northern part of the country including the Upper West Region still experience disproportionally high levels of deprivation and food insecurity. Research has tends to explain the dynamics and complexities of food insecurity in the Region, yet variation of the incidence of food insecurity across different geo-political districts in the region and its association with human health is less examined. In response, this thesis examines the relationship between household food insecurity and health in the Upper West Region of Ghana. Results from quantitative survey (n=1438) conducted in all the eleven districts of the Upper West Region from May to August, 2014 show that households that received remittance and located in both rural and urban areas as well as non-remittance receiving households in rural areas were more likely to report being severely food insecure compared to non-remittance receiving households in urban areas. Those who reported being food insecure were more likely to report poor mental health. Although migration and remittance have been used by households to address food insecurity, the findings here show that migration and remittance may not adequately impact on food insecurity in all contexts, giving prominence to the role of local context in influencing the persistent food insecurity situation in the Upper West Region of Ghana. The research demonstrates that use of Household Food Insecurity Access Scale (HFAIS) in most sever periods of food insecurity would produce much higher scores of food insecurity compared to scores produced from use of Food Consumption Scores (FCS). Also, the use of subjective health rating tool (the DUKE Health Profile) in this research indicates its wider applicability. The study makes suggestions for an integrated food security policy, decentralization of mental health care, and expansion of the economic potential of the Upper West Region. Future research directions are also discussed

‘QUEENMOTHER’ CONCEPT IN THE UPPER WEST REGION OF GHANA: IS THIS ADVANCEMENT OR AN EMERGING CONFLICT WITH TRADITION IN A PATRIARCHAL SOCIETY?

The concept of ‘queenmother’ is not new in Africa. Scholars have indicated the importance of this institution in Ghanaian traditional political system. With increasing women’s empowerment, there is a growing realization that women are co-agents of nation building resulting in the expansion of roles of queen mothers as conduits of development. Consequently, patriarchal societies without queen mothers such as the Upper West Region (UWR) of Ghana are encouraged to install one. While this practice has been going on for centuries in matriarchate, its replication in patriarchates raises questions and concerns. Using interpretative methods involving focus group discussions and in-depth interviews with traditional leaders and elders, this research explored the perceptions and challenges of this emerging concept in the UWR. The concept as practiced in matriarchate has been adopted wholesale into patriarchates and this may have led to the perceived nonfunctional nature of the concept. This concept also conflicts with the traditional and deep-seated cultural values of the people, especially those related to the marriage institution. Furthermore, the perceived roles of queen mothers seem to conflict with those already performed by traditionally recognized ‘Tindaamba’ and ‘pognaaba’. To avoid potential conflicts already existing women leaders (pognaaba) should play the role of ‘queenmothers’ in these societies

Persistent misconceptions about HIV transmission among males and females in Malawi

Background: The prevalence of HIV in Malawi is one of the highest in sub-Saharan Africa, and misconceptions about its mode of transmission are considered a major contributor to the continued spread of the virus. Methods: Using the 2010 Malawi Demographic and Health Survey, the current study explored factors associated with misconceptions about HIV transmission among males and females. Results: We found that higher levels of ABC prevention knowledge were associated with lower likelihood of endorsing m

Drivers of diversification and pluriactivity among smallholder farmers—evidence from Nigeria

Diversification and pluriactivity have become a norm among farm business owners (FBOs) due to persistent low farm income. This study applies the resource-based theory to examine drivers of diversification and livelihood income-oriented towards a sustainable livelihood. Our framework develops hypotheses about the impact of internal and external resources on livelihood choices at the household level. We use a survey of 480 rural Nigerian farmers (agripreneurs), applying a Multivariate Tobit to test our framework. We find that education plays the most significant role in all types of employment options. The more FBOs are educated, the more the likelihood that they will choose non-farm or wage employment. This study revealed that while the agriculture sector’s share of rural employment is declining, non-farm is on the increase. More so, there is a decline in farming among the young generation, marital status bias and gender influence in resource allocation. The socioeconomic (income and food security) and socio-cultural (employment and rural-urban migration) implications of rural sustainability linked to UN Development Goals have been highlighted and analysed in this article

Food security outcomes in agricultural systems models: Current status and recommended improvements

Improvement of food security is a common objective for many agricultural systems analyses, but how food security has been conceptualized and evaluated within agricultural systems has not been systematically evaluated. We reviewed the literature on agricultural systems analyses of food security at the household- and regionallevels, finding that the primary focus is on only one dimension of food security-agricultural output as a proxy for food availability. Given that food security comprises availability, access, utilization and stability dimensions, improved practice would involve more effort to incorporate food access and stability indicators into agricultural systems models. The empirical evidence base for including food access indicators and their determinants within agricultural systems models requires further development through appropriate short and longterm investments in data collection and analysis. Assessment of the stability dimension of food security (through time) is also particularly under-represented in previous work and requires the development and application of appropriate dynamic models of agricultural systems that include food security indicators, coupled with more formalized treatment of robustness and adaptability at both the regional and household levels. We find that agricultural systems models often conflate analysis of food security covariates that have the potential to improve food security (like agricultural yields) with an assessment of food security itself. Agricultural systems modelers should exercise greater caution in referring to analyses of agricultural output and food availability as representing food security more generally

The Psychosocial Health and Wellbeing Impacts of Large Scale Land Acquisitions in Coastal Tanzania

This dissertation examines the psychosocial health and wellbeing impacts of Large Scale Land Acquisitions (LSLAs) in coastal Tanzania. Contemporary acquisition of large parcels of land in low-income countries by investors is both transformational and a neo-colonization strategy depending on the philosophical frame and scale of analysis. Despite multiple narratives about its impacts across scale, there is consensus in the conceptualization of LSLAs as a global force that is changing local ecologies and communities. Yet, the impact of these changes on the psychosocial health and wellbeing of local populations is less evident. This study employs mixed methods that combines qualitative and quantitative approaches in order to understand how three interrelated concepts in LSLAs—changing local landscapes, ecological governance and multiple vulnerabilities—explain differentiated psychosocial health and wellbeing impacts of LSLAs among local populations. Results from qualitative analysis of in-depth interviews (n=37) show that LSLAs is destructive to therapeutic spaces, and thus adversely impacting the psychosocial health of local populations. The quantitative analyses (n=1,782) reveal widespread perception of poor ecological governance in LSLAs context—only 7% of the population reported good ecological governance. Individuals with poor (OR=3.00, p≤0.01) and fair (OR=4.22, p≤0.001) perception of ecological governance were more likely to report poor psychosocial health as they worry over the sustainability of their environments. Regarding how multiple vulnerabilities structure LSLAs impact on food insecurity (a predictor of psychosocial distress), the quantitative analyses further show migrant women were the most adversely impacted overall, and that male non-migrants (OR=1.58, p≤0.05) were worse impacted compared to female non-migrants. The study also found that with the influence of climate change, LSLAs impact on non-migrants’ food insecurity is reduced (women=2.4%; men=0.2%), while migrants’ food insecurity is exacerbated (women=1.4%; men=1.7%). The study makes important contributions to theory, methodology and policy. Theoretically, by demonstrating how LSLA is associated with psychosocial health, the study extends ecological change and health framework into the analysis of health in LSLAs literature. Also, the finding that non-migrant males are more vulnerable to food insecurity impact of LSLAs demonstrates gender-based complexities in long-term impacts of ecological change. Applying therapeutic landscapes in LSLAs is helpful in broadening the conceptualisation of lands in LSLAs context, while disparities in psychosocial health impacts extends the utility of social determinants of health. Methodologically, the study demonstrates the value of mixed methods in analysis of complex phenomena such as psychosocial health and LSLAs. The findings in this study amplify the need to introduce health considerations into LSLA policymaking in Tanzania, and similar context. Importantly, the findings challenge the viability of Tanzania’s national development agenda (vision 2025), which heavily relies on LSLAs