Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu

Context: This paper reports on findings from the ex-post evaluation of the Maewo Capacity Building project in Maewo Island, Vanuatu, which was funded by World Vision Australia.Objectives: To examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security and health and nutritional outcomes in Maewo Island, using Ambae Island as a comparator.Setting: Two-stage cluster survey conducted from 6 to 20 July 2004, which included anthropometric measures and 4.5-year retrospective mortality data collection.Participants: A total of 406 households in Maewo comprising 1623 people and 411 households in Ambae comprising 1799 people.Main outcome measures: Household food insecurity, crude mortality rate (CMR), under-five mortality rate (U5MR) and malnutrition prevalence among children.Results: The prevalence of food insecurity without hunger was estimated at 15.3%(95% confidence interval (CI): 12.1, 19.2%) in Maewo versus 38.2% (95% CI: 33.6, 43.0%) in Ambae, while food insecurity with hunger in children did not vary by location. After controlling for the child&rsquo;s age and gender, children in Maewo had higher weight-for-age and height-for-age Z-scores than children of the same age in Ambae. The CMR was lower in Maewo (CMR &frac14; 0.47/10 000 per day, 95% CI: 0.39, 0.55) than in Ambae (CMR &frac14; 0.59/10 000 per day, 95% CI: 0.51, 0.67) but no difference existed in U5MR. The major causes of death were similar in both locations, with frequently reported causes being malaria, acute respiratory infection anddiarrhoeal disease.Conclusions: Project initiatives in Maewo Island have reduced the risks of mortality and malnutrition. Using a cross-sectional &lsquo;external control group&rsquo; design, this paper demonstrates that it is possible to draw conclusions about project effectiveness where baseline data are incomplete or absent. Shifting from donor-driven evaluations to impact evaluations has greater learning value for the organisation, and greater value when reporting back to the beneficiaries about project impact and transformationaldevelopment in their community. Public health nutritionists working in the field are well versed in the collection and interpretation of anthropometric data for evaluation of nutritional interventions such as emergency feeding programmes. These same skills can be used to conduct impact evaluations, even some time after project completion, and elucidate lessons to be learned and shared. These skills can also be applied more widely to projects which impact on the longer-term nutritional status ofcommunities and their food security.<br /

Food Security Strategies for Vanuatu

This report describes and analyzes food security conditions and policies in Vanuatu. The national food security systems are dualistic in nature, and the rural and urban food security systems are weakly related. Household food security in rural areas is primarily determined by access to arable land and fishery resources, whereas in urban areas household food security is primarily determined by access to employment. Household food security has been a concern in both rural and urban areas. Both under nutrition and over nutrition are highly relevant indicators that nutritional food security is an important issue in the country.food security, Food Security and Poverty,

Food Security Strategies for Vanuatu

This report describes and analyzes food security conditions and policies in Vanuatu. The national food security systems are dualistic in nature, and the rural and urban food security systems are weakly related. Household food security in rural areas is primarily determined by access to arable land and fishery resources, whereas in urban areas household food security is primarily determined by access to employment. Household food security has been a concern in both rural and urban areas. Both under nutrition and over nutrition are highly relevant indicators that nutritional food security is an important issue in the country

The practice of integrating adaptation and disaster risk reduction in the south-west Pacific

Disaster risk reduction (DRR) and emergency management (EM) efforts are integral to climate change adaptation (CCA). The integration of DRR with adaptation is globally recognized as a rational use of resources benefiting both areas. There is a substantial literature on the topic, but little on the practice of implementing such integration on the ground. This paper presents some of these experiences at national and agency levels in the south-west Pacific and outlines possible future directions to support policy and practice. Based on the perspectives of practitioners from Australia, Vanuatu and the Solomon Islands, it explores institutional changes with country examples, and the range of constraints and enabling factors in integrating adaptation with DRR and EM practices. The Australian aim of spreading responsibility for CCA and DRR integration through mainstreaming across departments and agencies was seen as effective in increasing whole-of-government approaches. However, in both Vanuatu and the Solomon Islands the concentration of information, responsibility and actions through a single focal point was more effective in reducing overlap and providing a clearer picture of what was being implemented, by whom and where. The findings demonstrate a need to consider the experiences arising from practical implementation of the integration agenda and to document the lessons from this experience in a way that can inform policy and practice