Are there examples of nutrition programming in an urban setting? Why were they successful? What are the main challenges they had to overcome and how were these addressed?
More than half of the world’s 7 billion people now live in urban areas. As the world’s population is becoming increasingly urbanised, new challenges are arising. The rural-urban gap in nutrition has narrowed in recent decades – essentially because the situation has worsened in urban areas. Ensuring adequate nutrition and food security for people living in urban areas is arguably one of the most significant challenges. The poorest urban-dwellers spend up to 75% of their income on staple foods alone. The ‘food poor’ refers to those unable to meet all nutritional needs due to expenditure on other basic non-food essentials.
The body of knowledge on basic indicators, including food security and nutrition, is still limited (Mohiddin et al 2012). Although there is usually a greater diversity of food products available in cities, little food is produced in urban areas. For people living in urban areas, the main determinant of food insecurity is not production but accessibility. Access to food depends on household income, the price of food and the location of food outlets. Access is therefore usually dependent on cash exchange. This dependence leaves poor urban dwellers vulnerable to price increases and other market shocks. Many people do not have a fixed income, which also leads to insecurity. The situation is made worse by some authorities discouraging agriculture in urban areas, which can be a means of supplementing nutrition.
Urban communities tend to have high population densities. They can also be very transitional, with migration being a constant feature. Poor people living in informal settlements and slums face a unique set of challenges. Although urban areas usually has better healthcare, education and sanitation compared to rural areas, proximity does not equate to access. There are many barriers to access, including cost and working hours. Each urban area has its own characteristics. What works in rural areas may not work in urban areas and an in depth analysis is recommended prior to any intervention (Mohiddin et al 2012). With many actors working to improve nutrition status, better coordination is needed between them. Urban-specific skills are needed for planning. In particular planners must understand gender sensitivities in urban areas.
There is a paucity of research focused on urban food. To date, much of the research has focused on nutrition-related disease. More research is needed on food-borne disease, particularly in Africa. The assurance of safe food is essential to improving the quality of life for those already affected by disease. Equally, persons suffering from food-borne illness are more likely to contract other communicable diseases. Much more research is necessary on the issue of food-borne disease, right across the food supply and distribution chain.
In some cases, enough and sufficient varied nutritious food may be available, but affordability can limit access. Price can be a reason for choosing which food and where to buy it, but the possibility to buy on credit or in small quantities may also be factors of influence as well. Seasonality may also affect price and thus access.
This helpdesk report details examples of nutrition programming in an urban setting. It considers whether the programmes were succesful, and if so, why. It also identifies the main challenges experienced.
Thompson, S. Helpdesk Report: Nutrition programming in urban settings. Health and Education Advice and Resource Team (HEART), (2014) 19 pp.