Ethnic expansions and between-group differences in children's health: a case study from the Rukwa Valley, Tanzania

The Sukuma ethnic group appears to be expanding across Tanzania at a rate far greater than other ethnic groups in the area. In this paper, the household-level dynamics that may be fueling this expansion are explored by comparing measures of infant mortality and child health with another Tanzanian ethnic group, the Pimbwe. Consistent with expectations, the Sukuma appear to have comparable levels of fertility but lower child mortality. As predicted, compared to the Pimbwe, Sukuma children are also heavier and taller for their age, suggesting better nutritional status. Four hypotheses about why the Sukuma are so successful in this area are addressed. Surprisingly, the results show that household food security and wealth are not related to children's nutritional status, nor can maternal effects account for the observed health differences. Several lines of evidence suggest that different patterns of infant feeding practices may underlie the differences in children's nutritional status.     

Native River Boats in ‘Irāq

The Maasai are cattle pastoralists, living on the grass savanna in southern Kenya and northern Tanzania. This article, which deals with Kenya, describes Maasai women as “heads of houses”. The house as a physical structure shelters and symbolically embodies a matrofocal unit of consumption and resource sharing which is the smallest unit of Maasai society. In terms of livestock property, such units are subordinated to larger, patriarchal units. According to the author, the relative autonomy of Maasai houses, and in particular women's control over food resources is significantly decreasing. The reason for this is the present commercialization of Maasai production.     

Seasonal changes in household food insecurity and symptoms of anxiety and depression

There is growing awareness that common mental health disorders are key contributors to the burden of disease in developing countries. Studies examining the correlates of mental health have primarily been carried out in urban settings and focused on the burden rapid economic change places on individuals. In these settings, poverty and low education are consistent predictors of anxiety and depressive symptoms. We argue here that these variables are proxies for insecurity, and that a more general model of symptoms of depression and anxiety should focus on locally salient forms of insecurity. Building on previous work in a seasonal subsistence setting, we identify food insecurity as a potent source of insecurity in a rural African setting, and then test whether seasonal changes in food insecurity are correlated with concomitant changes in a measure of symptoms of anxiety and depression among 173 caretakers. Results indicate that food insecurity is a strong predictor of symptoms of anxiety and depression (P < 0.0001), that changes in food insecurity across the seasons predict changes in symptoms of anxiety and depression (P < 0.0001), and that this is robust to the inclusion of covariates for material assets and household production. These results hold for individuals in both ethnic groups studied (Pimbwe and Sukuma); however, at the group level the burden falls disproportionately on Pimbwe. The results add to the growing literature on the causes of population level differences in mental health disorders and suggest new research avenues and strategies to link mental health disorders with variation in physical and biosocial outcomes.     

Fortified Bomas and Vigilant Herding are Perceived to Reduce Livestock Depredation by Large Carnivores in the Tarangire-Simanjiro Ecosystem,Tanzania

Human-carnivore conflict (HCC) is an increasingly important issue in Tanzania, especially where humans live adjacent to protected areas (PAs). We conducted semi-structured interviews (n = 300) to compile information on livestock husbandry practices and evaluate perceptions about the effectiveness of these methods in the Tarangire-Simanjiro ecosystem of northern Tanzania. Fortified bomas were perceived to be very effective (97.7%) in reducing nighttime depredations, while adult herders were perceived to be effective (71%) in reducing daytime depredations. Domestic dogs were perceived to be more effective at night, but an equal number of respondents found them to be effective during herding as those who found them to be not effective. Our results also show that boma type had a significant effect on livestock depredation. We recommend the use of fortified bomas as a long-term solution to prevent nocturnal livestock loss and adult herders for livestock during the day.     

Cattle Raiding and Its Correlates: The Cultural-Ecological Consequences of Market-Oriented Cattle Raiding Among the Kuria of Tanzania

Among the agro-pastoralist Kuria people of Tanzania, many young men are engaged in an illicit livestock trade in which cattle stolen in Tanzania are sold to Tanzanian and Kenyan buyers for cash. In contrast to earlier theoretical formulations that have focused on pastoralist livestock raiding's presumed benign human-ecological functions of redistribution and herd management, this paper argues that Kuria cattle raiding is the driving force behind deleterious, and severe, human-ecological consequences in the study area, including a plummeting cattle population and a steady decline in food production in northern Tanzania's agriculturally bountiful Tarime District.     

Nutritional Consequences of Wealth Differentials in East African Pastoralists: The Case of the Datoga of Northern Tanzania

Among African pastoralists evidence that wealth is associated with other measures of household success is scant and the significance of wealth differentials for family welfare remains poorly understood. Predictions that wealth in livestock is associated with increased adequacy of household food supply and with improved child nutrition are tested with longitudinal data on herd size, household composition, food supply, and anthropometric status collected in 1992 for a sample of traditional Datoga households (n = 20) living in the Eyasi basin in northern Tanzania. Although a majority subsisted below poverty cutoffs estimated for east African pastoral populations, there was large variation among households in measures of wealth and resource availability. Individuals in relatively wealthy households did not appear to benefit either in terms of adequacy of household food supply or in terms of average growth performance of young children. Theoretical and methodological challenges in the study of the relationship between wealth and health in nomadic pastoralists are discussed.     

Traditional ecological knowledge underlying herding decisions of pastoralists

Pastoralists have traditional ecological knowledge (TEK), which is important for their livelihoods and for policies and interventions. Pastoralism is under pressure, however, which may result in a decline of pastoral lifestyle and its related TEK. We, therefore, addressed the following objectives (i) to inventorise and assess how pastoralists characterise and value soils and forages in their environment, (ii) to analyse how soil, forage and livestock (i.e. cattle) characteristics relate to herding decisions and (iii) to determine whether TEK underlying herding decisions differs across generations. Data were collected through focus groups and individual interviews with 72 pastoralists, belonging to three generations and to three agro-ecological zones. Using a three-point scale (high, medium, low), four grasses and three tree forages were assessed in terms of nutritional quality for milk, meat, health and strength. Using their own visual criteria, pastoralists identified five different soils, which they selected for herding at different times of the year. Pastoralists stated that Pokuri was the best soil because of its low moisture content, whereas Karaal was the worst because forage hardly grows on it. They stated that perennials, such as Andropogon gayanus and Loxoderra ledermannii, were of high nutritional quality, whereas annuals such as Andropogon pseudapricus and Hyparrhenia involucrata were of low nutritional quality. Afzelia africana was perceived of high quality for milk production, whereas Khaya senegalensis had the highest quality for meat, health and strength. Pastoralists first used soil, then forage and finally livestock characteristics in their herding decisions. Pastoralists’ TEK was not associated with their generations, but with their agro-ecological zones. This study suggests that pastoralists had common and detailed TEK about soils, forages and livestock characteristics, underlying their herding decisions. To conclude, pastoralists use a holistic approach, combining soil, vegetation and livestock TEK in herding decisions. Such TEK can guide restoration or improvement of grazing lands, and land use planning.     

The Landscape Ecology of Pastoral Herding: Spatial Analysis of Land Use and Livestock Production in East Africa

Understanding landscape-scale patterns of herding is critical in identifying and assessing the impacts of pastoral grazing. Here, a general model of herding is developed based on the Sukuma agropastoral system in the Rukwa Valley, Tanzania. Using this conceptual framework, the factors affecting the maximum distances herds travel from home and the distribution of grazing around pastoral settlements are examined. The distribution of dry season water structured the landscape-scale distribution of grazing throughout the year, not just during the dry season. Water availability strongly affected the distances herds ranged from home in the dry season and the distribution of grazing around pastoral settlements throughout the year. Associations between cattle productivity and herding practices were also examined. The effects of traveling further from home, keeping cattle in large herds, and using/living in areas of high settlement densities were examined on the following measures of productivity: intake rates, foraging behavior, milk yields, and body conditions. Cattle from larger herds were observed to walk more while actively foraging and engage in more walking bouts (taking ten steps without taking a bite). The increased walking of large herds may explain why they range farther from home and highlight the importance and ubiquity of herd splitting among pastoralists. However, herd size effects were not apparent in intake rates or milk yields. Milk yields were negatively affected by traveling farther from home. These data demonstrate substantial variability within herding populations and show interesting similarities with herding systems in substantially more arid areas.     

Addressing management questions for Ngorongoro Conservation Area, Tanzania, using the Savanna modelling system

Ngorongoro Conservation Area (NCA), in northern Tanzania, is a multiple-use area of importance to Maasai pastoralists and wildlife conservation. We adapted the Savanna modelling system to the NCA, creating an Integrated Management and Assessment System that allows users to assess responses to alternative management actions. We used the system to conduct fifteen experiments reflecting potential management questions. Results suggest that: the distribution of rainfall throughout the year may have a greater impact on the ecosystem than its quantity; cattle may be near a carrying capacity determined not by forage limitations but because of disease risks; increasing survival and reducing disease in livestock yields greater returns than increasing birth rates; allowing livestock to graze in areas where they are currently excluded may lead to a slight increase in livestock populations, but sometimes leads to large declines in wildlife populations; few ecosystem effects were noted when households and cultivation were allowed to grow at 3% per year for 15 years; and when up to 5% of the study area was in cultivation, there were declines ≤16% in livestock and wildlife populations, except for elephants, which declined by 48%. Users may modify our experiments using tools we have developed, or address other NCA management questions.     

Precarious Alliances: The Cultural Politics and Structural Predicaments of the Indigenous Rights Movement in Tanzania

Since 1990, over one hundred indigenous nongovernmental organizations (INGOs) have emerged in predominantly Maasai areas in Tanzania, attempting to organize people around diverse claims of a common "indigenous" identity based on ethnicity, mode of production, and a long history of political and economic disenfranchisement. Despite attempts to foster unity and promote common political agendas, the indigenous rights movement has been fractured by sometimes quite hostile disagreements over priorities, competition over resources, and tensions over membership and representation. This article explores the complicated causes and consequences of these tensions by focusing on the discussions, disagreements, and silences that occurred during a recent attempt to reconcile indigenous groups in Tanzania. The workshop offers a unique window on the cultural, political, and historical dynamics of the indigenous rights movement in northern Tanzania, the principles and practices of inclusion and exclusion that have defined and shaped the movement, and the internal and external stresses that have made alliances within and among the INGOs, donors, and the government precarious, at best. [Keywords: indigenous peoples, social movements, cultural politics, Maasai, Tanzania]     

Maasai Socioeconomic Conditions: A Cross-Border Comparison

A single round household survey was conducted between October 1997 and May 1998. Information was collected on 1545 Maasai households in Kenya and Tanzania using a standardized questionnaire. These data represent the first large-scale, cross-border comparable survey of socioeconomic indicators for the Maasai. The structure of the study is similar to that of a natural experiment: one ethnic group living in two very different nation-states. The survey results describe a current snapshot of Maasai livelihoods. Living arrangements are described at both the household (olmarei) and multihousehold (enkang) level, together with changes in housing type. The roles of cultivation, transhumant migration, and employment are described, including a consideration of the prevalence of murranism (warriorhood). The implications of rising levels of sedentarization and cash crop production for Maasai economic diversification are explored. Participation by Maasai in the tourism industry is extremely low despite the proximity of Maasai to major international tourist destinations in East Africa. Levels of formal education show a marked sex bias in completed primary school education in both countries, with far fewer women than men having attended school.     

Pastoral Sedentarization and Its Effects on Children’s Diet,Health, and Growth Among Rendille of Northern Kenya

Throughout the arid regions of Africa formerly mobile pastoral populations are becoming sedentary. Although pastoral sedentarization is encouraged by international development agencies and national governments as solutions to food insecurity, poor health care, and problems of governance, it has not been demonstrated that abandoning the pastoral way of life, and particularly childrens access to milk and other livestock products, is beneficial to the health and well-being of pastoral populations. This paper reports the results of a 3-year study of one pastoral and four settled Rendille communities of northern Kenya based on data from 17 repeated bimonthly surveys of childhood dietary, growth, and morbidity patterns and household level economic strata. Bivariate analysis of 5,535 measurements from 488 children from birth to 9 years revealed that age-specific height and weight measurements for the pastoral community are uniformly heavier and taller than children from the sedentary villages. Multivariate analysis using Generalized Estimating Equations methodology showed that the amount of milk consumed was always a statistically significant determinant of child weight and height growth, regardless of drought or non-drought times and breastfeeding status. Other significant determinants of child growth include morbidity and poverty, both associated with sedentary communities. These results indicate that international development assistance should not neglect improvements in livestock production and support of pastoral movements in Africas arid lands.     

Can the world afford to ignore biotechnology solutions that address food insecurity?

Genetically engineered (GE) crops can be used as part of a combined strategy to address food insecurity, which is defined as a lack of sustainable access to safe and nutritious food. In this article, we discuss the causes and consequences of food insecurity in the developing world, and the indirect economic impact on industrialized countries. We dissect the healthcare costs and lost productivity caused by food insecurity, and evaluate the relative merits of different intervention programs including supplementation, fortification and the deployment of GE crops with higher yields and enhanced nutritional properties. We provide clear evidence for the numerous potential benefits of GE crops, particularly for small-scale and subsistence farmers. GE crops with enhanced yields and nutritional properties constitute a vital component of any comprehensive strategy to tackle poverty, hunger and malnutrition in developing countries and thus reduce the global negative economic effects of food insecurity.     

Food insecurity among Inuit preschoolers: Nunavut Inuit Child Health Survey, 2007–2008

Background

Food security (i.e., a condition in which all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life) has been noted to be lower in indigenous communities in Canada. We investigated the prevalence of inadequate food security, or food insecurity, among Inuit households with preschool children.

Methods

We conducted a cross-sectional survey of the health status of 388 randomly selected Inuit children aged three to five years in 16 Nunavut communities during the period from 2007 to 2008. From the survey data, we classified levels of food insecurity specifically among children. We also classified levels of overall food insecurity of the household of each child. We calculated the weighted prevalence of levels of child food insecurity and of household food insecurity.

Results

Nearly 70% of Inuit preschoolers resided in households rated as food insecure (69.6%; 95% confidence interval [CI] 64.7%–74.6%). Overall, 31.0% of children were moderately food insecure, and 25.1% were severely food insecure, with a weighted prevalence of child food insecurity of 56.1% (95% CI 51.0%–61.3%). Primary care-givers in households in which children were severely food insecure reported experiencing times in the past year when their children skipped meals (75.8%), went hungry (90.4%) or did not eat for a whole day (60.1%). Primary caregivers in households in which children were moderately food insecure reported experiencing times in the past year when they worried food would run out (85.1%), when they fed their children less expensive food (95.1%) and when their children did not eat enough because there was no money for food (64.3%).

Interpretation

We observed a high prevalence of household food insecurity, with a substantial proportion of children with severely food insecure status. Interventions are needed to ensure a healthy start in life for Inuit preschoolers.According to the 1996 World Food Summit, food security exists when “all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life.”¹ Food security is essential for public health² and important for child development. Suboptimal food security, or food insecurity, has deleterious effects on children’s academic performance and psychosocial development.^3,4 In Canada, food insecurity is higher in the three territories than in the provinces.⁵ According to limited data, a high degree of food insecurity exists among Inuit in particular.^6,7 Further, in most remote communities, the cost of food is at least double that in southern Canadian cities.⁸We assessed the prevalence of food insecurity among Inuit preschool-aged children.     

Expansion of human settlement in Kenya's Maasai Mara: what future for pastoralism and wildlife?

Aim Wildlife and pastoral peoples have lived side‐by‐side in the Mara ecosystem of south‐western Kenya for at least 2000 years. Recent changes in human population and landuse are jeopardizing this co‐existence. The aim of the study is to determine the viability of pastoralism and wildlife conservation in Maasai ranches around the Maasai Mara National Reserve (MMNR). Location A study area of 2250 km² was selected in the northern part of the Serengeti‐Mara ecosystem, encompassing group ranches adjoining the MMNR. Emphasis is placed on Koyake Group Ranch, a rangeland area owned by Maasai pastoralists, and one of Kenya's major wildlife tourism areas. Methods Maasai settlement patterns, vegetation, livestock numbers and wildlife numbers were analysed over a 50‐year period. Settlement distributions and vegetation changes were determined from aerial photography and aerial surveys of 1950, 1961, 1967, 1974, 1983 and 1999. Livestock and wildlife numbers were determined from re‐analysis of systematic reconnaissance flights conducted by the Kenya Government from 1977 to 2000, and from ground counts in 2002. Corroborating data on livestock numbers were obtained from aerial photography of Maasai settlements in 2001. Trends in livestock were related to rainfall, and to vegetation production as indicated by the seasonal Normalized Difference Vegetation Index. With these data sets, per capita livestock holdings were determined for the period 1980–2000, a period of fluctuating rainfall and primary production. Results For the first half of the twentieth century, the Mara was infested with tsetse‐flies, and the Maasai were confined to the Lemek Valley area to the north of the MMNR. During the early 1960s, active tsetse‐control measures by both government and the Maasai led to the destruction of woodlands across the Mara and the retreat of tsetse flies. The Maasai were then able to expand their settlement area south towards MMNR. Meanwhile, wildebeest (Connochaetes taurinus) from the increasing Serengeti population began to spill into the Mara rangelands each dry season, leading to direct competition between livestock and wildlife. Group ranches were established in the area in 1970 to formalize land tenure for the Maasai. By the late 1980s, with rapid population growth, new settlement areas had been established at Talek and other parts adjacent to the MMNR. Over the period 1983–99, the number of Maasai bomas in Koyake has increased at 6.4% per annum (pa), and the human population at 4.4% pa. Over the same period, cattle numbers on Koyake varied from 20,000 to 45,000 (average 25,000), in relation to total rainfall received over the previous 2 years. The rangelands of the Mara cannot support a greater cattle population under current pastoral practices. Conclusions With the rapid increase in human settlement in the Mara, and with imminent land privatization, it is probable that wildlife populations on Koyake will decline significantly in the next 3–5 years. Per capita livestock holdings on the ranch have now fallen to three livestock units/reference adult, well below minimum pastoral subsistence requirements. During the 1980s and 90s the Maasai diversified their livelihoods to generate revenues from tourism, small‐scale agriculture and land‐leases for mechanized cultivation. However, there is a massive imbalance in tourism incomes in favour of a small elite. In 1999 the membership of Koyake voted to subdivide the ranch into individual holdings. In 2003 the subdivision survey allocated plots of 60 ha average size to 1020 ranch members. This land privatization may result in increased cultivation and fencing, the exclusion of wildlife, and the decline of tourism as a revenue generator. This unique pastoral/wildlife system will shortly be lost unless land holdings can be managed to maintain the free movement of livestock and wildlife.     

Health and human rights in Chin State, Western Burma: a population-based assessment using multistaged household cluster sampling

Background

The Chin State of Burma (also known as Myanmar) is an isolated ethnic minority area with poor health outcomes and reports of food insecurity and human rights violations. We report on a population-based assessment of health and human rights in Chin State. We sought to quantify reported human rights violations in Chin State and associations between these reported violations and health status at the household level.

Methods and Findings

Multistaged household cluster sampling was done. Heads of household were interviewed on demographics, access to health care, health status, food insecurity, forced displacement, forced labor, and other human rights violations during the preceding 12 months. Ratios of the prevalence of household hunger comparing exposed and unexposed to each reported violation were estimated using binomial regression, and 95% confidence intervals (CIs) were constructed. Multivariate models were done to adjust for possible confounders. Overall, 91.9% of households (95% CI 89.7%–94.1%) reported forced labor in the past 12 months. Forty-three percent of households met FANTA-2 (Food and Nutrition Technical Assistance II project) definitions for moderate to severe household hunger. Common violations reported were food theft, livestock theft or killing, forced displacement, beatings and torture, detentions, disappearances, and religious and ethnic persecution. Self reporting of multiple rights abuses was independently associated with household hunger.

Conclusions

Our findings indicate widespread self-reports of human rights violations. The nature and extent of these violations may warrant investigation by the United Nations or International Criminal Court. Please see later in the article for the Editors'' Summary     

Improving Health-Related Quality of Life among People Living with HIV: Results from an Impact Evaluation of a Food Assistance Program in Uganda

Introduction

Widespread food insecurity in Africa continues to compromise an effective response to the AIDS epidemic. Health-related quality of life (HRQoL) is a comprehensive indicator of physical, mental, and social well-being that is associated with food insecurity and increasingly used to assess the well-being of people living with HIV/AIDS (PLHIV). We examined the impact of a food assistance intervention, previously shown to have reduced household food insecurity and improved nutritional status, on HRQoL of PLHIV.

Methods

We capitalized on an existing intervention targeting antiretroviral therapy (ART)- naïve PLHIV in Uganda, and conducted a prospective impact evaluation including a treatment and a comparison group. Data analyzed included 640 participants from two districts (318 in the intervention district) interviewed in both clinic and household settings at baseline and again approximately one year later. The main outcomes considered were physical and mental health dimensions of HRQoL, and other outcomes included self- and healthcare provider-reported symptoms. We utilized difference-in-difference propensity score matching methodologies to infer causality and examine program impacts.

Results

Over 12 months, food assistance significantly increased physical health scores (PHS) by 2.85 (P < .01) or approximately 0.35 SD, and reduced substantially the number of self- and healthcare provider-reported HIV-related symptoms by 3.83 and 2.68, respectively (P < .01). There was no significant impact, however, on mental health scores (MHS).

Conclusions

This study demonstrates the potential importance for HRQoL of including food assistance programming as part of the standard of care for PLHIV in areas of widespread food insecurity.     

Free markets and dead mothers: the social ecology of maternal mortality in post-socialist Mongolia

Beginning in 1990, Mongolia, a former client state of what was then the Soviet Union, undertook liberal economic reforms. These came as a great shock to Mongolia and Mongolians, and resulted in food shortages, reports of famine, widespread unemployment, and a collapse of public health and health care. Although economic conditions have stabilized in recent years, unemployment and poverty are still at disturbingly high levels. One important consequence of the transition has been the transformation of the rural, primarily pastoral, economy. With de-collectivization, herding households have been thrown into a highly insecure subsistence mode of production, and, as a consequence, have become vulnerable to local fluctuations in rainfall and availability and quality of forage, and many now lack access to traded staples and essential commodities. Household food insecurity, malnutrition, and migration of impoverished households to provincial centers and the capital of Ulaanbaatar are one result. Reductions to investments in the health sector have also eroded the quality of services in rural areas, and restricted access to those services still functioning. Evidence suggests that women are particularly vulnerable to these political-ecological changes, and that this vulnerability is manifested in increasing rates of poor reproductive health and maternal mortality. Drawing on case-study ethnographic and epidemiological data, this article explores the links between neoliberal economic reform and maternal mortality in Mongolia.