Household food security in South Africa: evaluating extension's paradigms relative to the current food security and development goals
K. A. Abdu-RaheemI; S. H. WorthII
IPhD Student at the University of KwaZulu-Natal. This article is part of the author's PhD Thesis. University of KwaZulu-Natal, Post Bag X 01, Scottsville 3209, South Africa. Email: email@example.com. Cell: 079 3463070; 073 2598469
IISupervisor, Senior Lecturer, Agricultural Extension and Rural Resource Management, University of KwaZulu-Natal. Email: firstname.lastname@example.org Tel: 033-2606159
Food insecurity is still a great concern for many households in South Africa. This situation is connected to the high level of poverty that exists in the country, particularly in rural areas. Rural households use five key pathways to address their food insecurity and poverty: an agricultural path; a multiple-activity path; an assistance path; a micro-enterprise path and an exit path. Using this framework of pathways, this paper presents a philosophical argument exploring the role agricultural extension can play to realise the goals of food security and poverty alleviation in South African rural households. Drawing on relevant published works, this paper argues that extension is particularly well positioned to address food insecurity and poverty through the instruments of technology transfer and innovation, human capital development, social capital development and increasing market access. These instruments were found capable of influencing the full range of pathways when applied through the agricultural path.
Establishing food security, particularly household food security, is widely acknowledged as an important milestone in advancing the living standards of the rural poor. One avenue toward realizing this is through small-scale agriculture, which can be fostered through appropriate agricultural extension. However, food security programmes and extension approaches and agendas often are not compatible. Food security has about 200 definitions (Hoddinott, 2001). This study, however, makes use of the definition given in the State of Food Insecurity 2010 report by the Food and Agricultural Organization (FAO) which states: "food security is a situation that exists when all people, at all times, have physical, social and economic access to sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active and healthy life" (FAO, 2010:8).
Although, globally, sufficient food is produced to make it possible to achieve food security (Islam, 1995), the number of undernourished in the world has increased from about 840 million in 1996 (FAO, 1996) to about 925 million in 2010 (FAO, 2010), with 98% living in developing countries (FAO, 2010). The United Nations Children's Fund (UNICEF) indicates that at least 150 million children are undernourished, 32 million of whom live in Africa (UNICEF, 2001). This demonstrates that producing sufficient food globally does not necessarily imply equitable and proportionate distribution among people. Similarly, sufficient food production nationally may also not translate to food security at the household level, as is the case in South Africa (van der Berg, 2006). It can also occur that a household has sufficient food, but it is inequitably distributed within the household (Hyder et al., 2005).
Many factors contribute to food insecurity at the household level: political instability, civil friction and wars, macroeconomic imbalances, environmental degradation, poverty, increased population, gender discrimination, poor health and illiteracy (Smith et al., 2000) . These factors may be categorized as follows:
(a) Insufficient food availability at the national level, resulting in food insecurity at the household level;
(b) Insufficient household food production or lack of economic power to purchase food; and
(c) Inequitable intra-household access to food.
Poverty, which falls into the second category, is strongly correlated with food insecurity (Barrett, 2010). Therefore, it is necessary to address poverty and food security simultaneously. Further, it is of value to establish how agricultural extension can contribute simultaneously to alleviating poverty and achieving food security. This paper will explore this question by discussing South Africa's food security condition, food security as a public and an economic good, pathways for households to exit poverty and food insecurity, agricultural extension in relation to achieving food security, and agricultural extension paradigms. The paper will finally suggest ways to achieve this dual objective by synthesizing the objectives of public agricultural extension with the food security and development targets.
2. SOUTH AFRICA'S FOOD SECURITY CONDITION
South Africa produces enough food to feed its population, but experiences rapidly increasing rates of household food insecurity (van der Berg, 2006). Although employment has risen in the country, it has not attained the level where it can significantly address the issue of income poverty (Aliber, 2009). Further, while the national government provides social grants which help to minimize the rate and effect of food insecurity within the country, 40-50% of South Africans live in poverty (Machethe, 2004 citing Terreblanche, 2002). Approximately, 35% of the total South African population - about 14.3 million people - experience hunger and under-nutrition (Rose & Charlton, 2002), the majority being children, women and the elderly.
Recently, prices of wheat and maize, which form part of the staple foods in South Africa, have increased in world markets (Heady & Fan, 2008). This development worsens the food insecurity condition as households now face more difficulties in procuring food items from their earnings. As the FAO (2009) notes that landless and female-headed households, together with both the rural and urban poor, constitute the major groups most affected, this situation is likely to persist over the next decade (Heady & Fan, 2008).
Other factors contributing to the food insecurity situation of South African households are increases in the cost of electricity and oil prices. The electricity price is set to increase by 100% between 2008 and 2011. Regular increases in the oil price result in higher prices for food items and fertilizer, the production of which petroleum forms an indispensable input. The cost of transportation also increases, forcing food prices to increase proportionately (Altman et al., 2009).
In 2008 an estimated 39.26% of the total South African population lived in rural areas (World Bank, 2010). Further, 65% of those identified as "poor" and 78% of those identified as "chronically poor" reside in rural environments (Woolard & Leibbrandt, 2002). These statistics suggest that interventions to combat food insecurity in South Africa should be largely directed to rural communities.
Smallholder agriculture is a major tool for creating employment, for human welfare and for political stability in sub-Saharan Africa, particularly in rural areas (Delgado, 1998). Further, small-scale agricultural production helps reduce rural poverty and food insecurity (Lele & Agarwal, 1989). South Africa is no exception to this experience. Machethe et al. (2004) report that of the total household income in rural South African households, smallholder farming constitutes the greatest single source of that income; it accounts for over 40% of the total household income. Other sources of income identified by Machethe et al. (2004) were non-farm income including pension remittances, wages, family businesses and other sources each of which was less than 40% of the total household income. Given that, worldwide, most poor people live in rural areas and that agriculture is their main source of livelihood, focusing on factors that will enhance smallholder agriculture will bring about a lasting solution to the problems of rural poverty and food insecurity (Lopez, 2002).
3. FOOD SECURITY AS A PUBLIC AND AN ECONOMIC GOOD
According to Paarlberg (2002), public goods refer to goods that are non-excludable, and which do not dwindle due to consumption. He argues that the supply of public goods is a responsibility of any government to its people. Although food security is not a public good because it is excludable and can dwindle, it should be treated as a public good by the state. Paarlberg (2002: 13) asserts:
"In the area of food security, one such good might be a supply of cheap food made available to the poor through a public food distribution system. In other cases, the pursuit of food security might even require that private goods (such as land) be taken from a traditionally privileged category of citizens, with or without compensation, for redistribution to disadvantaged citizens. In still other cases, food security might require government action to reduce racial prejudice or gender inequity."
Furthermore, Diouf (2002) argues that the voluntary signing of the World Food Summit Pledge by the governments of the UN member states to halve the current food insecurity rate is an indication of their full acknowledgement that food security should be treated as a public good and all governments must address food insecurity. The implication is clear: the importance of government in ensuring food security to its citizens cannot be overemphasized.
Considering food security as an economic good, agricultural economists Johnston and Kilby (1975) and Eicher & Staatz (1984) reported that aggregate economic output and employment rates receive quicker and better growth when development interventions are concentrated on peasant and small-scale farmers. Conversely, some social scientists argue that service delivery, mainly aimed at increasing production by small-scale poor producers in remote locations, will only result in low yields and declining results (Farrington et al., 2002; Berdegué & Escobar, 2002).
The South African government has applied various strategies to address poverty and food insecurity within the country. It has used social grants and, over decades, has established a number of institutions and programmes focusing on food security including the National Nutrition Council (established in the 1940s), the National Nutrition and Social Development Programme (established in 1990), the Community Based Nutrition Programme, and the Primary School Nutrition Programme (both established in 1994). Addressing broader issues in food security, the Integrated Nutrition Strategy (INS), also established in 1994, focused on land reform, agricultural credit provision, infrastructure and comprehensive farmer support as tools to enhance agricultural production (Bonti-Ankomah, 2001). However, the INS has not made any appreciable progress in the area of comprehensive farmer support (Machethe, 2004). Machete further indicates that the South African Government needs to give more support to the extension sector as the primary source of support to small-scale farmers to improve agricultural production, especially at the rural household level.
4. PATHWAYS EXPLORED BY RURAL HOUSEHOLDS TO ADDRESS FOOD INSECURITY AND POVERTY
Finding a pathway out of food insecurity and poverty requires a multidimensional approach (World Bank, 2000). De Janvry & Sadoulet (2001: 9-10) identify four pathways which households use to address their food insecurity and poverty: an "agricultural path"; a "multiple-activity path"; an "assistance path"; and an "exit path". In addition, Haggblade, Hazell, & Reardon (2002) identify a fifth path, a "micro-enterprise path".
Agricultural path: This pathway refers to using agricultural production by the rural poor who have access to land and other farming resources. However, of challenge to the long-term usefulness of this path is a prediction made by Cour et al., (1998) that people following this path are likely to be marginalised in the future by commercial farmers who are able to apply technologies and marketing systems that current developments demand. This path constitutes the focus of integrated rural development interventions for some time now, and has met with mixed success due to difficulties in adoption of existing rural development packages by rural communities (World Bank, 1997).
Multiple-activity path: This pathway refers to rural households using off-farm income sources as their main means of livelihood, and agricultural production as secondary. Households in this path often use off-farm income to finance their farming activities. They are caught between two limited income sources. While these households have land, they are not strategically located for markets which limit income from farming. Off-farm job opportunities are also limited, restricting off-farm income. They must use both income sources (De Janvry & Sadoulet, 2001). Further, López & Valdés (2000) note that the income earned by households in this path is lower on average compared to that for those who rely completely on off-farm sources of income.
Assistance path: This pathway refers to extremely poor households that depend on transfers (e.g. remittances from a family member working away from home) as their primary source of income. It includes households without other resources for which remittances are their permanent source of income and households that have other resources but, due to immediate circumstances, use remittances as a temporary income source and as a safety net, protecting them from having to sell off their productive assets. Such households use this pathway to prevent themselves from losing their assets and thereby degenerating from their transient poverty condition to perpetual poverty (De Janvry & Sadoulet, 2001).
Exit path: This pathway refers to the situation in which rural poor migrate from their rural environment to urban centres for the express purpose of escaping poverty. Although this seldom features in the discussion of agricultural and rural development, it has been identified as a means used frequently by rural families to cope with poverty and food insecurity (De Janvry & Sadoulet, 2001). Rivera 2004, quoting Berdegué, 2003, argues that the significance of this pathway should not be underestimated in that remissions made by migrants in Latin America amount to several billion US dollars per year. Contrarily, O'Hare & Rivas (2007) argue that migrations mostly result in engendering transfers of poverty to urban centres -urbanisation of poverty in the wording of the UN-Habitat (2003) - and erosion of rural human resources (the educated and young adults) rather than alleviating poverty conditions. Further, O'Hare & Rivas (2007) indicate that rural-urban migration may likely plunge the ordinary poor in rural communities into extreme poverty due to diminution of the human resource base.
Micro-enterprise path: This path refers to the situation in which rural poor own and manage businesses for a livelihood, which are sometimes related to agriculture. These businesses often include merchandise and food shops, processing services and storage facilities (Haggblade, Hazell, & Reardon, 2002). Further, Rivera (2004) indicates that people using this path are often better off than those who are solely reliant on agriculture. Orr & Orr (2002) indicate that establishment of an individual or a family micro-enterprise is important for the poor to earn an income.
Critically analysing these paths, it is apparent that 'income generation' is central and common to all five pathways, and that agriculture is a major consideration for rural households in deciding how to escape poverty and food insecurity. Agriculture remains an income source in the first two and the micro-enterprise pathways and thus, efforts can be made to strengthen this as a viable income source. Given that the households in the latter pathways are in rural areas, it is suggested that small-scale agriculture be explored as a means to diversify incomes for these households to overcome dependence on remittances and avoid the need to leave the rural area, thereby creating additional options to overcoming poverty and food insecurity.
5. AGRICULTURAL EXTENSION'S ROLE IN ACHIEVING FOOD SECURITY
There is no single and specific definition of agricultural extension. Extension as a term was first employed in the description of some adult education programmes being run by the universities of Cambridge and Oxford in England in 1867. The main aim of these programmes was to extend research outputs of the universities beyond their boundaries into the surrounding communities (Jones & Garforth, 1997). Furthermore, Jones and Garforth (1997) state that the effort to disseminate and campaign for the use of improved agricultural systems and management methods dates back several decades in different locations in the world. However, prior to being named as such, the beginning of public extension or advisory systems dates back before 1867, with the United Kingdom and Ireland as the pioneers. Between 1845 and 1851 when Ireland was experiencing a potato famine, it was the public agricultural advisors who came to the rescue of potato farmers by assisting them to diversify production into different agricultural crops. Following this development, European and North American governments institutionalised the services of 'travelling instructors' in the second half of the 19th century.
5.1 Agricultural extension paradigms
To understand what role agricultural extension can play in addressing South African rural household food security concerns, it is useful to consider the general objectives and approaches of agricultural extension. Swanson (2009) identified four categories or models of agricultural extension: technology transfer; advisory services; non-formal education; and facilitation extension. Groot and Roling (1998) described a similar range of extension approaches. Worth (2006) suggests a fifth approach: facilitated learning. Table 1 provides a brief comparison of four of these approaches using eight critical factors: purpose, assumptions, source of innovation, promoter's role, farmers' role, supply/demand, orientation and target.
5.2 Synthesis of the objectives of public agricultural extension with food security and development targets
As South Africa becomes more conscious of the need to combat household food insecurity and rural poverty, extension emerges as a potentially powerful vehicle to achieve this. This is evidenced by the many meeting points between the objectives of agricultural extension and food security and poverty alleviation. Extension can make it possible for rural farming populations to integrate sustainable natural resource management and viable agricultural production with their food production systems. Figure 1 provides insight into how this is possible.
Figure 1 illustrates how agricultural extension influences rural household food security and poverty alleviation strategies through the agricultural path strategy. Its chief instruments of influence are technology innovation and transfer, human capital development, social capital development, and access to markets.
Figure 1 further illustrates that the introduction and innovation of agricultural technologies has direct and indirect effects on reducing household poverty. The major direct effect is that technologies lead to increased production for personal household consumption and profits for farmers (de Janvry and Sadoulet 2002). De Janvry and Sadoulet further argue that new technologies lead to higher yields and to reduced production costs which translate into higher profits. The indirect impacts of new technologies are reduced food prices (resulting from higher agricultural productivity and output), employment creation for households in the exit and assistance paths, and general economic growth (through investment, supply and consumption linkages), particularly for households using off-farm sources of income as in the multi-activity and micro-enterprise paths (Berdegué & Escobar, 2002).
Technology innovation and transfer in agriculture is a useful strategy, particularly in South Africa where revival of small-scale agriculture has been identified as a potential solution to the problem of involuntary unemployment (Klasen & Woolard, 2008). Farm jobs are created through increased need for planting, weeding, manure/fertilizer application, harvesting, and other production related activities. In Ethiopia for example, Berhe et al. (2009) note that nursery operation, by exploiting the opportunity afforded by limited supplies of planting materials, has resulted in creating employment opportunities for the landless youth and individual male and female farmers; and it also provides it's operators with significant income of between 100 and 11,000 USD per season. Off-farm employment opportunities will arise from "down-stream" post-harvest value-adding activities, such as agro-processing, storing, packaging and distribution. In addition, technology innovation and transfer can lead to increased labour wages (Berdegué & Escobar, 2002).
Furthermore, new technologies in agriculture stimulate linkages between farm and off-farm income sources (Reardon, et al., 2001), which consequently result in general economic growth. This is particularly important for those who utilise the multi-activity and micro-enterprise paths for a livelihood. Agricultural growth creates demand linkage for rural off-farm investments by advancing their demand capacities for production inputs and consumption commodities. Supply linkage is created when growth in agriculture provokes off-farm investments' capacities in supplying inputs and services to the agricultural sector. Investment linkage, however, is created when people in the multi-activity and micro-enterprise paths are enticed to diversify their income base by investing in agriculture given its sudden boom with high returns and increased profits in off-farm businesses, while those in farming business act vice versa for similar reason (Reardon, et al., 2001; Berdegué & Escobar, 2002).
These direct and indirect effects of technology innovation and transfer are not automatic. They are influenced by a number of factors including how early or late farming households adopt innovations, tradability of the products in question, whether the majority of households in the market are net-buyers or net-sellers (Berdegué & Escobar 2002). Similarly, De Janvry and Sadoulet (2000) note that a key factor in exploiting employment potential, is to educate rural youth for off-farm employment.
As shown in Figure 1, extension develops human capital. Developing knowledge and skills among farmers is one of the primary functions of extension. Depending on the area of extension focus, human capacity is built in a variety of areas including agricultural production, farm management, marketing, natural resource management (Swanson, 2006). Such human capacity development benefits households in whatever exit path they are using. The final two of extension's instruments of influence shown in Figure 1 - developing social capital and improving market access - are closely interlinked. Extension builds social capital among rural farmers by assisting them to form "bonds" among themselves (e.g. farmers' associations) and "bridges" linking them to post-harvest operations and markets (Swanson, 2006). This will help them reduce production costs and improve their profit margin through their strengthened bargaining powers in both input and output markets. Also, alliances between farming households brings about more articulation of their needs from extension officers, research bodies and other agricultural institutions (Swanson, 2006). Further, to sustain such social capital, particular attention should be given to organising rural youth (Pretty et al., 2001).
This paper has highlighted various means by which agricultural extension can help address food security and poverty at the household level. Its chief instruments of technology innovation and transfer, human capital development, social capital development and increasing market access are effective means of addressing food insecurity and poverty at the household level. The paper demonstrates that, by focusing on enhancing agricultural productivity and profitability (through the agricultural path option), all the other options available to rural households can also be enhanced. Thus, it is vital that agriculture remain an integral part of any government's strategy to address food insecurity and poverty at the household level. Whatever approach or combination of approaches used - technology transfer, advisory, facilitation, or learning - agricultural extension programmes should be reexamined and adjusted so that they are made to contribute to creating and maintaining food security and to alleviating poverty at the household level.
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K. A. Abdu-Raheem,
University of KwaZulu-Natal, Post Bag X 01,
Scottsville 3209, South Africa.
Cell: 079 3463070; 073 2598469
Food security in South Africa: a review of national surveys
Demetre Labadarios a, Zandile June-Rose Mchiza a, Nelia Patricia Steyn a, Gerda Gericke b, Eleni Maria Winifred Maunder c, Yul Derek Davids a & Whadi-ah Parker a
a. Population Health, Health Systems and Innovation, Human Science Research Council, 12th Floor Plein Park Building, 69–83 Plein Street, Cape Town, 8001, South Africa.
b. Department of Human Nutrition, University of Pretoria, Pretoria, South Africa.
c. Bournemouth University, Bournemouth, England.
Correspondence to Zandile June-Rose Mchiza (e-mail: email@example.com).
(Submitted: 13 April 2011 – Revised version received: 11 August 2011 – Accepted: 23 August 2011 – Published online: 04 October 2011.)
Bulletin of the World Health Organization 2011;89:891-899. doi: 10.2471/BLT.11.089243
Food insecurity has emerged as a global crisis following the global economic meltdown.1 According to the 2004 report of the Food and Agriculture Organization (FAO) on the state of food insecurity in the world, more than 814 million people in developing countries are undernourished.2 Of these people, 204 million live in countries of sub-Saharan Africa, including South Africa.
Despite the political and economic advances seen in South Africa since 1994, the country is plagued by poverty and unemployment and, following the recent global economic crisis, by steep food and fuel prices, high-energy tariffs and increasing interest rates.3 These adverse conditions have placed severe pressure on ordinary South Africans already struggling to meet their basic household needs. Thus, a proper definition of the term “food insecurity” and measures that are suitable for the South African context must be urgently developed.
Food security is said to exist, in accordance with its international definition, when in a society all people at all times have enough food for an active, healthy life.4 Food security as an umbrella term includes: (i) the availability of food that is nutritious and safe; (ii) an assured ability to procure and acquire food of good quality in a socially acceptable way (e.g. without resorting to emergency food supplies, scavenging, stealing or similar coping strategies). In contrast, food insecurity exists when food is not easily accessible and households have difficulty securing adequate food.2
In recent years particular attention has been paid to access to food and its measurement. This stems from the realization that even when food is available in markets, it may not be accessible to specific households.4 According to Davids,5 after 10 years of democracy a large proportion of South Africans still perceive themselves as lacking enough income to meet all their household needs. “Access” has been defined as a household’s ability to acquire enough food of sufficient quality to have all of its members meet their nutritional requirements and lead productive lives.6
Millions of dollars are spent annually on food aid programmes intended to alleviate hunger and poverty. For these programmes to work effectively, households at greatest risk of food insecurity have to be identified by means of an objective and accurate indicator of food access and food availability at the household level. The Community Childhood Hunger Identification Project (CCHIP) index, the household dietary diversity score and the food variety score are among the measures developed for this purpose in the United States of America.7–10 The CCHIP index defines hunger as the mental and physical condition arising from not eating enough food because of insufficient economic resources within the family or community. In contrast, the household dietary diversity score and the food variety score measure the average number of food groups or items consumed within a household over a period of 24 hours: from a total of 12 possible food groups and of 45 possible items, respectively.
No national survey has been conducted to assess all the dimensions of food insecurity in South Africa, although some national surveys have included specific components of food insecurity. Thus, the objective of the current study was to review the food insecurity components of these surveys and establish whether they covered food access, food utilization and food availability. Food access can be measured both in terms of the hunger experienced by individuals within a household or of the household’s dietary diversity. Conversely, food utilization can be measured using anthropometric parameters (height and weight), dietary intake or blood nutrient levels. Lastly, food availability can be measured using household food inventory and/or food procurement data.
We conducted a search of electronic databases for national surveys carried out between January 1999 and December 2009 in which the CCHIP index was used to establish the state of food insecurity in South Africa.
The databases searched were MEDLINE (PubMed), EMBASE and the Cochrane library and reviews. To make sure that we retrieved all surveys, we used keywords such as “food insecurity”, “food security” and “South Africa”, selected in accordance with the National Library of Medicine’s Medical Subject Headings. We then refined the search by including keywords for the time frame (i.e. January 1999 to December 2009) (Box 1). Only one investigator assessed the search results. After an initial thorough and systematic search, one investigator (the subject expert) double-checked the surveys to ensure that they met the inclusion criteria. The same investigator also checked the completeness of the results and determined whether the original CCHIP index developed by Swindale and Bilinsky7 had been used to measure food security in the surveys included.
Box 1. Search strategy
The research question
National surveys that measured food security/insecurity in South Africa from 1999 to 2008
Breaking down of the question into “facets” or “terms”
- Population – South Africa
- Study design – national surveys
- Outcome – food security/food insecurity
- Time frame – 1999 to 2008
Combination of terms
The terms were then combined using Boolean Logic (AND, OR) to create a set of results for articles relating to the aforementioned topic. The AND was used to ensure that all the search terms appeared in the record. For example, food AND security retrieved all records containing both the terms food and security. Moreover, the terms food security AND national surveys AND south africa were combined. “AND 1999 to 2008” was also used to narrow down or focus the search. The terms food security OR food insecurity were then used to accumulate similar search terms, thus expanding searches.
(food [MeSH Terms] OR food [All Fields]) AND security [All Fields] OR insecurity [All Fields] AND (south africa [MeSH Terms] OR (south [All Fields] AND africa [All Fields]) OR south africa [All Fields]) AND (federal government [MeSH Terms] OR (federal [All Fields] AND government [All Fields]) OR federal government [All Fields] OR national [All Fields]) AND (data collection [MeSH Terms] OR (data [All Fields] AND collection [All Fields]) OR data collection [All Fields] OR surveys [All Fields]) AND 1999 [All Fields] AND 2008 [All Fields]
Only three national surveys that used the CCHIP index to assess the level of food insecurity in South Africa – namely, the 1999 National Food Consumption Survey (NFCS),11 the 2005 National Food Consumption Survey Fortification Baseline – I (NFCS:FB-I),12 and the 2008 South African Social Attitudes Survey (SASAS)13 – were included. Their primary investigators were contacted to request consent to conduct secondary analyses of their data. The 1999 NFCS, which included children only, provided data on all aspects of food insecurity mentioned previously, as did the 2005 NFCS:FB-I, which included women and children. However, the SASAS, an annual survey conducted by the Human Sciences Research Council, provided data on hunger alone.
The 1999 NFCS and the 2005 NFCS:FB-I were conducted on South African households (2894 and 2469, respectively) with children aged 1 to 9 years. Both surveys assessed food procurement, anthropometric parameters and hunger, and both inventoried the foods in the households (all foods in 1999 and 2005; as well as fortified foods in addition to non-fortified foods in 2005). The SASAS, which measures the attitudes of individuals towards democracy, governance, poverty and social identity issues, was expanded in 2008 to include the measurement of hunger. The 2008 SASAS survey interviewed randomly selected adults (16 years of age and older) from randomly selected households. These adults were not necessarily the caregivers of the children in the households. Thus, to be able to compare the 2008 SASAS data (n = 3500) with the data from the 1999 NFCS and the 2005 NFCS:FB-I, we limited our secondary analysis to data from the SASAS survey to those households with children aged 1 to 9 years (n = 1150).
The population sample in the 1999 NFCS was selected based on the 1996 census sampling frame, whereas, the 2005 NFCS and SASAS were selected based on the 2001 census sampling frame, both provided by Statistics South Africa.14
All three surveys measured hunger using the CCHIP index,7 which has been validated in the South African context.11–13 The CCHIP index (Box 2) is composed of eight questions that investigate food insecurity at three levels: the household (question 1–2), the adult (question 3–4) and the child (questions 5–8). It also assesses food shortages, perceived food insufficiency or changes in food intake resulting from resource constraints. Furthermore, for each aspect of hunger (i.e. for all eight questions), two further questions explore the extent of the food insecurity over a period of 30 days.
Box 2. Questions on food insecurity and child hunger, Community Childhood Hunger Identification Project indexa
Household-level food insecurity
- Does your household ever run out of money to buy food?
- Do you ever rely on a limited number of foods to feed your children because you are running out of money to buy food for a meal?
- Do you ever cut the size of meals or skip meals because there is not enough money for food?
Individual-level food insecurity
- Do you ever eat less than you should because there is not enough money for food?
- Do your children ever eat less than you feel they should because there is not enough money?
- Do your children ever say they are hungry because there is not enough food in the house?
- Do you ever cut the size of your children’s meals or do they ever skip meals because there is not enough money to buy food?
- Do any of your children ever go to bed because there is not enough money to buy food?
We also included in the analysis relevant data from the 2005 Food Insecurity and Vulnerability Information and Mapping Systems (FIVIMS), which covered 597 households in Sekhukhune.15 Although this survey was not national in scope, it was included because it measured hunger in some rural South African provinces (Mpumalanga and Limpopo). Also, it used an adapted version of the CCHIP index and hence afforded a good comparison with the 2005 NFCS. However, only two questions (1 and 8) were exactly the same in the original and the adapted versions of the CCHIP index (Box 2).
We performed secondary analyses of the data from the four surveys. Details of data analyses for the individual surveys are presented in the primary studies.11–13,15 In brief, SAS 845 (SAS Institute, Cary, USA) was used to analyse the data from the NFCS and the NFCS:FB-I, and SPSS-SA (SPSS Inc., Chicago, USA) to analyse the data from the SASAS and FIVIMS.
We assessed food insecurity over the period from 1999 to 2008, as reflected in access to food, by comparing CCHIP index data from the four existing databases. The level of food insecurity was given by the number of affirmative responses on the CCHIP index. For example, respondents who answered “yes” to up to four questions were classified as being at risk of food insecurity, whereas those who answered “yes” to five questions or more were classified as experiencing food insecurity. Conversely, those who responded “no” to all eight questions were considered to be free from food insecurity.
Data on access to food (presented as nutrient adequacy as well as dietary diversity and variety) is expressed as means and their standard deviations. The prevalence of food insecurity (at the national, province, household, question and questionnaire item level) is expressed as percentages. Data on food utilization (presented as anthropometric z-scores) is expressed as percentages. Food availability is expressed as the number of food items in the household inventory.
Table 1 compares the results of the CCHIP index observed in the three national surveys. Food insecurity clearly decreased in South Africa at both the household and the individual level from 1999 to 2008. The results of the 2005 FIVIMS study were similar to those observed in the NFCS:FB-I conducted the same year.
Table 2 summarizes the results of the three national surveys in terms of the proportion of people who were free from, at risk of and experiencing food insecurity. Overall, between 1999 and 2008 the prevalence of food insecurity in South Africa appears to have been reduced by more than half, from 52.3% to 25.9%. However, the proportion of people at risk of experiencing food insecurity remained practically unchanged. The reduction was noted in both urban and rural areas, where food insecurity decreased from 42.0% to 20.5% and from 62.0% to 33.1%, respectively (Fig. 1). Among the provinces, the Eastern Cape had the highest prevalence of food insecurity in 1999 (83.0%), followed by the Northern Cape (63.0%), Limpopo (55.0%) and the North West province (62.0%), all of which are rural. By 2008, the prevalence of food insecurity had decreased in all provinces, although the Eastern Cape still had the highest prevalence (45.4%). On the other hand, food insecurity in the Northern Cape had decreased dramatically, from 63% to 14.2% (Fig. 2).
Fig. 1. Food insecurity in urban and rural areas according to three national surveys spanning 1999–2008, South Africa
Fig. 2. Food insecurity at the provincial and national levels according to three national surveys spanning 1999–2008, South Africa
Access to food
Table 3 presents data on nutrient adequacy, food variety and dietary diversity scores from the 1999 NFCS. The results clearly show that more than one third of the children in all age groups scored very low in terms of food diversity (mean score: 3.58; standard deviation, SD: ± 1.37) and food variety (mean score: 5.52; SD: ± 2.54).9
The anthropometric status (expressed as z-scores) of children aged 1–9 years in the NFCS surveys was used as a proxy measure for food utilization. Fig. 3 shows that stunting is still a very common condition in South Africa. In 2005, 18.0% of the children were chronically undernourished (stunted).
Fig. 3. Anthropometric data (as a proxy for food utilization) for children aged 1–9 years in two National Food Composition Surveys (NFCS), South Africa
Fig. 4 shows that the dietary diversity score was positively related with z-scores for underweight, stunting and wasting among children included in the 1999 NFCS. Height for age and weight for age were more than zero standard deviations above the mean only when the dietary diversity score was 6 or above. A similar trend was seen in nutrient adequacy ratios, which reached 100% only when the dietary diversity score was 5 or above. Nutrient adequacy ratios were generated by dividing the children’s intake of each of 11 micronutrients (vitamins A, B6, B12 and C, niacin, thiamin, riboflavin, folate, calcium, iron and zinc) by the recommended intake for that nutrient using the intakes for gender and age recommended by the World Health Organization and FAO, and then multiplying the total by 100.9
Fig. 4. Relationship between z-scores and dietary diversity scorea for children aged 1–9 years in the 1999 National Food Composition Survey, South Africa
Fig. 5 presents household food availability data for the 1999 NFCS. Notably, all formal urban households and households with a higher income (> 12 000 rand (R), or > US$ 1522 per annum) had more food items in the household inventory (an average of 15.7 different ones) than rural households and households with lower income (≤ R12 000, or ≤ US$ 1522 per annum), which averaged 7.4 different food items. Statistics South Africa classifies urban areas according to predominant settlement type and land use. Cities, towns, townships and suburbs are typical formal urban settlements. Informal settlements (squatter camps and shacks), hostels, institutions, industrial and recreational areas, and small holdings within or adjacent to any formal urban areas are also classified as urban. Any area that is not classified as urban, including tribal areas and commercial farms, is classified as rural.14
Fig. 5. Food availability as measured by an inventory of households earning ≤ R12 000 or > R12 000 (≤ US$ 1522 or > US$ 1522) per annum in the 1999 National Food Composition Survey, South Africa
Food availability also differed across provinces. In all provinces other than the Western Cape food variety was lower in poorer and rural households than in higher-income and urban households (average of 5 versus 14 different food items, respectively). The Western Cape recorded the greatest food variety (average of 15 food items) across households of all income levels and both rural and urban (data not shown).
Food insecurity constitutes a global crisis. This explains why eradicating extreme poverty and hunger is the first Millennium Development Goal. In this light, the results presented in this paper, which point to a reduction in the prevalence of food insecurity in South Africa between 1999 and 2008, are extremely encouraging.
What, then, are the country-specific factors that have contributed to this decrease? One of them could be the explicit recognition in the current South African constitution that the right to food comes under the Bill of Rights, along with several others with which it is related.16 As such, several government policies designed to address food insecurity have been put into effect and enforced.17 These policies have led to food fortification, food supplementation, school feeding programmes and day care centre schemes.
The National School Nutrition Programme (NSNP) aims to foster better quality education by enhancing children's active learning capacity; alleviating short-term hunger; providing an incentive for children to attend school, regularly and punctually; and addressing certain micro-nutrient deficiencies.18 Since 1999, the government has allocated more than R450 million (US$ 58 million) to the NSNP,18 and nongovernmental organizations have contributed concurrently to this programme. For instance, in the Western Cape, the Peninsula NSNP fed about 64 392 children in 368 primary schools in 2001.18 By 2009, the number had increased to at least 200 000.17 Although this is encouraging, some schools, especially in rural areas, have not yet been reached. Infrastructural factors such as poor roads or transportation to these schools may be among the barriers.18
Another government initiative that targets food insecurity is social grants. These come in the form of old age pension funds, disability grants, foster care grants, care dependency grants and child support grants.17 All of these have been shown to increase women’s purchasing power as well as their access to food.17 In the period from 1999 to 2003, approximately 2.6 million South Africans received social grants and by 2007 this figure had increased to 12 million.17 Despite this remarkable achievement, not all South Africans who qualify for these grants are managing to access them. One reason may be that social welfare officials in different provinces are not consistent in observing the set national criteria for determining who is eligible for these grants. Intra-departmental corruption within the social welfare system and stringent guidelines for selecting those who qualify for grants are among several factors that keep the grants from reaching all poor South Africans.19–21
Tradition and agricultural practices heavily influence the type of diet consumed by South Africans. However, this study highlights income and access to food as the most important determinants of food availability. Indeed, the majority of South African households still struggle to sustain a decent income; the estimated average income of the poor is less than R1000 (US$ 127) every month.11 As a result, the women residing in these households find it very difficult to purchase enough food to feed the entire household. According to Bonti-Ankomah,22 the average South African adult requires a minimum of ± R9.55 (± US$ 1.22) every day or ± R286.5 (± US$ 36.38) each month (depending on inflation) to procure a healthy balanced diet. The average household in South Africa has four members23,24 and requires around R38.20 (US$ 4.85) every day or R1146 (US$ 145.54) every month to procure a healthy diet for all of them. Lehohla25 has suggested that the situation may be even worse since poorer South African households tend to have six or seven members. Moreover, the average of eight food items stocked in the cupboards of poorer households according to the 1999 NFCS household inventory data is substantially below the minimum requirement of 17 items needed to maintain a healthy, well balanced diet according to Bonti-Ankomah.22
Our findings show that the nutrient density of the diet consumed by South African children is insufficient to meet their nutrient requirements. Similarly, they have shown alarmingly low food variety and household dietary diversity scores, both of which have been positively related to children’s nutritional status.9 Despite evidence that food fortification programmes have improved the micronutrient status of South African children,26 they have failed to improve dietary diversity and overall macronutrient intake. Hence, stunting still affects a large proportion of children.11 Deficits in macronutrient intake and poor dietary diversity could conceivably be addressed by means of strategies not dependent on income, such as the promotion of subsistence farming and efforts to increase awareness of the nutrient content of indigenous fruits and vegetables.26 However, the majority of the South African population lacks land for growing its own food and will have to continue to purchase food items commercially.27
This study has several limitations. First, although the CCHIP was assessed for content and face validity,13 the item analysis to ensure each question’s validity was not performed before any of the South African studies. Second, the surveys followed somewhat different sampling criteria. The 1999 and 2005 NFCS included only child caregivers (2894 and 2469 women 18 years of age and older, respectively), whereas the SASAS included 1150 people, male or female, who were not necessarily the children’s caregivers. Finally, the three surveys were conducted at different times of the year – the two NFCS surveys between January and April, and the SASAS between August and October– and this may have influenced the responses given by the participants on food availability and the food stocked in the households.
In summary, food insecurity has decreased in South Africa over the past 10 years. However, a substantial proportion of households remains at risk of hunger or is experiencing hunger. Although the measures and programmes initiated by the South African government appear to be beneficial, they need to be run more effectively to further alleviate food insecurity.28 Moreover, the lack of access to land for the South African majority must be addressed through sustainable, non-income-dependent measures, such as the promotion of subsistence farming.28
The Human Science Research Council of South Africa provided financial support for this study.
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- Swindale A, Bilinsky P. Household Dietary Diversity Score (HDDS) for measurement of household food access: indicator guide, version 2. Washington: United States Agency for International Development; 2006; Available from: http://www.fantaproject.org/downloads/pdfs/HDDS_v2_Sep06.pdf [accessed 16 September 2011].
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- Labadarios D, editor. The National Food Consumption Survey (NFCS): children aged 1–9 years, South Africa, 1999. Stellenbosch; Directorate: Nutrition, Department of Health, National Food Consumption Survey Consortium; 2000.
- Labadarios D, Swart R, Maunder EMW, Kruger HS, Gericke GJ, Kuzwayo PMN, et al., et al. Executive summary of the National Food Consumption Survey Fortification Baseline (NFCS-FB-I) SA, 2005. SA J Clin Nutr 2008; 21: 247-300.
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- Statistics South Africa Census 2001 [Internet]. Concepts and definitions for Statistics South Africa (Report No. 03-02-26, version 2). Pretoria: SSA. Available from: http://www.statssa.gov.za/inside_statssa/standardisation_concepts_definitions.asp [accessed 16 September 2011].
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