an Eldis Resource
Impact of drought and HIV on child nutrition in Eastern and Southern Africa
Determining short- and long-term trends in child malnutrition and how these are affected by drought and HIV
Authors:
J. B. Mason
Publisher:
Tulane Institute for International Development , 2007
Objective: To determine short- and long-term trends in child malnutrition and how these are affected by drought and HIV.
Design: Secondary epidemiological analysis of area-level data derived from national surveys, generally from mid-1990s to mid-2000s.
Setting: Data from countries in the Horn of Africa (Ethiopia, Kenya, Uganda) and southern Africa (Lesotho, Malawi, Mozambique, Swaziland, Zambia, and Zimbabwe), compiled and analyzed under UNICEF auspices.
Subjects: Secondary data: children 0-5 years for weight-for-age; HIV prevalence data from antenatal clinic surveillance; food security data from UN sources (FAO, ILO, others).
Results: Overall trends in child nutrition are improving as national averages, slowed but not stopped by the effects of intermittent droughts. In southern Africa underweight prevalences show signs of recovery from the 2001-3 crisis. Food security early warnings tend to be confirmed by subsequent food production and price indicators, and these relate as expected (if weakly) to malnutrition changes: real time warnings are useful. Areas of higher HIV have better nutrition (in both country groups), but this counter-intuitive association is removed controlling for environment and SES. In non-drought periods (in the Horn countries) underweight improves by 0.8 ppts/year. In low HIV areas in Eastern Africa nutrition deteriorates during drought, with underweight prevalences 5-12 percentage points (ppts) higher than in non-drought periods, with less difference in high HIV areas, in contrast to southern Africa where drought and HIV together were previously found to interact.
Conclusions: Despite severe intermittent droughts and the HIV/AIDS epidemic (now declining but still with very high prevalences), underlying trends in child underweight are improving when drought is absent: resilience may be better than feared. Preventing effects of drought and HIV could release potential for improvement, and supported by national nutrition programs – generally lacking but developing in places, e.g. Ethiopia – could accelerate rates of underweight reduction (now generally averaging 0.3 ppts/year or less) to those needed to meet MDG goals (0.4—0.9 ppts/year).
