N. Karanja, G. Prain, D. Cole, F. Yeudall, D S. Mbugua, M. Njenga, D Sellen and S. Kiarie CIP Annual Meeting October-November 2008 - PowerPoint PPT Presentation

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Addressing food and nutrition challenges facing HIV/AIDS affected households through horticulture and livestock production in Nakuru town, Kenya,. N. Karanja, G. Prain, D. Cole, F. Yeudall, D S. Mbugua, M. Njenga, D Sellen and S. Kiarie CIP Annual Meeting October-November 2008.

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N. Karanja, G. Prain, D. Cole, F. Yeudall, D S. Mbugua, M. Njenga, D Sellen and S. Kiarie CIP Annual Meeting October-November 2008

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Addressing food and nutrition challenges facing HIV/AIDS affected households through horticulture and livestock production in Nakuru town, Kenya,

N. Karanja, G. Prain, D. Cole, F. Yeudall, D S. Mbugua, M. Njenga, D Sellen and S. Kiarie

CIP Annual Meeting October-November 2008

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Why the project

  • Kenya’s AIDS epidemic stands at 5.1% among adults, with prevalence among women (8.7%) compared to men (4.6%) (UNAIDS, 2007).

  • People Living with HIV/AIDS (PLWHA) in resource- limited settings are often unable to follow optimal food and nutrition recommendations for antiretroviral therapy owing to lack of access to the foods required.’ Castleman, et. al. (2003)

  • Provision of food aid on its own to PLWHA is unlikely to have a marked impact on nutrition, morbidity, survival, food security and general quality of life.’ Swindale, A. (2004)

  • Effective strategies to increase food security and enhance livelihood form an important part of mitigating and treating HIV/AIDS.

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Nakuru, Kenya

  • fourth biggest town, historically railway, agriculture, national park, on trucking route

  • Estimated population 300000

  • 40.5% of its residents are affected by poverty (KHDR, 2006).

  • HIV/AIDS prevalence 5.3-7.0% update,1/4 adults (FHI, 2000).

  • 40% of households practise urban agriculture (Foeken, 2006)

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  • Determine role of crop and livestock production in livelihoods of HIV/AIDS affected urban households

  • Develop and evaluate strategies to improve livelihoods and food and nutrition security of HIV/AIDS affected through small livestock and horticultural production systems

  • Develop capacity of policy makers and other actors in food and nutrition security approaches in relation to HIV/AIDS affected communities

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Sustainable Environment and Health through Urban Agriculture(SEHTUA)

The innovative partnership was founded in 2006 and is comprised of:

  • International agricultural research organizations: CIP, ILRI

  • HIV/AIDS self-help groups

    • Badili Mawazo

    • ICROSS (International Community for the Relief of Starvation and Suffering)

  • NGO - Family Health International (FHI &Nuru ya Jamii group).

  • FBOs – PCEA (Presbyterian Church of East Africa), Catholic dioceses of Nakuru (CDN – Love and Hope Centre),

  • Municipal Council – health and environment departments

  • Ministries of Agriculture and Livestock , Health

  • Donors: CIDA&CIHR post-doctoral fellowships

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Diagnostic (Baseline)studies

  • 154 households (HH) with at least one PLWHA and one child aged 2 -5yrs

  • Structured interviews on livelihoods, food and nutrition securityand crises faced by HH (CARE, 2003 & DFID guidance sheets) & focus group adaptation)

  • Nutrition status through anthropometric assessment and dietary intakes

  • Food security through dietary diversity assessment

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ResultsCrises Experienced

  • HH commonly experienced:

    • severe food shortage (77%),

    • eviction (37%) due rent and stigma

    • hospitalization (34%),

    • job loss (26%), and/or

    • death of an adult (17%).

  • Female headed HH reported more crises (mean 2.83, 95% CI 2.52-3.13) compared to male headed HH (mean 2.10, 95% CI 1.80-2.40). Anderson et al. (2008) www.aids2008.org.

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Health and Land Access

  • Female headed HH also experienced:

    • more illness over the last month (67.1% versus 57.1%),

    • Less access to medical care (50% versus 40%) and

    • less access to land for farming (22.9% versus 44.7% ).

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Food Security Status

  • Almost all households were food insecure:

    • 73.4% severely

    • 24.0% moderately

    • 1.9% mild

  • Mean household dietary diversity score was 8.1 from a total of 15 food groups as follows :

    • Oils and fats 96.8%.

    • Vegetables 91.6%

    • Grains 95.5%

    • Roots and tubers 49.4%

    • Dairy products (62.3%),

    • Legumes and nuts (33.1%),

    • Animal source foods 56.8% (Fish, meats and eggs) Mbugua et al. (2008)www.aids2008.org.

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Vegetable Interventions

  • leadership/governance training

  • Land access for those from extremely poor-hire of 8 acres and donations from church and MoA

  • Training on traditional African vegetables (production, utilisation and marketing)

  • Starter seedlings and fertilizers and implements etc.

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Dairy Goat Interventions

  • Animal management training/skills development

  • Production of fodder (sweet potato vines, Napier grass).

  • Presentation of 40 dairy goats and four bucks to 40 hh

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Stories of Hope (i)

  • Jane a 40-year-old mother of six, once a second-hand clothes dealer.

  • Diagnosed as HIV-positive two years ago, she spent all her capital on treatment

  • She later joined Badili Mawazo(BM), ... six other women at Manyani, where she learned how to grow vegetables

  • “Besides taking antiretroviral drugs, the traditional vegetables make me stronger every day”

  • I do not buy vegetables since I started growing my own.

  • “I sell the surplus vegetables & the money I earn lets me meet my children’s needs and buy recommended food like eggs, white meat and wheat.”Average sales from BM US$ 15 and for home consumption worth US$10 per month

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Stories of Hope (ii)

  • Jackson*, father of two, worked as a guard and a small-time hawker in Nakuru town, but he was getting weaker and weaker.

  • “I had to stay out in the cold all night sometimes on an empty stomach,” he said. “A medic advised me to quit this strenuous job.”

  • As a founder of Badili Mawazo, he he learned to care for the dairy goats.

  • “It changed my social and economic life tremendously,”

  • He is happy with what he does and enjoys milking his dairy goat .

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Capacity building


  • Bachelors degree 4( Toronto, UON, Makerere Universities)

  • Masters degree 5 (Toronto&Egerton Universities)

  • Post doc 2 (University of Toronto)


  • group dynamics and governance, entrepreneur modules to HIV affected Community ,Government and other actors

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Monitoring and Evaluation

  • Continuous monitoring of the intervention activities on a weekly basis and at the weekly support group meeting.

  • Monthly data collection on farm activities ;days abscent due to illness, goat health/kidding and feeding, vegetable harvested (sold and consumed) and milk output by farmers.

  • Impact assessment on livelihoods and food and nutrition security( ongoing post-docs)

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Social& political

  • Participation in farm labour difficult due to illness among PLWHA & considerable distance of some farms

  • Moving from food handouts to food production due to dependence syndrome takes time

  • Political, election related troubles in early 2008 lead to interment of some participants


  • Water shortage for vegetable and sweetpotato fodder production affecting quality and quantities

  • High kid and goat mortality due to low quality of feed during the dry season.

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Next Steps

  • Close monitoring and evaluation should provide insights into pathways by which crop and livestock production can impact livelihood, food intake, and nutrition security status of HIV/AIDS affected HH.

  • Follow up whether availability of goat milk provides safe infant feeding options for mothers with HIV/AIDS, an animal source food for young children, and earnings from sale.

  • Evaluation of appropriateness of other micro livestock (indigenous poultry, rabbits, aquaculture)

  • Investigation on suitable multipurpose sweetpotato varieties, their management for fodder and conservation technologies for dry season feeding

  • Suitability of urban areas as sites for vine multiplication rural farmers

  • Crop-livestock interactions for sustainable soil health

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  • N. Andersen (2007) Assessment of Sustainable Livelihoods, Food Security and Illness in HIV/AIDS Affected Households in Nakuru, Kenya. M.A. Thesis. University of Toronto, Canada.

  • N. Andersen, S.Mbugua, D. Sellen, D. Cole, N. Karanja, F. Yeudall, G. Prain, M. Njenga (2008) Application of the Sustainable Livelihoods Framework to Assess Households in Nakuru, Kenya. Paper presented at the XVII International AIDS Conference, 3 – 8 Mexico City. Poster Abstract MOPE878. www.aids2008.org.

  • D. Cole, N. Andersen, M. Samuel, N. Karanja, F. Yeudall, M. Njenga, D. Sellen, G. Prain, Sustainable Environments and Health Through Urban Agriculture (SEHTUA) (2008) SEHTUA: Community based action research project to strengthen Livelihood and Food Security for Households Affected by HIV/AIDS Through Urban Agriculture. Paperpresented at the XVII International AIDS Conference, 3 – 8 August, Mexico City. Oral Abstract TUAD0403. www.aids2008.org.

  • S. Mbugua, N. Andersen, P. Tuitoek, F. Yeudall, D. Cole, D. Sellen, N. Karanja, G. Prain, SEHTUA Partners (2008) Assessment of Food Security and Nutrition Status Among Households Affected by HIV/AIDS in Nakuru Municipality, Kenya. Paper presented at the XVII International AIDS Conference, 3 – 8 August, Mexico City. Poster Abstract TUPE0665. www.aids2008.org.

  • Mbugua S., Andersen N., Karanja N., Yeudall F., Tuitoek P., Prain G., Cole D., Sellen D., Randolph T., Njenga M. (2007) Combating HIV/AIDS in Urban Communities through Food and Nutrition Security: The role of women led microlivestock enterprises and horticultural Production in Nakuru town.Paperpresented at From Research to Action: Mitigating the impact of HIV/AIDS on Agriculture and food security in West Africa. 1 -4 October, Cotonnou Benin. Oral presentation.

  • S. Mbugua, N. Karanja, M. Njenga (2008) Gardens of Hope for Victims of HIV/AIDS in Nakuru, Kenya.Story in the Urban Grown, The Newsletter of the Kansas City Centre for Urban Agriculture. October 2008. www.kccua.org/urbangrown/ug-10-08.htm

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  • Funded by CGIAR-CIDA linkage program

  • Commitment by Badili Mawazo group

  • Faith based organization in Nakuru (Presbyterian, Catholic Diocese of Nakuru)

  • Nakuru provincial general hospital

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