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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- PowerPoint Presentation
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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- - 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-


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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

why the project
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.
nakuru kenya
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)
objectives
Objectives
  • 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
sustainable environment and health through urban agriculture sehtua
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
diagnostic baseline studies
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
results crises experienced
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.
health and land access
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% ).
food security status
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.
vegetable interventions
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.
dairy goat interventions
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
stories of hope i
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
stories of hope ii
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 .
capacity building
Capacity building

Academic

  • Bachelors degree 4( Toronto, UON, Makerere Universities)
  • Masters degree 5 (Toronto&Egerton Universities)
  • Post doc 2 (University of Toronto)

Technical

  • group dynamics and governance, entrepreneur modules to HIV affected Community ,Government and other actors
monitoring and evaluation
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)
challenges
Challenges

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

Technical

  • 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.
next steps
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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PUBLICATIONS

  • 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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Acknowledgements

  • 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