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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-

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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  1. 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

  2. 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.

  3. 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)

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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% ).

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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 .

  14. 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

  15. 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)

  16. 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.

  17. 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

  18. 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

  19. 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

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