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Migration, HIV and food security.  A focus on Johannesburg through a livelihoods lens
 

Migration, HIV and food security . A focus on Johannesburg through a livelihoods lens

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  • TWO IMAGES
  • Shocks:  Sudden events which undermine livelihoods. These include retrenchment, the death of an economically active household member, as well as the impact of hazards such as drought, floods or other extreme weather events, which are often made worse by mismanagement of the environment.   Stresses:  Ongoing pressures which face households and individuals. These include long-term hunger and limited access to essential services such as health or water supplies. Another stress is the degrading of the natural resource base, something, which may force people to travel further for fuel and other natural resources.
  • The theoretical framework for this intervention drew on work done on urban livelihoods, Paulo Friere’s adult learning, social anthropology and the reflect methodology. Sustainable Livelihoods is a people-centred, participatory and responsive approach to development. SL based programmes starts from where individuals, households and communities currently are, in relation to their livelihoods, and builds from there. This ensures that people - and their current, existing strengths (assets) - are built upon. Stresses are chronic – they include hunger, the fear of violence, unemployment Shocks , are acute - such as shack fires, evictions, rape, theft. Assets – whether they are financial (grants or microfinance loans), physical (a house that does not leak), social (community groups), act as buffers - they enable an individual, household or community to cope with , and recover from , stresses and shocks A SL approach involves assisting individuals to obtain additional assets (strengths) and build these in order to access and obtain additional resources. By continuously building and developing this asset base, an individual is better able to cope with shocks and stresses encountered on a daily basis. ---------------------------- Need to be imaginitave, creative Multi-disciplinary Adult educations Participatroy rural appraisals Reflect Social anth Livelihoods Understand and draw to create a strong theoretical framework Adjusted from various literature etc S ustainable livelihoods (SL) is a people-centred, participatory and responsive approach to development. A sustainable livelihood is “ a livelihood that can cope with and recover from stresses and shocks and maintain or enhance its capabilities and assets both now and in the future…. ” (Carney, 1998)
  • The theoretical framework for this intervention drew on work done on urban livelihoods, Paulo Friere’s adult learning, social anthropology and the reflect methodology. Sustainable Livelihoods is a people-centred, participatory and responsive approach to development. SL based programmes starts from where individuals, households and communities currently are, in relation to their livelihoods, and builds from there. This ensures that people - and their current, existing strengths (assets) - are built upon. Stresses are chronic – they include hunger, the fear of violence, unemployment Shocks , are acute - such as shack fires, evictions, rape, theft. Assets – whether they are financial (grants or microfinance loans), physical (a house that does not leak), social (community groups), act as buffers - they enable an individual, household or community to cope with , and recover from , stresses and shocks A SL approach involves assisting individuals to obtain additional assets (strengths) and build these in order to access and obtain additional resources. By continuously building and developing this asset base, an individual is better able to cope with shocks and stresses encountered on a daily basis. ---------------------------- Need to be imaginitave, creative Multi-disciplinary Adult educations Participatroy rural appraisals Reflect Social anth Livelihoods Understand and draw to create a strong theoretical framework Adjusted from various literature etc S ustainable livelihoods (SL) is a people-centred, participatory and responsive approach to development. A sustainable livelihood is “ a livelihood that can cope with and recover from stresses and shocks and maintain or enhance its capabilities and assets both now and in the future…. ” (Carney, 1998)
  • Okay, now some thought on your arguments in the slides.  I am a little uneasy about the slide depicting sources of income.  What is important here is that you make the argument that although based on deriving an income in some way, urban livelihoods are diverse (in terms of income sources, income activities in both the informal and formal sectors, diverse family members involved in different activities, the “unpaid” role of child-care and food preparation, etc).  My worry is that this slide oversimplifies what these livelihoods look like.  Am I being to finickity?
  • 43% of informal resident households receive a grant 9% of formal households receive a grant
  • The theoretical framework for this intervention drew on work done on urban livelihoods, Paulo Friere’s adult learning, social anthropology and the reflect methodology. Sustainable Livelihoods is a people-centred, participatory and responsive approach to development. SL based programmes starts from where individuals, households and communities currently are, in relation to their livelihoods, and builds from there. This ensures that people - and their current, existing strengths (assets) - are built upon. Stresses are chronic – they include hunger, the fear of violence, unemployment Shocks , are acute - such as shack fires, evictions, rape, theft. Assets – whether they are financial (grants or microfinance loans), physical (a house that does not leak), social (community groups), act as buffers - they enable an individual, household or community to cope with , and recover from , stresses and shocks A SL approach involves assisting individuals to obtain additional assets (strengths) and build these in order to access and obtain additional resources. By continuously building and developing this asset base, an individual is better able to cope with shocks and stresses encountered on a daily basis. ---------------------------- Need to be imaginitave, creative Multi-disciplinary Adult educations Participatroy rural appraisals Reflect Social anth Livelihoods Understand and draw to create a strong theoretical framework Adjusted from various literature etc S ustainable livelihoods (SL) is a people-centred, participatory and responsive approach to development. A sustainable livelihood is “ a livelihood that can cope with and recover from stresses and shocks and maintain or enhance its capabilities and assets both now and in the future…. ” (Carney, 1998)
  • The theoretical framework for this intervention drew on work done on urban livelihoods, Paulo Friere’s adult learning, social anthropology and the reflect methodology. Sustainable Livelihoods is a people-centred, participatory and responsive approach to development. SL based programmes starts from where individuals, households and communities currently are, in relation to their livelihoods, and builds from there. This ensures that people - and their current, existing strengths (assets) - are built upon. Stresses are chronic – they include hunger, the fear of violence, unemployment Shocks , are acute - such as shack fires, evictions, rape, theft. Assets – whether they are financial (grants or microfinance loans), physical (a house that does not leak), social (community groups), act as buffers - they enable an individual, household or community to cope with , and recover from , stresses and shocks A SL approach involves assisting individuals to obtain additional assets (strengths) and build these in order to access and obtain additional resources. By continuously building and developing this asset base, an individual is better able to cope with shocks and stresses encountered on a daily basis. ---------------------------- Need to be imaginitave, creative Multi-disciplinary Adult educations Participatroy rural appraisals Reflect Social anth Livelihoods Understand and draw to create a strong theoretical framework Adjusted from various literature etc S ustainable livelihoods (SL) is a people-centred, participatory and responsive approach to development. A sustainable livelihood is “ a livelihood that can cope with and recover from stresses and shocks and maintain or enhance its capabilities and assets both now and in the future…. ” (Carney, 1998)
  • The theoretical framework for this intervention drew on work done on urban livelihoods, Paulo Friere’s adult learning, social anthropology and the reflect methodology. Sustainable Livelihoods is a people-centred, participatory and responsive approach to development. SL based programmes starts from where individuals, households and communities currently are, in relation to their livelihoods, and builds from there. This ensures that people - and their current, existing strengths (assets) - are built upon. Stresses are chronic – they include hunger, the fear of violence, unemployment Shocks , are acute - such as shack fires, evictions, rape, theft. Assets – whether they are financial (grants or microfinance loans), physical (a house that does not leak), social (community groups), act as buffers - they enable an individual, household or community to cope with , and recover from , stresses and shocks A SL approach involves assisting individuals to obtain additional assets (strengths) and build these in order to access and obtain additional resources. By continuously building and developing this asset base, an individual is better able to cope with shocks and stresses encountered on a daily basis. ---------------------------- Need to be imaginitave, creative Multi-disciplinary Adult educations Participatroy rural appraisals Reflect Social anth Livelihoods Understand and draw to create a strong theoretical framework Adjusted from various literature etc S ustainable livelihoods (SL) is a people-centred, participatory and responsive approach to development. A sustainable livelihood is “ a livelihood that can cope with and recover from stresses and shocks and maintain or enhance its capabilities and assets both now and in the future…. ” (Carney, 1998)
  •   And finally, although the DDS revealed a generally low diversity of diet, recent studies by WFP and the VAM show that in fact urban diets are generally more diverse that the rural “sending” areas.  I’ll source these studies for you.  Good to reflect on this and to mention that another study would bring in this dimension.
  • Another “missing slide” for the workshop (I know I am increasing the presentation) is on the policy engagement/ influence process that you have facilitated.  This is key for our stakeholders.  In this regard please make mention of the advisory group, your connections and engagement with the City, your plans for future dissemination (through WV and the possibility of extra funds from them for this).  I can’t express strongly enough that this argument is key; Renewal is committed to policy dialogue and trying to show how research might influence responses to HIV/FS.  I can help with this if necessary, possibly even bringing I into the earlier section

Migration, HIV and food security.  A focus on Johannesburg through a livelihoods lens Migration, HIV and food security . A focus on Johannesburg through a livelihoods lens Presentation Transcript

  • Theme 1: AIDS, Agriculture and Livelihood Security
  • Projects under Theme 1
    • Risks and Vulnerabilities to HIV and AIDS within the Plantation Systems of the Lake Victoria Basin (ongoing with AMREF);
    • Quantifying the Impact of HIV/AIDS on Government Agricultural Extension Service Delivery in Zambia and Malawi (ongoing);
    • Urban-Rural Linkages in Three African Cities (winding up);
    • Longitudinal Tracking in Kenya-Nairobi Urban Slums (winding up); and
    • Changing Livelihoods in the Face of AIDS (CLIVIA) (beginning with HEARD).
  • Urbanisation & Urban-Rural Links
    • Emphasis on “livelihoods” as opposed to “rural livelihoods”
    • Acknowledging changing systems and increased urbanisation (Durban, Mbekweni, Nairobi, Jo’burg, Windhoek, Addis Ababa)
    • Focusing on urban-rural linkages incl migration
    • Considers HIV and AIDS and food insecurity as key dimensions of these areas – eg. informal urban areas (SA)
  • PLANET OF SLUMS? 6% of urban pop in developed countries live in slums 78% of urban pop in the least developed countries live in slums The Challenge of Slums – UN-HABITAT Report ! Kibera , Nairobi Swilling, M. 2007
  • Recognising the complexity of African cities: the importance of diversity
    • UR Links study engages complexity :
      • Adopts an “ecohealth” approach
      • Focus on different types of migrants: Internal & external
      • Complex linkages; people, food, money, goods (reciprocity)
      • Diverse settlement types
    • Mixed methodology:
      • Quantitative surveys in Addis Ababa, Johannesburg & Windhoek
      • Qualitative research with different groups including children
      • Engaged decision makers throughout
  •  
  • Migration, HIV and food security A focus on Johannesburg through a livelihoods lens Jo Vearey and Lorena Nunez University of the Witwatersrand Forced Migration Studies Programme Health and Migration Initiative
  • African cities are characterised by rapid urbanisation – including high rates of in-migration : Internal (from within South Africa) Circular migration Cross-border
  • Urban informal settlements have double the HIV prevalence of urban formal areas.
  • African urban environments
    • High rates of migration ;
    • Increasing pressure on appropriate housing ;
    • High urban HIV prevalence rates – highest in urban informal areas;
    • Dependency on survivalist livelihoods located within the informal sector;
    • Increasing urban inequalities that impact ‘urban poor’ groups.
  • Objectives
      • To explore the linkages between HIV, migration and urban food security through a livelihoods lens.
      • To better understand differences in urban livelihood systems between:
        • Those residing informally and those residing formally ;
        • Internal and cross-border migrants.
  • Johannesburg study sites Workshop venue
  • Methodology
    • Cross-sectional household survey (2008)
      • Johannesburg: a complex urban context
      • Purposively selected areas across urban informal and formal
        • 3 inner-city suburbs
        • 1 informal settlement
    • Administered questionnaire;
    • Cluster-based random sampling.
    • 487 households:
      • 60% (n = 293): South African internal migrants
      • 31% (n = 150): Cross-border migrants
      • 9% (n = 44): Always resided in Johannesburg
  • ASSETS (strengths) Outcome Stressors Shocks financial physical human social hunger lack of access to food sickness: themselves and those back home
    • Urban migrants
      • Internal South African migrants
      • Cross-border migrants
      • Always lived in Johannesburg
    HIV pressure to remit FOOD SECURITY: (access to food, dietary diversity score & food shortage) SOCIAL PROTECTION FAMILY BACK HOME SOCIAL CAPITAL HOUSING INCOME REGULARHIV TESTING INFORMATION: HIV testing and ART EDUCATION HEALTH STATUS natural loss of income death of a family member Unreliable income
  • ASSETS (strengths) Outcome Stressors Shocks financial physical human social hunger Lack of access to food Sickness: themselves and those back home
    • Urban migrants
      • Internal South African migrants
      • Cross-border migrants
      • Always lived in Johannesburg
    HIV pressure to remit FOOD SECURITY HEALTH STATUS natural
  • Who are the migrants? n = 293 n = 150 n = 44 n = 487 Chi-square = 62.4; p = <0.001 ♀ ♂
  • 0 20 40 60 80 100 120 140 160 10 20 30 40 50 60 70 80 Age (yrs) Absolute frequency Distribution of age among the respondents N = 487
    • The average of respondents is 33 yrs old and half of them have less than 30 yrs old.
    • Female cross-border migrants are the youngest group (median, 25 years)
    • Men who have always lived in Johannesburg are the oldest (median 36 years).
    Who are the migrants?
  • ASSETS (strengths) Outcome Stressors Shocks financial physical human social hunger Lack of access to food Sickness: themselves and those back home
    • Urban migrants
      • Internal South African migrants
      • Cross-border migrants
      • Always lived in Johannesburg
    HIV pressure to remit FOOD SECURITY HEALTH STATUS natural
    • What are their assets?
      • Income
      • Social protection
      • Social capital
      • Housing
      • Regular HIV testing and knowledge of ART
  • Distribution of number of incomes in the household within each migration status group
  • Social protection Grants n = 83 n = 27
  • Housing Chi-square = 364.696; p = <0.0001 n = 479
  • Repeated HIV testing and knowledge of ART Chi-square = 18.420; p = <0.0001 n = 485 National HIV prevalence in urban informal settlements is double that of urban formal areas: 18% compared to 9% (HSRC, 2005)
  • ASSETS (strengths) Outcome Stressors Shocks financial physical human social hunger Lack of access to food Sickness: themselves and those back home
    • Urban migrants
      • Internal South African migrants
      • Cross-border migrants
      • Always lived in Johannesburg
    HIV pressure to remit FOOD SECURITY HEALTH STATUS natural
    • What stressors do urban migrants face?
      • An interlinked livelihood
        • Perception of risk of HIV
        • Pressure to remit
  • Perception of risk of HIV Chi-square = 14.221; p = 0.0002
  • Linkages and pressure to remit
  • An interlinked livelihood system Johannesburg Another place Provision of remittances Receiving remittances Stressors ASSETS (strengths)
  • ASSETS (strengths) Outcome Stressors Shocks financial physical human social hunger Lack of access to food Sickness: themselves and those back home
    • Urban migrants
      • Internal South African migrants
      • Cross-border migrants
      • Always lived in Johannesburg
    HIV pressure to remit FOOD SECURITY HEALTH STATUS natural
    • What are the shocks that urban migrants face?
      • Loss of income; death of a family member; arriving in Johannesburg
        • Poor food access
      • Specific sickness episode, HIV and Aids
  • Shocks causing food shortage Chi-square 52.788; p = <0.0001
  • Food shortage: respondents residing informally are more likely to have experienced a food shortage in the last 12 months
  • Sickness and HIV
    • Shocks
      • A specific sickness episode which may be related to HIV or Aids
      • This sickness can affect the respondent, a household member in the city, or a household member back home
  • Sickness and HIV: if the individual in the city becomes too sick to work, the majority will return back home Support 54% 67% Importance of food Burden on the household back home. Urban livelihood that supports another household ‘back home’ would be affected. 65% informal 48% formal
  • An interlinked livelihood system SICKNESS Johannesburg Family back home Provision of care, including food ASSETS (strengths) Stressor Shocks Remittances stop Stressor Shocks Sickness Another place
  • Sickness and HIV: if someone ‘back home’ becomes sick with HIV/AIDS Send money home Return home to provide care 33% 19% Nothing 34% Bring to JHB 14% 63% 11% 6% 21% Informal Formal n = 457 Chi-square = 40.796; p = <0.001
  • An interlinked livelihood system Johannesburg SICKNESS Another place Family in JHB ASSETS (strengths) Stresses Shocks Stresses Shocks Sickness Send money Travel home Bring them to the city Remittances
  • ASSETS (strengths) Outcome Stressors Shocks financial physical human social hunger Lack of access to food Sickness: themselves and those back home
    • Urban migrants
      • Internal South African migrants
      • Cross-border migrants
      • Always lived in Johannesburg
    HIV pressure to remit FOOD SECURITY HEALTH STATUS natural
    • Outcomes of the livelihoods system:
      • Health status
      • Urban food security (DDS)
  • Health status
  • Food access: respondents residing informally are more likely to report that their food access has worsened since moving to Johannesburg Chi-square 32.170; p = <0.0001
  • 24 hours Dietary Diversity Score: respondents residing informally are more likely to have a deficient dietary score Chi-square 89.880; p = <0.0001 Score 0 - 3 Score 4 - 6 Score 7 - 9 24 hour Dietary Diversity Score
  • 24 hour Dietary Diversity Score migration status Chi-square 19.252; p = 0.0007
  • Linkages to the National Strategic Plan
    • South African NSP (2007 – 2011)
      • Recognition of migrants (internal and cross-border, refugees, asylum seekers and undocumented);
      • Emphasis on informal settlements and recognition of highest HIV prevalence.
    • However:
      • Lack of guidance for how to implement action at the local level;
      • This research contributes to generating such a framework – through dialogue with policy makers and practitioners, including local government.
  • Policy engagement
    • Local - City of Johannesburg
      • Ongoing engagement through FMSP and MRC linkages
      • Forthcoming dissemination workshop
    • Regional - SADC
      • SADC Parliamentarian Meeting on migration
      • Regional guidelines on migration and HIV
    • Multi-disciplinary national technical advisory group
        • Medical Research Council
        • University of the Witwatersrand
        • Population Council
        • IFPRI - RENEWAL
      • Research planning, analysis, discussion, engagement, use of data
  • Policy recommendations
    • The importance of an interlinked livelihood system
      • Rural-urban linkages
      • The meaning of ‘home’
      • Rural development must engage with the urban, and urban development must engage with rural
  • Ongoing and future research
    • Ongoing research:
      • Student projects
      • Wits
      • MRC/Centre for Health Policy
    • Research needs:
      • Rural sending communities
      • The role of social networks within the livelihoods system
      • Intra-household dynamics
        • Migration decisions
        • Resource use
      • Intervention Research: process evaluations