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Vearey drimie migurbfoodsec 27nov2012
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  • Not for circulation: please contact jo.vearey@wits.ac.za There are several ways of viewing food security: dietary diversity is one. Also access to food…. But I’m trying to keep it simple. I can ‘talk to it’ if needed (i.e. about other ways we measured food security).
  • Use of the map to emphasise that migration is a global reality and that southern Africa is mostly circular migration, most of which takes place within countries.
  • I suggest we state these up front. So that they’re clear from the start.

Vearey drimie migurbfoodsec 27nov2012 Vearey drimie migurbfoodsec 27nov2012 Presentation Transcript

  • Internal migration, informal settlements, food security and HIV:the role of developmental local government Jo Vearey, PhD and Scott Drimie, PhD Conference on Urbanisation, Migration and Food Security in Cities of the Global South, Cape Town, 27th November 2012 jo.vearey@wits.ac.za
  • Through a focus on the City of Johannesburg, to explore the linkages between urbanisation, migration, and health in South Africa.1. To present the complexity of the South African urban context (and to challenge common assumptions).2. To provide an overview of contemporary population movements in South(ern) Africa.3. To consider the role of developmental local government in responding to migration, urbanisation, informal settlements, food security and HIV.4. To provide suggestions for strengthened, localised responses to migration, urbanisation, food security and HIV in South Africa. © Monica Mabasa, 2010
  • "Johannesburg – a World Class African City of the Future – a vibrant, equitable African city, strengthened through its diversity; a city that provides real quality of life; a city thatprovides sustainability for all its citizens; a resilient and adaptive society." http://www.joburg.org.za/index.php?option=com_content&view=article&id=7343&catid=73&Itemid=114#ixzz2DPMsf9x5
  • 1.The complexity of the South African urbancontext: challenging assumptions • Urban health advantage v’s an urban penalty • The urban poor: a growing population • Interlinked deprivations • Inequalities and inequities in health • Quadruple burden of disease • Social determinants of health
  • 1. Inadequate and often unstable income;2. Inadequate, unstable or risky asset base;3. Poor-quality and often insecure, hazardous and overcrowded housing;4. Inadequate provision of ‘public’ infrastructure (as this increases the health burden);5. Inadequate provision of basic services, including health services;6. Limited or no safety net, such as access to grants*;7. Inadequate protection of poorer groups’ rights through the law; and8. Poorer groups’ voicelessness and powerlessness within political systems and bureaucratic structures.* It is important to recognise that the South African situation is different to many low-income country contexts. In South Africa, a social welfare system exists that includes: disability grants, child support grants, child foster care grants, care dependency grants and old-age
  • Urban inequalities Urban inequalities – differences between rich and poor groups/places - are a predictor of poor population health. Urban inequalities are experienced in multiple ways, including health outcomes.Migration Internal (from within a country) migration and external (cross-border) migration are features of urban growth and of the urban context. This includes those migrating in pursuit of economic opportunities as well as individuals fleeing persecution (asylum seekers and refugees). Many urban migrants remain connected to their household of origin through an interlinked livelihood system.Informal settlements Urban growth places pressure on limited appropriate and well-located housing and land tenure opportunities. This results in increases in the numbers of people residing informally in and on the edge of urban areas.Residents with “weak Urban poor groups may experience challenges in claiming their rights within the city. This can include the right to access basic services, housing, health services and employment. rights to the city” (Balbo & Marconi, 2005: 13)Urban HIV prevalence Whilst not all developing country urban contexts experience high urban HIV prevalence, this is particularly true in sub-Saharan Africa. In South Africa, urban HIV prevalence is found to be double that in rural areas, and highest within urban informal settlements. HIV provides a contextual challenge which requires much more than a sectoral health response.Fragile livelihoods The livelihoods of urban poor groups are determined by the context in which they are located, and the opportunities and constraints that this context provides. Survivalist livelihood strategies refer to individuals working within the informal economy during a time of crisis. A period of survival is when individuals are unable to plan far into the future, and instead spend their energy surviving day to day. (Vearey, 2008) Vearey et al., 2010
  • Urban inequality Urban inequities in health 0.76 0.75 0.75 0.74 0.74 0.74 0.73 0.72 0.72 0.72Gini coefficient 0.72 0.7 0.68 0.67 0.66 0.64 0.62 rg rg th n n an d wn ia ei do an bu bu e or b nt To ab on ur R et s itz fo ne iz e D Pr st L ar m ap El Ea an st oe m C Ea rt h er Bl Po Jo et Pi (Figure adapted from UN-HABITAT, 2008: 72)
  • A quadruple burden of disease The Lancet, 2009 HIV/AIDS Maternal, and newborn and TB child health Food security Non-communicable Violence and diseases injury
  • Urban informal settlements:overlapping vulnerabilities = inequities in health Food Fragile insecurity livelihood activities Access to Housing services density
  • DIEPSLOOT EXT. 1: 2000 - 200910
  • WHO Commission on the Social Determinants of Health (2008)
  • Thomas, 2011
  • In a context of high HIV prevalence, urban informal settlements have poor food security.Score 0 - 3 Score 4 - 6 Score 7 - 9 Chi-square 89.880; 24 hour Dietary Diversity Score p = <0.0001
  • 2. South(ern) Africa is associated withhistorical and contemporary populationmovements.  Internal > cross-border  Heterogeneity
  • Approximately 214 million cross-border migrants (around 3% of the world’s population) and 740 million internal migrants globally.“......migration is not a random individualchoice. People who migrate are highlyorganised and travel well-worn paths.” (Harcourt, 2007: 3)Therefore, responses to urban health must engage with migration as a key social dynamic. Source: HDRO staff estimates based on University of Sussex (2007) database
  • Migrants reflect health characteristics of place of origin ANDadditional influences that result from the process of migration Gushulak & McPherson, 2006
  • Migration is an ongoing process. Migrants do not report moving toSpaces of vulnerability access health care, ART or other services.Heterogenity: internal, cross-border, young, old, men, women, On arrival, migrants tend to befamilies, urban-rural, urban-urban. healthier than the host population.Migrants have been in the city for This “healthy migrant effect”differing lengths of time: long-term tends to fall away quickly.v’s recent v’s always Johannesburg. If they become too sick to work,The overwhelming majority of migrants will return back home tomigrants move in order to seek seek care and support (salmonimproved livelihood opportunities. effect). © Thembi, 2010
  • 44% of 28.1% of 4.4% of the Gauteng’s Western Cape’s South Africanpopulation were population were population were born in a born in a born outside of different different South Africa province province 2,199,871 people were born outside of South Africa Census 2011
  • Percentage of international migrants living in urban settlement by District Municipality
  • 7,4% of Gauteng’spopulation are non-citizens3.3% of Western Cape’s population are non-citizens 3.3% of theSouth Africanpopulation are non-citizensCensus 2011
  • Cross-border migrants as share of the population 1990 2010 2011 Namibia 7.9 6.3 Botswana 2.0 5.8 South Africa 3.3 3.7 3.3 Swaziland 8.3 3.4 Mozambique 0.9 1.9 Malawi 12.2 1.8 Zambia 3.5 1.8 DR Congo 2.0 0.7 Lesotho 0.5 0.3 Source: http://esa.un.org/migration/p2k0data.asp
  • 3. In South Africa, developmental localgovernment has a critical role to play in addressingthe health consequences of migration andurbanisation.
  • “local government committed to working with citizens and groups within the community to find sustainable ways to meet their social, economic and material needs and improve the quality of their lives” (RSA, 1998: 23)
  • Source: INCA CBF MRC DPLG Handbook
  • 4. Localised responses are required. Data Analysis Disaggregation: place, migrant categories, housing type
  •  Cities are complex spaces  Multi-level, intersectoral responses that engage with complexity are required  Context is key: who are the most deprived? Migration status? Housing type? Place in the city? Urban-rural linkages? Urban-urban linkages? Migration, urbanisation and urban health present interlinked development challenges to local government  The developmental mandate of local government is evolving slowly Improved data (and analysis) is needed for pro-poor policy and programming  Design and analysis: engage with complexity  Disaggregate at the local level: place, migration status, housing type
  • Internal migration, informal settlements, food security and HIV:the role of developmental local government Jo Vearey, PhD and Scott Drimie, PhD Conference on Urbanisation, Migration and Food Security in Cities of the Global South, Cape Town, 27th November 2012 jo.vearey@wits.ac.za