1. food and drink

 UNIVERSITY OF WESTMINSTER School of Life Sciences 2012/2013 Research Project in Public Health Nutrition Community suggestions on how to reduce food insecurity in Ndagwe, Lwengo district, Uganda Author: Daniel Brancati Supervised by: Regina Keith This report is submitted in partial fulfillment of the requirements of the University of Westminster for the award of Master of Science in International Public Health Nutrition Study Title Community suggestions on how to reduce food insecurity in Ndagwe, Lwengo district, Uganda Author Daniel Brancati Supervisor Regina Keith 1. Acknowledgements The author would like to thank Mr. Ben Jerevazio Ssemwogerere for his help and support, as well as for his hospitality during the 3-­‐week data collection. The author also thanks Ms. Doreen Nankinda for her work as translator and assistance during the interview transcriptions. Additionally, the author also thanks Regina Keith for her supervision and the University of Westminster for co-­‐funding this project. 2 2. List of abbreviations AICD Africa Infrastructure Country Diagnostic CEC Commission of the European Communities FAO Food and Agriculture Organization of the United Nations FEWS Famine Early Warning System FGD Focus Group Discussion FIC Feinstein International Center HB Haemoglobin IFPRI International Food Policy Research Institute MAAIF&MH Ministry of Agriculture, Animal Industry and Fisheries & Ministry of Health, Uganda MFPED Ministry of Finance, Planning and Economic Development, Uganda MMM Medical Missionaries of Mary Health Centre NAADS National Agricultural Advisory Services NCD Non-­‐communicable diseases NGO Non Governmental Organisation PIS Participant information sheet SACCOS Savings and Credit Cooperative Societies TANGO Technical Assistance for Non Governmental Organisations UNEP United Nations Environmental Programme UNICEF United Nations Children’s Fund USAID United States Agency for International Development WFP World Food Programme WHO World Health Organization WIC Written informed consent WTO World Trade Organization 3 Table of contents 1. Acknowledgments p 2 2. List of abbreviations p 3 3. Summary p 8 4. Introduction p 9 4.1 Factors influencing food security p 9 4.1.1 Health p 9 4.1.2 Education p 10 4.1.3 Demographic growth p 11 4.1.4 Roads p 11 4.1.5 Climate change p 11 4.1.6 Economic systems p 11 4.2 Food security status in Uganda p 12 4.3 Coping strategies p 12 4.4 Nutritional status in Uganda p 12 4.5 The importance of nutrition for human development p 13 4.6 Ugandan food and agriculture policies p 14 4.7 Agriculture and food security p 14 4.8 Seasonal fluctuations p 15 4.9 Agriculture, food security and socio-­‐cultural factors p 15 4.9.1 Women’s role p 15 4.9.2 Smallholder farmers and food trade p 16 4.10 The study location p 17 4.11 Aim and objectives p 17 4 5. Methodology p 18 5.1 Methods p 18 p 19 5.2.1 Pilot interviews p 19 5.2.2 Subsistence farmer key informants p 19 5.2.3 Women only focus group discussion p 19 5.2.4 Teacher focus group discussion p 20 5.2.5 Literate key informants p 20 5.2 Sampling rationale 5.3 Data collection p 20 5.4 Data analysis p 21 5.5 Ethical statement p 22 5.6 Feedback to participants p 22 6. Study limitations p 22 7. Findings p 24 7.1 Theme 1: problem of low agricultural productivity p 24 7.2 Theme 2: problem of seasonal fluctuation in food availability p 26 7.3 Theme 3: problem of inadequate use of food in the household p 27 7.4 Theme 4: adaptation of community behaviour p 29 7.5 Theme 5: sustainable solution and future developments p 31 7.6 Interconnection of the five themes p 33 7.7 The problem tree p 34 p 36 p 36 p 36 8.3 Need of food purchases due to land shortages p 36 8. Discussion 8.1 Trading system implications 8.2 Poor investment strength in agriculture 5 8.4 Post-­‐harvest facilities to reduce seasonal fluctuations p 37 8.5 Stronger bargain power to enhance incomes p 37 8.6 Necessity of proper food utilisation p 37 8.7 Adaptations to food shortages p 38 8.8 Policy implications p 38 9. Conclusions and recommendations p 38 9.1 The importance of cooperatives p 38 9.2 Further possible interventions p 39 10. References p 41 p 46 p 48 p 49 p 51
p 53 p 54 11. Annexes Annex 1: Invitation letters from the partner NGO in Uganda Annex 2: Sample and interview features Annex 3: The Questionnaire, its changes and the simplified phrasings developed after the validation interviews Annex 4: Participant Information Sheet Annex 5: Written informed consent document Annex 6: Identified codes and related statements 6 List of Tables and Figures Table 1: Types of foods produced in the Ndagwe sub-­‐county Table 2: Applicable coping strategies in case of food shortages Table 3: Further possible coping strategies deriving from the open-­‐ended question p 16 Figure 1: The conceptual framework of the nutritional status determinants in the Ugandan context p 10 Figure 2: Price fluctuations in Mbarara p 11 p 30 p 31 Figure 3: Stunting trends in under five year-­‐old children in Uganda p 13 Figure 4: Rain and food availability seasonality calendar p 15 Figure 5: The Lwengo district in Uganda Figure 6: Problem of low agricultural productivity Figure 7: Problem of seasonal fluctuation in food availability Figure 8: Problem of inadequate use of food in the household Figure 9: Adaptation of community behaviour Figure 10: Sustainable solutions and future developments p 17 p 25 p 26 p 28 p 29 p 32 Figure 11: Interconnection of the five themes Figure 12: The problem tree 7 p 34 p 35 3. Summary Under-­‐nutrition is still a problem in many countries, with several negative consequences for human development. In Uganda, there is mainly a problem of chronic under-­‐nutrition with high (33%) stunting levels in under five year-­‐old children and one of its causes is food insecurity. This study aims to investigate the causes leading to food insecurity in Ndagwe, in the Lwengo district, Uganda, in order to develop sustainable solutions for reducing it. The availability, accessibility and utilisation of food, as well as the coping strategies in case of food shortages in the community are evaluated as part of this study. Possible agricultural related measures to reduce food insecurity are explored. In order to reach the study’s aims, qualitative research methods are applied in eight key informant interviews and two focus group discussions carried out with a variety of people ranging from subsistence farmers, women groups, teachers and non-­‐governmental organisation (NGO) personnel. Thematic analysis was applied for all interviews and five themes emerged: low agricultural productivity, seasonal fluctuation in food availability and inadequate use of food within the household. A fourth theme describes the impact of food shortages on community behaviour and an additional one indicates sustainable solutions and future developments for food security in the region. These findings indicate that the trading system disadvantages the subsistence farmers, whose bargaining power is weak. This leads to poverty and to poor investment possibilities in agriculture, such as irrigation and fertilisers. Processing and storage facilities are inappropriate, leading to fluctuations in food availability between the rainy and dry seasons, thus affecting food prices. Cooperatives are seen as the ideal solution as a combined effort is necessary both to gather the marketable quantities and to ensure the investment possibilities for the needed infrastructures and inputs. At the same time farmers’ bargaining power is strengthened and incomes would increase. All stakeholders should promote solutions such as the cooperatives, to empower the smallholder farmers in order to generate long lasting food security. 8 4. Introduction In the past twenty years under-­‐nutrition has slowly decreased globally, but the number of children under five years of age, that fail to reach normal linear growth is still high at an estimated at 165 million worldwide (Black et al., 2013). Under-­‐nutrition is associated with 45% of all children’s deaths, which leads to 3.1 million child deaths per year (Black et al., 2013). Tackling food security is key in reducing these figures. The understanding of food security has steadily developed in the past decades and led to an evolution of this concept. At first it was seen as a food supply problem, fostering availability of food through constant supply at global level (CEC, 1974). Afterwards the concept of accessibility came in by understanding the multifactorial aspects of food insecurity, focusing on the individual and household capacity to acquire sufficient food in terms of quality and quantity (Campbell, 1991). Today the common definition derives from the Rome Declaration signed at the 1996 World Food Summit, indicating: Food security occurs ‘when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their dietary needs and food preferences for an active and healthy life’ (FAO, 1996). The three pillars used to describe and understand food security are availability, accessibility and utilisation. Availability is achieved when ‘sufficient quantities of food of appropriate quality [are] supplied through domestic production or imports’ (FAO, 2006, p1). Food access exists when ‘individuals [have] adequate resources for acquiring appropriate foods for a nutritious diet’ (FAO, 2006, p1). Whereas the concept of utilisation links food to ‘adequate diet, clean water, sanitation and health care to reach a state of nutritional well-­‐being where all physiological needs are met, bring[ing] out the importance of non-­‐food inputs in food security’ (FAO, 2006, p1). Additionally, stability in terms of climatic or economic shocks, may also undermine food security, and is considered as its fourth dimension (FAO, 2006). 4.1 Factors influencing food security As described by the UNICEF conceptual framework (Figure 1), a number of factors can influence nutritional outcomes. It is important to understand the basic and underlying causes leading to food insecurity and malnutrition in order to tackle the problem at its roots. Factors such as health, education, infrastructures, climate change and trading systems, can impair food security. 4.1.1 Health In Uganda, Malaria greatly impacts health due to the relatively low (43%) use of insecticide treated nets (UNICEF, 2013). HIV/AIDS prevalence is at 7.2% (UNICEF, 2013) and the affected communities are more likely to experience food insecurity (Tsai et al., 2011). The most vulnerable are the under-­‐five year-­‐old 9 children with identified mortality causes being pneumonia (17%), malaria (13%), diarrhoea (10%) and HIV/AIDS (7%) (Countdown to 2015, 2012). Anaemia (HB<110 g/L) in women is high and can reach up to 63% in western Uganda (Mbule et al., 2013). The impact of disease is exacerbated by the on average high (50%) out-­‐of-­‐pocket health costs (Countdown to 2015, 2012).
Figure 1 The conceptual framework of nutritional status determinants in the Ugandan context Source: MAAIF&MH (2005); p7. 4.1.2 Education The achievement of higher education is also linked to food security as schooling directly and positively influences earnings in adulthood and improved parental education is strongly associated with better child nutritional outcomes (Ruel and 10 Alderman, 2013). Literacy levels in Uganda have increased in the past ten years from 65% to 69.2%, with gender inequalities still existing especially in secondary education (MFPED, 2010). This aspect is important due to the role that women play in household food security (FAO, 2011). 4.1.3 Demographic growth The high Ugandan population growth of 3% a year (UNICEF, 2013) may also be an influencing factor for food security, due to higher demand for food and resources, such as water and land. Agricultural productivity has been observed to sharply decrease if the population density surpasses 650 persons per km2 (Jayne and Muyanga, 2012), affecting food production. 4.1.4 Roads Infrastructures and roads in particular are important to connect areas. The distance and road quality from local markets have an important role in food security, influencing the possibility to sell the produced food to generate income (Yamano and Kijuma, 2010). In Uganda over 80% of the roads are all-­‐season, and usable also if it rains, but investments are still needed especially in the rural areas and for maintenance (AICD, 2011). 4.1.5 Climate change The amount of rainfalls is particularly influenced by climatic changes, with precipitations becoming more irregular and unpredictable (Hartter et al., 2012). Farmers have the necessity to adapt to changed conditions (Thompson et al., 2010), which would ideally imply irrigation in the East African reality (Bryan et al., 2013) in order to maintain agricultural production. Figure 2 Price fluctuations in Mbarara Source: FEWS (2013). 4.1.6 Economic systems Food prices have been fluctuating in the past years (Figure 2), which represents a problem due to the high (53.5%) percentage of income spent on food in 11 Uganda (WFP, 2009). Pisani (2007) argues that the neo-­‐liberal trading system negatively impacts food security, allowing competition between actors that have diverse production capacity and costs. This open market favours those countries and regions where production costs are lower and those that subsidise their exports (Pisani, 2007). Thus disrupting the importing country’s own food production and exposing it to the market’s price fluctuations (Pisani, 2007). In contrast, the World Trade Organisation (WTO) argues that the liberal trading system fosters prosperity and economic growth, through better governance, promoting cost cuts and lower prices (WTO, 2008). All the above-­‐mentioned factors can influence food security. The role that each factor plays is context specific, and needs to be understood in relation to the culture and customs in the region of interest. 4.2 Food security status in Uganda The World Food Programme (WFP) (2009) estimated the Ugandan population’s food security status, through indicators such as education, agricultural productivity, household assets (like livestock), anthropometric indices and market analyses. It estimated that the majority (72.4%) of Ugandans are food secure, whereas 6.3% do not have adequate access to nutritious food, and are therefore categorised as food insecure; 21.3% are borderline between these two categories, not having always adequate access to nutritious food, rather experiencing fluctuations in time (WFP, 2009). 4.3 Coping strategies When food shortages occur, a number of coping strategies can take place. These can be simply defined as ‘the things that people do when they cannot access enough food’ (TANGO/FIC, 2008, p1). Exploring the coping strategies simplifies the identification of food insecure groups or regions. Measuring food insecurity is a complex issue, but people experiencing food shortages are very aware of its effects. They will seek adaptation, which are those mechanisms leading to a behaviour change on how to cater and utilise food. Measuring these adaptations is an easy way to evaluate the food security status and its changes in time. 4.4 Nutritional status in Uganda An important instrument to evaluate the type of nutritional problem that occurs, are the anthropometric indices. One of them is stunting, which ‘reflects a process of failure to reach linear growth potential as a result of suboptimal health and/or nutritional conditions’ (WHO, 1997, p46). Stunting in under-­‐five year-­‐old children in Uganda, is high at 33% (UNICEF, 2013), but has decreased especially in the past decade (Figure 3), suggesting that policies and interventions have been having a positive impact. Wasting figures, which indicate acute and short-­‐term under-­‐nutrition are not alarming at 5% (UNICEF, 2013), whereas underweight is estimated at 14% (UNICEF, 2013). 12 The high stunting figures show that the problem in Uganda is mainly of chronic under-­‐nutrition. Figure 3 Stunting trends in under five year-­‐old children in Uganda 60% 50% 48% 46% 45% 40% 39% 33% 30% 20% 10% 0% 1988-­‐1989 1995 2000-­‐2001 2006 2011 Source: Countdown to 2015 (2012); UNICEF (2013). 4.5 The importance of nutrition for human development Child and maternal under-­‐nutrition have long-­‐term consequences that strongly impact human development (Victora et al., 2008). If under-­‐nutrition occurs in uterus and during the child’s first two years of life, stunting and growth failure occur with major implications for health during adulthood (Black et al., 2013). If children gain weight later in childhood, after having experienced restrictions during foetal life and infancy, as adults they will be at higher risk of contracting non-­‐communicable diseases (NCD), such as diabetes, hypertension and other cardiovascular diseases (Black et al., 2013). Such diseases are increasing worldwide (Black et al. 2013) and have also been reported in Uganda, where NCDs and obesity are linked to lifestyle changes (Baalwa et al., 2010; Peltzer and Pengpid, 2011). If girls are stunted, they will be more likely to have low-­‐weight (<2.5 kg) babies, who can be affected as adults by the above-­‐described NCDs (Black et al., 2013). The intergenerational effects of under-­‐nutrition span for at least three generations (Victora et al., 2008). Moreover, calcium and iron deficiency greatly impact maternal mortality, and particularly anaemic women will have low-­‐weight offspring (Black et al. 2013). There is ‘strong evidence that adequate nutrition in utero and in the first 2 years of life is essential for [the] formation of human capital’ (Victora et al., 2008, p352), and therefore children’s and women’s nutrition is a secure investment to enhance development. 13 Evidence suggests that nutritional interventions, carried out along with other approaches in the field of agriculture, women’s empowerment, schooling, social protection and food systems bring great ameliorations in child and maternal under-­‐nutrition (Bhutta et al. 2013). These interventions are defined as nutrition-­‐sensitive, combining nutritional approaches with other programmes that tackle under-­‐nutrition’s underlying causes (Ruel and Alderman, 2013). Therefore a multi-­‐sectorial approach in nutrition can be considered (IFPRI, 2011). 4.6 Ugandan food and agriculture policies The Ugandan government drafted multi-­‐approach policies, such as the Uganda Food and Nutrition Policy (MAAIF&MH, 2003) and the National Food and Nutrition Strategy (MAAIF&MH, 2005). These action plans cover aspects such as processing, storage, marketing, food trade and aid, sanitation, food standards, health, education, gender, nutrition and agriculture, as well as activities deemed to ameliorate them. The Ugandan government is trying to modernise and professionalise agriculture mainly through two initiatives. One is the Savings and Credit Cooperative Societies (SACCOS), which are member-­‐based institutions that provide micro-­‐
finance to its members, who are often semi-­‐illiterate subsistence farmers (Nuwagaba, 2012). The other one is the National Agricultural Advisory Services (NAADS), which has the aim to transfer agricultural knowledge and improved technologies, as well as to invite farmers to adopt profitable business management practices and helping in market access, in order to increase farmers’ incomes and livelihoods (Benin et al., 2011). 4.7 Agriculture and food security In Uganda, agriculture represents 29% of the gross domestic product (GDP), employing 62% of the population (WFP, 2009) and ‘almost 80% of the households participate in agricultural activities to some extent’ (WFP, 2009, p46). Smallholder farmers that on average own 1.7 acres (6.9 km2), produce about 96% of the food of Ugandan origin that is sold in the country (WFP, 2009). The high number of people involved in agriculture shows the important socio-­‐
economic role that it plays in food provision in Uganda. Important agricultural factors have to be considered in order to achieve food security. There is evidence of a relationship between food security and soil fertility. Yamano and Kijuma (2010) argue that the higher soil fertility, understood as the amount of soil organic matter, the higher the yields. Soil fertility is found to be an important factor in increasing farmers’ income in rural Uganda (Yamano and Kijuma, 2010). Another factor to consider is biodiversity, which represents the variety of living organisms and their interaction in an ecosystem (UNEP, 2010). Chappell and La Valle (2011) have reviewed the linkage between food insecurity and biodiversity loss and suggest that there is a strong association between the two. 14 The loss of soil fertility and biodiversity can be caused by high use of purchased petroleum-­‐derived pesticides and fertilisers, which prices are usually too high for poor subsistence farmers (Tomich et al. 2011). The United Nations indicates that more eco-­‐friendly practices, defined as agroecology, are the most suitable to achieve food security and ‘strongly contribute to the broader economic development’ (De Schutter, 2010, p1). However, there is yet a lack of evidence that agricultural programmes directly impact nutritional outcomes and further research is required (Ruel and Alderman, 2013), but ‘the need for investments to boost agricultural production, keep prices low, and increase incomes is undisputable’ (Ruel and Alderman, 2013, p1). 4.8 Seasonal fluctuations In Uganda, subsistence farmers plant when the rainy season starts and as a consequence of rain-­‐fed agriculture practices, there can be fluctuations in food available from their lands. This occurs twice a year as shown in Figure 4. Rainy and dry seasons can be more or less long depending on the rains, which became less predictable in recent years (Hartter et al., 2012). Figure 4 Rain and food availability seasonality calendar in Uganda 4.9 Agriculture, food security and socio-­‐cultural factors In most instances it is not the lack of food availability that leads to hunger, but other factors such as accessibility, cultural acceptability, environmental sustainability and information about food supplies and markets (Chappell and La Valle, 2011). Naranjo (2012) confirms that in Brazil poor farmers’ main problems can be identified in difficulties in access and control their land, in the ability and freedom to invest time and capitals into their own activities and sell their produce through accessible trade markets. This is likely to occur also in African realities, even if direct research is lacking. 4.9.1 Women’s role Women have a key role in providing household food security (FAO, 2011), but face many difficulties in accessing resources such as land, credit (Hart, 2012) and 15 in controlling incomes deriving from cash-­‐cropping (Fischer and Qaim, 2012). Moreover, women are overburdened with time consuming farming work, which has negative consequences for their health and impairs women’s participation in decision-­‐making activities in the community (Hyder et al., 2005), reducing them de facto to labourers with no or little voice on what they do. In contrast, when agricultural interventions focus on women, household nutritional improvements are more likely to occur (Ruel and Alderman, 2013). 4.9.2 Smallholder farmers and food trade Alinyo and Leahy (2012) confirm the link between food security and gender issues, but also indicate the skewed bargaining power existing between seller and buyer. In eastern Uganda, it is common practice for smallholder farmers to sell all their harvest at once at very low prices, and indebt themselves throughout the scarcity season to purchase the needed goods and services, including food (Alinyo and Leahy, 2012). With the next harvest, they will pay back their loans at high interest rates, leading to a vicious poverty cycle (Alinyo and Leahy, 2012). From an economic perspective, this process takes place due to the imperfection of food systems, where a rigid demand is met by a fluctuating offer (Pisani, 2007). People need to eat every day, but harvest occurs in specific periods of the year. This fluctuation underlines the importance of appropriate storage facilities and conservation practices to preserve food in time. Positive experiences have been done in building up cooperatives, that include several smallholder farmers in order to scale up their organisational capacity and consequently the ability to access markets (Barham and Chitemi, 2009; Kaganzi et al., 2009). Table 1 Types of foods produced in the Ndagwe sub-­‐county
Type of food Matooke Cowpeas Millet Maize Cassava Sweet potato Peanuts Beans Per capita food production (Kg) 148.2 2.8 15.9 42.7 55.3 16.8 3.2 2.6 Adapted from: MMM (2010), p38 16 4.10 The study location In the particular reality of the Ndagwe sub-­‐county, in the Lwengo district, Uganda, (Figure 5) most families farm at subsistence level using hoes and owning in average about 2 acres (8.1 km2), ranging from 0.2 to 100 acres (MMM, 2010). The population has in most cases (60%) just completed primary school and the main staple food in the area are the green bananas, from which matooke is cooked (Table 1) (MMM, 2010). The main water sources are open ponds and drinking water needs to be boiled (MMM, 2010). Almost two-­‐thirds of the population reported to have experienced food shortages at some point in the year, mainly due to droughts (MMM, 2010). Figure 5 The Lwengo district in Uganda 4.11 Aim and objectives Given the above-­‐mentioned multifaceted aspects of food security and the particular role that agriculture plays in the Ugandan setting, the present study aims to explore sustainable approaches to reduce food insecurity in Ndagwe sub-­‐
county, Lwengo district, Uganda. The project’s objectives are to evaluate food availability, accessibility and food utilisation, to explore the causes of food insecurity, investigate the community’s coping mechanisms in situations of food shortages and evaluate the feasibility, acceptability and usefulness of agricultural related measures that could reduce food insecurity. 17 5. Methodology The present study employs qualitative research tools, combining semi-­‐structured interviews and focus group discussions (FGD). Qualitative research is characterised by ‘seeking answers to questions about the what, how or why of a phenomenon’ (Green and Thorogood, 2004, p5), in contrast to quantitative research methods that answer the how much or how many question (Green and Thorogood, 2004). In qualitative research, data collection occurs rather through interviews or observations, utilising words as data, whereas quantitative research relies on measurements, considering numbers as data (Green and Thorogood, 2004). In the present context, quantitative data such as the stunting figures previously exposed, give essential information on the severity of chronic under-­‐nutrition, but in order to understand its causes, a more insightful approach is needed. Qualitative research offers the methods to gather data that picture the food security situation and cast light also on its underlying causes. Therefore, this methodology has been selected to investigate the study’s aim and objectives. This section aims to expose the employed methods and describe the undertakings that limited the probability of errors occurring, in order to secure the study’s validity. This is an important part of ensuring quality in qualitative research (Mays and Pope, 2000). 5.1 Methods For the purposes of answering the research questions, interviews were scheduled with eight key informants that included subsistence farmers and NGO personnel. Two FGDs were conducted with a teacher’s and a women’s group. The questions were piloted in two interviews and these were excluded from the final analysis. An open-­‐ended questionnaire has been tailored to the study’s purposes and was administered orally. The participants were asked to indicate applicable coping strategies in the community from a given list. Additionally, a participative tool (problem tree) describing several potential causes of food insecurity was used to identify problematic factors in the community. The study design has been tailored to combine the advantages of both individual interviews, that give personal in-­‐depth accounts and the group interviews, which allow interaction among participants on the particular issue that is being discussed (Green and Thorogood, 2004). The data collection took place in a 3-­‐week timeframe in May-­‐June 2013. The researcher is fluent in English and undertook this study as part of a MSc thesis, having previously volunteered in the same area. He was familiar with the research setting and led all interviews and FGDs. 18 5.2 Sampling rationale A purposeful sampling method has been applied, in which individuals are selected based on the their suitability to give the most significant information on the topic of interest (Patton, 2002). Within the purposeful sampling, the rationale for the participant selection was to have wide variation and include diverse individuals with different experiences and perspectives on the issue of food security. In the literature there is lack of evidence on the sample size that should be considered (Guest et al. 2006) and some argue that ‘there are no rules for sample size in qualitative inquiry’ (Patton, 2002, p244). The sample size depends on the purpose, on the time and resources available (Patton, 2002), which are all factors that were considered in this study. The investigation should continue until no more new information is generated, indicating that saturation is reached (Guest et al. 2006). The researcher collaborated with a local NGO running a primary school and the NGO director was the main contact person on the ground (invitation letters in Annex 1). The NGO is located in the Makondo parish, which is one of four parishes in the Ndagwe sub-­‐county. In order to select the appropriate participants, the researcher explained the questionnaire and indicated the sample needed for the interviews to the director, who knows the families in the surroundings personally. Annex 2 provides details regarding the selected sample and other aspects of the interviews. 5.2.1 Pilot interviews Two pilot interviews were carried out to verify the questions’ suitability. The selected interviewees were an agricultural and veterinary advisor and one local priest, both in direct contact with families in Ndagwe. The pilot interviews showed that the questionnaire fits the context, even though some simpler phrasings should be utilised. Additionally, further queries were added to the existing questions, which were deemed relevant by the piloting team. The questionnaire, its changes and the simplified phrasings are reported in Annex 3. 5.2.2 Subsistence farmer key informants Subsistence farmers are those directly affected by food shortages when occurring and therefore important informants about food security. In order to be selected, the farmers needed to have the intellectual ability to understand the questions and answer them in a well-­‐articulated way. They also needed to own and farm land. A mixture of men and women headed households was considered. 5.2.3 Women only FGD Women play a central role in household food security (FAO, 2011) and therefore seven women from different areas in Ndagwe were invited to take part in the FGD. They also had to fulfil the criteria set for the subsistence farmers key informants, but it was not relevant if they were from a woman or man headed household. On the planned day, eleven women showed up and all were allowed to participate. 19 5.2.4 Teacher FGD Seven teachers from the NGO partner primary school were invited to participate in the FGD. They work outside farming and bring an additional prospective on food security. Having a mixed gender group is also interesting and can reveal differences. Moreover the teachers know each other and this helps in creating a relaxed atmosphere. The NGO director was excluded to avoid any influencing. 5.2.5 Literate key informants In order to have also the perspective of professionals actively working to improve people’s living conditions, four literate key informants were selected from NGOs, development agencies and health centres operating in the area. Also in this case the selection aimed at containing professionals from different backgrounds. These informants are able to indicate a wide breadth of realities that they experience before hand. 5.3 Data collection Every interview was preceded by the study explanation through the participant information sheet (PIS) (Annex 4). A hard copy in English was left to each participant. Once everything was clear the written informed consent (WIC) document was signed (this was signed by all recruited participants before the interview). In the case of the subsistence farmers, even though they insisted to sign themselves, it was evident that they did not understand fully what was stated in the documents. Therefore two witnesses confirmed with their signature that the study has been translated and elucidated orally (example in Annex 5). This is common practice in diverse settings of interview-­‐based research (Angeles-­‐Llerenas et al., 2007). All interviews were recorded using a digital voice recorder. The questions were handled as a semi-­‐structured interview guide as described by Patton (2002, p343), further asking the “Whys”, if deemed relevant, depending on the first answer provided. This technique’s advantage is to make interviews with diverse people more comprehensive, allowing the use of different question phrasings (Patton, 2002) depending on the interviewee’s background. The researcher had the freedom to build up a conversation around a certain topic (Patton 2002), which led to the acquisition of important information. This interview methodology helped also during the FGDs (Patton, 2002). The question on coping strategies, had the particular feature to be asked as an open question in the first place, but also through a pre-­‐designed list afterwards (Table 2), which was used by the researcher to query about applicable coping strategies. This was added because the interviewees were able to give some examples through the open question, but did not to recall all eventual possibilities, and therefore asking through a list is helpful. The list derives from TANGO/FIC (2008) and was slightly adapted after the pilot interviews. Following the interview, the researcher also showed a problem tree (reported in Figure 12), where many different possible sources of food insecurity were summarised. This was done in order to investigate if other causes, beyond those asked through the questionnaire, relevantly undermine food security. Also in this 20 case the researcher asked one by one, if the causes reported are a problem or not in the present context. After going through the whole problem tree, it was further enquired which are the three most important causes that should be considered as a priority. The problem tree contains a mixture of direct and indirect causes of food insecurity and was designed in this way in order to facilitate the understanding of the diverse people interviewed. In the FGDs the procedure was similar. The only difference was that the participants were asked one by one to come into a separate room after the FGD ended, and the coping strategy list and the problem tree were shown to them individually. Not all interviews were held in English and translation was needed. A female graduate fluent in both English and Luganda, was chosen as a translator to ensure all female participants were at ease when discussing topics that could be gender sensitive. The translator is from the capital Kampala and did not know the study participants. The researcher’s role was deemed less influencing for the women, because he is a foreigner that is not part of the local culture and society. These considerations are part of the author’s reflexivity process that aims at increasing the study’s credibility as outlined by Mays and Pope (2000). In cross-­‐cultural qualitative studies, oral interview translations can by itself undermine research quality (Green and Thorogood, 2004, p98-­‐100). In order to minimise the inaccuracies, the translator was trained by the researcher for one day before the data collection started, examining the diverse aspects of food security as well as the questionnaire. Additionally, she participated in the pilot interviews held in English, and could observe the procedures and how the questions were asked. During the interviews in Luganda, the researcher first asked the questions in English, with the translator translating both question and incoming answer. After the interviews, incentives were given out to all participants, without them having expected it. In order to decide proportionate and useful incentives, the issue was carefully discussed with the NGO director. 5.4 Data analysis A thematic analysis has been applied, following the steps proposed by Braun and Clarke (2006). This method has been preferred to others due to its flexibility, capacity to identify key features in the dataset and because it adapts to the researcher’s relatively low experience, which are all considered advantages of thematic analysis (Braun and Clarke, 2006, p97). In comparison the grounded theory and the framework analysis rely on more complex procedures (Green and Thorogood, 2004, p203-­‐213) deemed less suitable for the present study. All key informant interviews were fully transcribed, whereas the FGD statements were summarised into common themes, due to transcribing difficulties with group interviews where several participants talk at the same time. Only the statements in English were transcribed. The translator assisted with the transcription process, indicating statements in Luganda that were not translated 21 during the interviews. These were added to the transcriptions and highlighted by rectangular brackets. In this way no statement was lost. After transcription, the recordings were played one more time to ensure their faultlessness. These procedures enhance the study’s credibility (Fade, 2003). All transcribed data were printed out and all statements were tagged with a specific code indicating the statements’ meaning. Following this, all statements with the same code were summarised under the same sheet. The code's weight resulted from it and codes being mentioned by more informants with higher number of statements indicated greater importance of the specific issue. In order to find overarching themes, the codes were written on paper slips and the researcher combined them in the analysis, with the aim to answer the study question. The codes that were mentioned by two or less informants were excluded. 5.5 Ethical statement The study was approved by the University of Westminster, UK, Ethics Committee. No participant was under the age of 18. Confidentiality has been ensured, recordings and data are safely stored and cannot be linked to any participant. All recruited participants have accepted to participate and no one has refused any question or recording or any other aspect of the study. The clear information reported in the PIS and WIC prove the present study’s ethical integrity as understood by Fade (2003). 5.6 Feedback to participants The literate participants will receive a copy of the final draft via postal correspondence or email. The farmers and teachers will be informed via the NGO director that will make sure that they are updated about the study results. This aspect of the study is explained in the PIS. 6. Study limitations The study has several limitations, which however do not impact in a significant way the overall results. There are some limitations in the sample selection, which should have been broader. Time and organisational constrains hindered the addition of further informants. In particular the subsistence farmers are all from the Makondo parish, which is only one of the four parishes in Ndagwe. This is due to the presence of bias in selecting people that were known by the NGO director and were mostly parents of children enrolled in the school. The teachers represent the reality in one school, which might be limited. Three out of four literate key informants were from outside the Ndagwe sub-­‐county, giving therefore indication rather on the whole Lwengo district, and not specifically on the sub-­‐county, even though the realities within Lwengo are unlikely to be significantly different one from another. 22 Informants that would have been interesting to add are the semi-­‐commercial farmers, who are those professionalising farming, as well as the middlemen traders. They have not been considered due to time constrains. The very poor households that were described as ‘starving’ by the NGO director, during the participant selection meetings were excluded. Individuals from these households were deemed not to have the intellectual ability to answer the questions. Due to the agricultural connotation of the questionnaire, the landless households were also excluded. Nevertheless these may face even greater challenge in food provision for their families. Translating interviews is itself a limitation and influences the data collection (Green and Thorogood, 2004, p98-­‐100), and in some instances the translator had to summarise long monologs. The bias was minimised, having the translator assisting during transcriptions, identifying non-­‐translated statements mentioned by the informants in Luganda language. These were added to the transcripts within rectangular brackets. The researcher’s role in such an environment relates inevitably to the perception of white Europeans in African rural areas, automatically categorising them as wealthy. Therefore even if the study was carefully explained, the subsistence farmers’ perception was that the researcher would somehow intervene to solve their problems. The positive aspect was that they were keen to tell their biggest concerns without hesitation. The literate informants were less influenced by the researcher’s foreign origins. These aspects indicate reflexivity on the author’s role, strengthening the study’s credibility as asserted by Mays and Pope (2000). The researcher increased his understanding on the issue and his ability to lead interviews as time passed, which might have influenced the first interviews. However, the pilot interviews were a helpful tool to enhance experience, allowing credible data collection throughout the study. Investigating the coping strategies through a given list has the limitation to exclude some other possible coping mechanisms. Therefore this was handled by asking which coping strategies exist with an open-­‐ended question first, before going through the list reported in Table 2. In the problem tree (Figure 12), malaria was omitted but should have been added. MMM (2010) indicates that 82% of all treatments are for malaria and it is likely to impact food security. Also the poor processing and storage facilities should have been split into two separated boxes in Figure 12. The main limitation in the data analysis derives from the fact that the researcher worked alone. The processes of coding and analysis were undertaken only once and only by one person. This is usually done by two or more researchers working independently and comparing their analyses afterwards (Green and Thorogood, 2004). Summarising the FGD statements into common themes may have led to merging some of them, with the consequence of underestimating the number of statements for a specific code as reported in Annex 6. The researcher tried to 23 avoid this as much as possible, even if sometimes issues were raised by several participants in animus discussions, making the transcribing process difficult. The reported results infer that saturation has been reached for some issues but not for others. Time constrains have not allowed to further investigate the non-­‐
saturated aspects. 7. Findings Several codes were identified through the coding process and are summarised in Annex 6. The analysis identified five overarching themes, of which three identify food security related issues, whereas the other two indicate consequent changes in community behaviours and possible solutions. The chosen quotes in this section are selected to assure authenticity as understood by Fade (2003), reporting the true interviewees’ perception to justify the study results. 7.1 Theme 1: problem of low agricultural productivity This theme (Figure 6) indicates that there is loss of soil fertility due to both poor practices and land overuse. The consequence is higher cost of agriculture, in order to have good yields, and this is particularly true for fertilisers, as a subsistence farmer informant confirmed: ‘The cow dung and the [synthesised] fertilizers are all expensive. This cow dung you have to buy it from the farms and then transporting it to this area. This is a lot of money. If I have the cow, I just collect the cow dung from my home and I put them into the garden, but I don’t have that animal’. Owning animals helps to implement crop-­‐livestock systems and would help reducing costs. Additionally, there is a lack of knowledge especially in some more sophisticated aspects, such as pest management and plant diseases that influence agricultural production, as pointed out by another informant: ‘There are going to be food shortages, just because… due to low production of beans, because beans were affected by pest diseases’. Loss of fertility can be connected to poor field practices and land overuse: ‘People plant always the same plants for many years on the same land, therefore fertility is lost. This is because of lack of knowledge in agricultural practices… because they don’t know’. But the land is also under pressure due to population growth, leading to land-­‐
shortages, as a female informant indicated: ‘The land is getting old, the increasing number of people in the household, and there are increasing number of people on the land. People are many with small portions of land’. 24 Figure 6 Problem of low agricultural productivity The rectangular boxes represent identified codes (see Annex 6) Relying on rainfalls and poor investment in irrigation plays a major role in low field productivity: ‘Normally the limiting factor during the dry seasons… [is] basically water. If plants here can get the water, the rest: the wind, the humidity and all that… remain more or less constant. So… relying on rainfalls is a big problem…’ One literate informant captured the reality and the links with poor investment capacity, poverty and low yields, as follows: ‘People tell us they don’t have seeds to plant when the rain starts… because they have consumed everything during the dry season… so you ask somebody how much have you planted? Nothing… why? I have land… it’s well prepared, but I have no seeds, I have no money… what can I do?... people don’t have seeds, some don’t have the farming implements… you find somebody has hoes or has one hoe… and it is very small… so… so he could get somebody to help… but what to use… the farming implements are not there… we use the hand-­‐hoes… yeah… imagine digging from here up to there with a hoe… very few families who can use tractor to prepare land… so our ways of farming it is still low… it is very hard to get 25 higher produce… yeah when you are using these hand-­‐hoes… and you know it needs spray [against pests]… you have to move around the whole village, and you end up giving up… you don’t have the whatever to spray on the maize… so such things are lacking’. 7.2 Theme 2: problem of seasonal fluctuation in food availability The problem of fluctuations in food availability (Figure 7) depends mainly on the lack of appropriate preservation facilities, in particular storage facilities, with its consequences elucidated by one informant: ‘They [the farmers] always sell the harvest at a very low price, because whenever the buyers come, they take advantage of the farmers because they don’t have anywhere to store the produce’. Figure 7 Problem of seasonal fluctuation in food availability The rectangular boxes represent identified codes (see Annex 6) 26 When farmers are poor, they are desperately in need of cash, as reported by an informant: ‘Now this is time for taking kids to school [and pay fees], somebody without money, you find that he will sell everything, not because he would have loved to, but needs money to run other things… also just to buy a soap or clothing…’ This has the consequence of poor selling conditions for the smallholder farmers, which is exacerbated by the sometimes, poor road quality, leading to high transport costs. Fluctuation in availability leads also to fluctuation in food prices, with higher prices in the scarcity period. Scarcity that also means less agricultural production and increased demand for purchasing food from shops, which is expensive. Consequently, a fluctuation in quantity and quality of consumed food can occur. Traders strongly influence price fluctuations due to speculation, as observed by some informants: ‘They will hold [the food] a bit and wait for like prices… because the people who do commercial farming realise that they do it extensively, and they are able to supply in the markets. But when it gets on the markets the prices kind of get low, and now this element of taking it outside to places like Juba comes in, and others will hold it a bit so that they can make some good profit.’ At the same time another informant pointed out: ‘The seller aims at maximising profits, not maximising sales. So the trader is aiming at selling at a high price, and not selling too much [at once].’ 7.3 Theme 3: problem of inadequate use of food in the household This issue (Figure 8) has the least strong evidence and some findings are contradictory, not allowing to give precise conclusions even if this aspect is of relevance. There is consensus that work overload leaves little time to women for food preparation, as one literate informant pointed out: ‘Some people have the food, but they don’t have the time to prepare the different varieties. Actually you can find the household having almost all the food types, but they prepare maybe matooke and beans, full stop.’ Portions are served according to age in terms of quantity, but it is not clear to what extent children and women are excluded from some foods, in particular meat. Also it is not clear if diets are appropriate or not. Probably there is variability among different households. In some households, when meat is available it is given out to all family members, whereas in others this seems not to be the case, as the two contrasting following statements indicate: 27 ‘In terms of the… the… different food types, protein, meat and all that, I think the fairness is there, they share… that kind of discrimination is no longer existing at home.’ In contrast: What happens is: ‘I [the father] have bought this half-­‐kilogram of meat, I want to eat it boiled, I want to eat it fried… it’s a half kilogram and you have twelve people in the whole home. So at the end of the day, you find these people [mother and children] just to eat soup. The mother has to put much soup so that children can enjoy soup, then the father eats the meat.’ Figure 8 Problem of inadequate use of food in the household The rectangular boxes represent identified codes (see Annex 6) The VS identifies two contradictory findings Investigating the appropriateness of food intake through qualitative interviews has been difficult also due to cultural perceptions, as a literate informant stated: ‘Here if someone takes a meal without matooke… he ends up saying: we didn’t eat! Things like rice, yams, cocoyams and all that, they are not considered food.’ 28 Additionally, considering the high (63%) anaemia figures (Mbule et al., 2013), a literate informant suggested the promotion of small animals: ‘Eating a cow at home… it’s not possible. So even if you have ten cows at home, you might go without beef. And when you sell them, it’s a big income, normally allocated for a big investment, in house, in motorcycle… it’s rare you find someone that has sold a cow to buy meat. So you find the households having those big animals… even goats, pigs are not very consumed. If the government or stakeholders, can promote what we call small animals for household use, poultry, rabbits, those animals that can easily be slaughtered at home. Because buying is really a complicated issue here…’ 7.4 Theme 4: adaptation of community behaviour The consequence of these problems for the community is to seek adaptation and change behaviour when food shortages occur (Figure 9). Figure 9 Adaptation of community behaviour The rectangular boxes represent identified codes (see Annex 6) The VS identifies two contradictory findings 29 The tendency is to rely on the food from the own land as much as possible and purchase only when strictly needed, due to high food prices, even though the food is always available in the shops: ‘They [the subsistence farmers] mostly eat from their land, the food they produce. They don’t purchase much food, except in… purchases are indication of serious normally crisis, when there isn’t any food in their land, that’s when they resort to buying…’ During the scarcity season people implement coping strategies (Table 2) to overcome this critical period, but it is not clear to what extent there are losses of property, such as animals or land, due to the lack of food. This contradictory finding suggests that there are different scenarios among diverse households. Table 2 Applicable coping strategies in case of food shortages Percentage of informants that identify the coping strategy as applicable Coping strategy Rely on less preferred and less expensive foods 100% Farmers: 100%; Teachers: 100%; Literate: 100% Borrow food from friend or relative 42% Farmers: 27%; Teachers: 57%; Literate: 75% 92% Purchase food on credit Farmers: 87%; Teachers: 100%; Literate: 100% Gather wild food or harvest immature crops Consume seed stock held for next season 85% Farmers: 80%; Teachers: 100%; Literate: 75% 96% Farmers: 93%; Teachers: 100%; Literate 100% Send children to eat with neighbours 23% Farmers: 1%; Teachers: 14%; Literate: 100% 4% Send household members to beg Farmers: 0%; Teachers: 0%; Literate: 25% 96% Limit portion size at mealtimes Peasants: 93%; Teachers: 100%; Literate: 100% Restrict consumption by adults in order for small children to eat 81% Farmers: 86%; Teachers: 86%; Literate: 50% 30 Percentage of informants that identify the coping strategy as applicable Coping strategy Feed working members of the household at the expense of non-­‐
working members 19% Farmers: 0%; Teachers: 43%; Literate: 50% Reduce number of meals eaten in a day 85% Farmers: 80%; Teachers: 86%; Literate: 100% 11% Skip entire days without eating Farmers: 13%; Teachers: 14%; Literate: 0% Drinking (porridge, tea or water) instead of eating 92% Farmers: 93%; Teachers: 86%; Literate: 100% List adapted from: TANGO/FIC (2008), p8 The most extreme coping strategies (Table 2) such as skipping entire days without food and not serve food to some household members are not very common. Similarly, those strategies that give sign of poverty, such as sending children to eat with neighbours or begging, are rare. Because people even if suffering, do not want to show their condition in the community. More commonly it is the amount and quality of food that decreases when shortages occur. Additional coping strategies that could occur are reported in Table 3. Table 3 Further possible coping strategies deriving from the open-­‐ended question Provide labour for food* Stealing from fields* Frequenting ceremonies (weddings, funerals, etc…) in order to get food* *The relevancy of these further coping strategies could not be assessed through the present study 7.5 Theme 5: sustainable solution and future developments This theme (Figure 10) shows that differentiation of family income is an important source of security, as one of the smallholder farmers reported: ‘I am a carpenter, when there are food shortages, I can go and buy some food, and even borrow, and tell them that when I sell the carpentry I can be able to pay back…’ The literate informants reported that policies have not helped the subsistence farmers as much as needed: 31 ‘The government has come up with many programmes, and one of them is the NAADS programme. But it appears like… it’s more for these wealth-­‐to-­‐do farmers. The modern farmers. It has not really impacted these subsistence farmers and the poor households…’ Figure 10 Sustainable solutions and future developments The rectangular boxes represent identified codes (see Annex 6) All subsistence farmers reported that food shortages will occur in the immediate future due to poor and irregular rainfalls. The region has great potential for agriculture, but in order to avoid further shortages, key investments in know-­‐how, irrigation and storage facilities are needed. These issues were reported by several informants: ‘Our production ideally is meant to be high.’ ‘But the challenge is on the techniques used on the farm.’ 32 ‘The crops are affected by pests during storage and are destroyed easily by rats and butterflies.’ Because: ‘Most of the families store their foods in their houses on the verandas.’ Cooperatives are seen as the ideal solution to help small subsistence farmers by all informants, because those lacking facilities cannot be owned by one farmer alone: ‘I think the cooperatives would be the ideal way to go. Because one: they will help the farmers to get some group loans, to help enhance the farming business and the second: they would also… ensure that they are able to look for market as a group. If they have that kind of produce stored in one place, and they know they have for instance a hundred tonnes of for instance beans, they would not be cheated by these middlemen. They are able to look for their own market and get their own profits…’ However, social difficulties in creating such organisations have to be addressed: ‘It is difficult because of ignorance. In our locality you find that some people want to do on their own. Other think, when we come together, that the other one will gain more than me… and today it works and tomorrow it collapses… there is that kind of lack of trust.’ And also: ‘In one statement I can say: cooperatives and these farmer organisations are good, but the biggest problem with them is corruption.’ 7.6 Interconnection of the five themes All the presented themes are interconnected one with another, as represented in Figure 11. When there are low yields, food cannot be enough throughout the year, leading to alternating food abundances and scarcities (Figure 4). This results in insufficient food in the household. Poor preserving facilities exacerbate fluctuations, which are aggravated by low field production, affecting again household food consumption. These three factors influence the community that will have to cope in case of food shortage. Solutions should consider all three dimensions in order to be sustainable. However, the present study is not able to provide direct suggestions to tackle improper food utilisation in the household, which is represented by a dashed line in Figure 11. 33 Figure 11 Interconnection of the five themes The dashed line indicates lack of evidence 7.7 The problem tree Most factors presented in the problem tree were seen as existing problems in the community (Figure 12). But priority should be given to agricultural knowledge, preservation facilities, price of agricultural inputs, as well as poverty and irregular rainfalls. Interestingly, low literacy levels are not seen as a major problem, even though evidence shows that these are strongly associated with improved nutritional outcomes (Ruel and Alderman, 2013). Probably the informants cannot identify the long-­‐term impact of schooling, and focus rather on immediate determinants of food insecurity. 34 35 8. Discussion Chronic under-­‐nutrition is still high in Uganda and the most important indicator is stunting in under-­‐five year-­‐old children. Reducing it has major impact on human capital (Victora et al., 2008) and consequently on development. Food security is necessary to achieve this goal and attention has to be paid to all context specific factors influencing it. 8.1 Trading system implications In Uganda a liberal trading system is in place. In order to ensure food security, there has to be constant excess in food availability to keep food prices low and grant accessibility. Traders who control the food buying and selling process need to have excesses in their stores in order to get rid of surpluses at low prices. This can only be achieved if productivity is high, if extensive storage and processing facilities are in place to preserve food in time and if there is greater competition among traders in the markets. At the same time household incomes need to increase to allow purchases when food from their own land is insufficient or not available. These issues confirm the need for relevant investments in this direction as indicated by Ruel and Alderman (2013). The liberal trading system for food commodities can itself negatively impact food security (Pisani, 2007), even though the issue is debated (WTO, 2008). Arguing against or for it, is not this study’s aim, but this reality has to be considered when problems and their possible solutions are under scrutiny. 8.2 Poor investment strength in agriculture The agronomic productivity is affected by the lack of knowledge especially in pest management and plant diseases. Additionally, poor soil practices led to fertility loss. Understanding these issues in detail would require a thorough agricultural field assessment, but it is evident that a major problem is the difficult access to inputs, such as seeds, fertilisers, spray pumps or even hoes. This inevitably leads to low yields. The major limiting factor in the dry season is water. If plants would be irrigated, much more could be harvested throughout the year, but there is very limited investment capacity for water collecting infrastructures. As soon as the rains are insufficient or divert from the usual pattern reported in Figure 4, there is lower produce and food shortages occur. Irrigation would increase yields and also reduce the seasonal fluctuation of food, because the dry seasons would become productive. The effect would be lower food prices. 8.3 Need of food purchases due to land shortages The problem of land shortages should not be underestimated and is likely to worsen in the coming years. This is directly linked to the Ugandan high demographic growth of 3% per year (UNICEF, 2013). As it is common in rural Africa, families are large and the children are many. In this context emphasis has to be put on accessing food from other sources as the own land, because this might not produce enough, which mainly means having sufficient income for 36 food purchases. This process is already under way in Ndagwe, with several households doing farming beside other income generating activities. Food supply chains are in place, because food can be purchased during the scarcity season and it is always available in the shops, but prices are heightened and cash is lacking. 8.4 Post-­‐harvest facilities to reduce seasonal fluctuations In order to reduce the fluctuation in availability, besides higher field production, also proper post-­‐harvest handling is required. In Ndagwe, most of the maize and rice are imported from outside the region, and matooke represents the main staple. There are no storage facilities for this easily perishable crop and once it ripens on the trees, it has to be consumed relatively quickly. Processing and storage facilities need therefore to be available and accessible. These facilities, along with higher yields, would have a major impact on food prices and would even out food availability in the year. Transport costs affect food prices to great extent and whenever there is need to move food from or to towns such as Masaka or Kampala where the preserving facilities are located, food prices increase significantly. This is both due to the impact of fuel costs and poor road conditions in some rural areas, resulting in drivers‘ overcharges because they fear for their vehicles. 8.5 Stronger bargaining power to enhance incomes Stronger bargaining power is necessary for the subsistence farmers in order to sell their surpluses at fair conditions and enhance incomes. The subsistence farmers produce what they eat and have very little money. When they need cash for other necessities, they sell whatever they have at very poor prices. This occurs usually during the harvest period when there is abundance for that specific crop. The buyer makes his price, knowing that the farmers are in desperate need of cash, resulting in the unfair deal. This process has been found to take place also in other parts of Uganda (Alinyo and Leahy, 2012). 8.6 Necessity of proper food utilisation It is not sufficient that food is present in the household to attain food security. It is also necessary that it is properly utilised within the home to ensure appropriate nutritional intake, which is the ultimate goal to reduce stunting. This aspect has been of difficult evaluation, but factors such as parental education, knowledge on the importance of food diversity and on children’s requirements may play a central role. If women have too much garden work, they will have little time to cook, which usually is done with firewood and takes long. It appears that in poorer households, there is higher chance that access to certain food types, such as meat, is denied to children or women. This tendency confirms the importance of education as highlighted by Ruel and Alderman (2013). 37 8.7 Adaptations to food shortages High prices in the shops imply that food is mainly consumed from the own land with purchases limited to a minimum. When food shortages occur, adaptation is sought through the coping strategies described in Table 2. These indicate that what basically happens is a drop in diversity and quantity of food consumed. When there is no food from their lands, people will purchase the most accessible from the shops, which is commonly maize flour, in order to prepare posho. It can therefore occur that families rely on this type of meal for several months, until the rain comes again and food can be newly harvested. 8.8 Policy implications The Ugandan government has followed the NAADS and SACCOS initiatives, but as found also by Alinyo and Leahy (2012), these appear to have had little impact for the subsistence farmers. Nevertheless they have helped to modernise agriculture to some extend and moved some farmers to semi-­‐commercial levels (Benin et al., 2011; Nuwagaba, 2012). But the smallholder farmers are the most vulnerable to food insecurity and therefore policies should specifically be drafted to include them. Cooperatives owned by the farmers themselves are the ideal solution to increase their bargaining power and consequently their incomes. Storage facilities, tractors and marketable quantities cannot be put together by one farmer alone, but there is need of a combined effort. The government should draw policies that favour these solutions. But even without specific state intervention, farmers should try to overcome social difficulties such as mistrust and corruption for the common good. It appears that the percentage of food secure population set at 72.4% by the WFP (2009) in Uganda, does not reflect the reality in Ndagwe, where 60.4% of the population has experienced food shortages at some point in the year (MMM, 2010). In practical terms, food secure at all times can be considered only those households that have enough income to purchase food in the scarcity season. Food security is therefore closely linked to income generation capacity. 9. Conclusions and recommendations The present study’s relevancy, as defined by Mays and Pope (2000), is given by the poor consideration that the arisen issues have in existing literature and interventions. The findings are also supported by Alinyo and Leahy (2012), who reported similar results. 9.1 The importance of cooperatives There is urgent need to favour solutions that focus on community empowerment. Initiatives should foster the establishment of farmer owned cooperatives both through government policies and NGOs’ sensitisation 38 campaigns. The social difficulties that hinder their formation should be addressed by extensive community support and farmers should come together in order to create trustful networks. Capacity building is needed, along with the willingness and motivation of the involved smallholders. However, the subsistence farmers are probably not able to initiate such organisations by themselves and would need external help, at least at the beginning. Government support has been crucial for farmer cooperative development in rural China (Deng et al., 2010) and this example should be followed. But the initiation role could be taken alternatively also by local or international NGOs. This study cannot furnish detailed recommendations on agricultural techniques, and further research is needed in this direction to understand which practices lead to low yields. But cooperatives would be helpful also due to their stronger investment possibilities in storage facilities and irrigation. The government should subsidise fertilisers and other agricultural inputs, which would incentivise higher yields. Within a structured organisation also knowledge transfers and sensitisation on proper food utilisation in the household would be logistically easier, and would help to achieve food security. However, further studies are needed to fully understand which crops are available at which point in the year and how these are utilised in the household. Separate food frequency questionnaires for both the abundance and the scarcity season could be helpful supporting tools for qualitative inquiry, to investigate this issue. 9.2 Further possible interventions In the present study, it is not clear to what extent women control income generated from food sales. Women from the FGD clearly stated that they have full control over income generated from sold food. But the strength of these findings is limited and contradictions have emerged, therefore this issue has not been presented in the findings. Nevertheless, the degree of women’s control over income may most probably shape proper food utilisation within the household. This is a very important aspect due to women’s role in household food security (FAO, 2011) and should be further investigated. If applied, nutritional interventions should be evidence-­‐based and follow Bhutta’s et al. (2013) recommendations. Promotion of universal schooling and implementation of nutritional education are important gender-­‐sensitive issues and should be included in programme proposals. If funds are available, cash-­‐
transfers to women could lift several families out of poverty as evidence from South America has been reported (Ruel and Alderman, 2013). Biofortification, which promotes the production of micronutrient-­‐rich crops, could also be considered. Moreover, encouraging the breeding of animals such as rabbits or chicken would provide cheap manure for the fields and at the same time allow access to valuable animal proteins. Promoting these small animals would have strong positive impact for both soil fertility and quality of dietary intake in the household, with long-­‐term impact on livelihoods. This solution is strengthened 39 by the evidence that iron deficiency anaemia has negative consequences on maternal mortality (Black et al. 2013). Nevertheless, before implementation, further research is required to ensure that it is culturally acceptable and feasible. Investments should also consider vocational trainings in out-­‐of-­‐farming activities. This seems vital and would bring security and diversity to household incomes. Such initiatives should be gender-­‐sensitive as well. The importance of activities outside farming will be even more relevant as the population grows and land shortages increase. Including the poorest strata of society in policies and interventions is very important. When the gap between rich and poor is wide, also poverty reduction strategies are less successful (Fosu, 2010). Therefore in order to build long-­‐
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45 Annex 1 - Invitation letters from the partner NGO in Uganda
46 47 Annex 2 Sample and interview features Gender Pilot interviews Ndagwe, sub-­‐county agricultural advisor M Priest from local parish M English Makondo parish 41 min Woman headed household (smallholder farmer) F Luganda Makondo parish 34 min Man headed household (smallholder farmer) M Luganda Makondo parish 39 min Man headed household (smallholder farmer) M Luganda Makondo parish 62 min Woman headed household (smallholder farmer) F Luganda Makondo parish 41 min Women only FGD (with 11 women) F Luganda Makondo parish 52 min Teachers Primary school teachers FGD (5 women, 2 men) M/F English Makondo parish 63 min NGO development officer NGO food security officer Lwengo district agricultural advisor Ndagwe sub-­‐county community health officer M English Masaka 40 min M English Masaka 52 min M English Lwengo town 48 min F English Makondo parish 44 min Subsistence farmer informants Type of key informant or group Literate key informants Conver-­‐
Interview sation location language Makondo English parish Cate-­‐
gory 48 Duration 41 min Annex 3
The Questionnaire, its changes (in bold) and the simplified phrasings developed after the pilot interviews Questions Simplified phrasings Q1 How do you judge the availability of
food?
• Are there seasonal differences
in availability?
Q2 Is there enough food in the markets,
shops, and in your area in general?
• Is there sometimes more,
sometimes less food, depending
on the season?
• The food you eat at home
comes from the owned land?
• Is food bought at the shops? Is it
expensive?
• Is it difficult to reach the shops
that sell food?
How do you judge the economic and
physical accessibility of food?
Q3 Do you think the food accessible is
a) Is part of the harvest sold?
• Do you sell it altogether at
harvest time? If yes, are you
happy of the price
conditions?
properly utilised?
a) In terms of income generating tool.
• Are farmers able to sell part
of their harvest? If they do,
do they sell it altogether at
dumped prices?
b) In terms of use within the
household.
• Is there dietary monotony in
the types of foods
consumed?
•
Is food fairly and
appropriately distributed
among the household
members?
• Do you think that people eat
many different foods or
always the same few?
Q4 Which are the coping-strategies used
in case of food shortages?
b)
What do people do when there is little
or not enough food at home? How do
habits change?
49 • Do people in the household
get fair and appropriate
amounts of food? Or do
some, for instance men, get
more and get the better
pieces, like meat?
Q5 Is the way of doing agriculture
appropriate to provide adequate food?
• Are the applied agriculture
practices sustainable in terms
of labour, time, cost, soil
fertility, land and water
management?
• Is the farmers’ knowledge
appropriate?
• Are there gender inequalities
in farming labour? Is it a
problem?
Are you happy on how agriculture is
done?
• Would you change something if
you could?
• Is the quality of the soil good?
• Do you buy fertilizers? Are they
expensive?
• Are the rains enough?
• Do you think that on-farm
advice in agriculture would be
helpful?
• Do you think women do much
more work on the farm as
men? Is this a problem?
• Do you think your farm will be
better or worse in the future?
Q6 Would the creation of cooperatives
among smallholder farmers help to
reduce food insecurity?
• Which are the difficulties in
creating cooperatives?
Do you think it could be a good idea to
create on organization of many
farmers that can work together and
sell their products together?
• Why is it difficult?
Q7 Does the condition and availability of
• Are the road conditions a
problem?
• Do you think storage facilities are
appropriate? Is this a problem?
• Do you think processing facilities
are sufficient?
infrastructures, such as roads or
processing and storage facilities or
others, influence the food security
status?
Q8 Anything else you would like to add?
Anything else you would like to add
that may influence being able to have
food at home?
50 Annex 4
Participant Information Sheet1
Title of the study:
Long-term solutions to reduce food insecurity: suggestions from the Lwengo
district, Uganda.
Responsible persons:
Regina Keith
Senior lecturer
University of Westminster
115 New Cavendish Street
W1W 6UW
London UK
[email protected]
Daniel Brancati
MSc candidate 2013
International Public Health Nutrition
University of Westminter
115 New Cavendish Street
W1W 6UW
London UK
[email protected]
Dear Participant,
This information sheet explains the features of the study on food security in
your region, to which you are asked to participate. This document has been
designed to ensure that you are informed about the study’s procedure and
objectives, as well as about your rights and duties as a participant, and
eventual risks and benefits that could occur from participating in the present
study.
The study aim
The aim of this study is to look at the security of food, by evaluating if there is
enough food in the surroundings of your community, if people can access it
and how they use food resources. This also has as objective to see what
people do and how they behave when there is lack of food (coping
mechanisms), and see if any agricultural related measure that could enhance
food security is perceived by the population as feasible, acceptable and
useful.
51 What is expected from the participant
You will be asked to participate in an interview and answer questions about
the study’s subject. You are expected to tell your opinion about the questions
asked on the topic, from your personal experience.
The interviews will be recorded on audiotapes and the researcher will take
notes.
No harm is expected to occur to you at any stage of the study.
Participant’s rights
You have the right to complain at any stage to the researcher, supervisor or
University of Westminster.
You have the right to withdraw at any stage of the study, to ask for withdrawal
of your data at any stage of the study.
You have the right to not answer any question and ask to skip to the next one
during the interviews, or to fully withdraw from the interview.
Data handling
All collected data will be kept anonymously and the data used will never be
traceable back to you.
During the data collection in Uganda, the documents and audiotapes will be
stored in the researcher’s accommodation, which will be locked in his
absence.
The collected data will be securely stored at the University of Westminster
locations and only authorised personnel will have access to it.
Feedback and intended use of data
The participants will receive feedback from the study once this has been
concluded. This will happen through postal correspondence.
The collected data will be only used for the purposes of the investigator’s MSc
research project and may be published. The data will not be used for any
other purpose.
1) This participant information sheet has been modified considering the University Hospitals, Cleveland Ohio, USA
templates: http://www.uhhospitals.org/clinical-research/institutional-review-board/forms-and-templates
52 Annex 5 - Example of signed written informed consent
document
53 Annex 6 - Identified codes and related statements
I = number key informants or groups mentioning the code (max = 10) S = number of statements associated to the code over the whole dataset F* = all subsistence farmer informants, L* = all literate informants Code Lack of knowledge in agriculture Seasonal fluctuation in food availability Poor storage facilities hinder to preserve food in time Disadvantageous selling conditions for farmers Good idea to create cooperatives Get food from own land whenever possible, purchases are limited Irregular and unpredictable rainfalls Expensive to purchase food Not enough food in the household Shops and markets are near Expensive access fertilisers and other agricultural inputs Seasonal fluctuation in food prices Social difficulties to create cooperatives Selling immediately after harvest due to other needs and nowhere to store Loss of soil fertility Poor road quality influences income generation Women do more work than men on the farm Problems with pest management Processing facilities are expensive to access Keep food for home consumption and sell surpluses Government allocation of resources do not impact the subsistence farmers Processing facilities are few in numbers and some are not available Food is always available at the shops Unhappiness about the way of doing agriculture Portion distribution of food according to age (in terms of quantity) Differentiation of family income gives security Monotonous and unbalanced diets (in terms of quality) Land shortages All get proportionally some meat Lack of good seed quality It is a problem that women do more work than men on the farm Men get disproportionally more meat High potential for agriculture, but key investment needed in agricultural knowledge, preserving facilities (storage, processing) and irrigation Seasonal fluctuation in dietary intake Seasonal fluctuation in food source (shop vs own land) Loss of property due to lack of food Good dietary diversity throughout the year Food shortages in the immediate future Not extreme to sell property, but people remain poor Poor planning of agricultural activity 54 I S 10 10 10 10 10 9 9 9 9 9 8 8 8 8 8 8 8 7 7 7 6 6 6 6 6 6 5 5 5 4 4 F* 4 L* 19 15 15 14 14 13 12 12 10 9 17 13 11 10 10 9 8 8 7 7 8 7 7 6 6 6 9 6 5 5 4 4 4 L* 4 4 4 4 4 3 F* 3 L* 3 4 4 4 4 3 3 3