By Richard Clarke, Consultant, Sahel and West Africa Club Secretariat
The rapid growth of cities in West Africa poses significant challenges across development dimensions. In particular, as the location of poverty spreads from rural to urban areas so have issues of food insecurity and malnutrition. Indeed, the potential impact of growing food insecurity in urban areas was highlighted by the widespread rioting over food prices in 2008.
The West African region is set to experience a further doubling of its urban population over the next 20 years, having grown from 6 million to 170 million between 1950 and 2015. This growth will place greater demands on regional food systems, which themselves are increasingly exposed to adverse global climatic and economic conditions, to provide cities with their nutritional needs.
So far, the development of food security indicators has not kept pace with these changes in population size and location, and the need to monitor food and nutrition insecurity in urban as well as rural areas.
Presently, the most commonly used measures of food security in West Africa are calculated by the Food and Agricultural Organization (FAO) of the United Nations. These measures rely on data from households to distribute a country’s food availability amongst groups. This provides national level estimates of the number of undernourished people compared to a given calorie threshold, without differentiation between urban and rural areas. These aggregate estimates are thus unable to accurately identify “hunger hot spots” where policy interventions, including food aid, are most required, and cannot distinguish nutritional trends between settlement types.[[i]].
That’s why the Sahel and West Africa Club Secretariat, working alongside Cornelia van Wesenbeeck from the Amsterdam Centre for World Food Studies, highlight exactly this need for more geographically precise data on food and nutritional security in a new working paper. The report summarises geo-referenced data to map the different calorific intakes of households in urban and rural areas, using data from anthropometric surveys in 17 West African countries. The findings are arresting.
Disaggregation is imperative
The analysis reveals significant differences in the prevalence and absolute numbers of the food insecure between rural and urban areas: 18% of rural adults and children in West Africa are classified as underweight, compared to 13% of the urban population. However, regardless of the location, it is the less wealthy households who are far more likely to be underweight than the richer. The poorest urban households are as likely as anyone living in rural areas to be severely or moderately underweight (1.3% and 2.3%, respectively, in cities compared to 1.3% and 2.5% on average in rural areas). The prevalence of severely stunted children is considerably higher in the poorest urban areas (14.6%) than in rural areas (9.8%). Chronic malnutrition is also shown to be a major issue amongst children, with 21% of urban and 35% of rural children on average suffering from severe or moderate stunting. Acute food security is less severe, but still prevalent throughout West Africa.
Prevalence of undernutrition in West Africa by country and location (BMI and weight for age)
The reverse picture can be seen for the overweight population: on average, 23% of the region’s adult city dwellers are overweight in comparison to 13% of the rural population. Similarly, it is the wealthier classes – who are overwhelmingly located in cities – and not the poorer, who are overweight. This highlights the nutritional-lifestyle transition occurring among affluent West Africans of decreased levels of physical activity and increased consumption of high calorie processed foods. The prevalence of overweight and obese children is very low, however, and is similar across urban and rural areas.
Prevalence of overweight and obese adults in West Africa
(As these figures illustrate, considerable cross-country variations exist, both in the prevalence and absolute numbers of the under- and over-nourished and in the differences between rural and urban areas.)
The research shows that, collectively, almost 110 million people live in West Africa who are not receiving the correct nutrition for their needs: 58 million people in the region are classified as underweight, while around 52 million are either overweight or obese. That 30% of the region’s population are either under- or over-nourished shows the severity of the challenge this “double burden” imposes on West Africa’s often already overstretched health systems. Furthermore, the coexistence of both insufficient and excessive calorie intakes suggests that undernourishment estimates might be biased. By relying on national average calorie intakes, they simultaneously underestimate both the number of underweight and overweight individuals in the region.
The methodology and indicators used to assess nutritional security in West Africa clearly need to be updated. But how exactly?
What needs to change?
Further research efforts need to focus on disaggregating national-level food and nutrition security indicators. Differentiations can be made between:
- rural settlements and urban agglomerations,
- the wealth of households, and
- the under-nourished and the over-nourished.
With more data, this analysis could go further in identifying the specific nutritional issues individual cities and rural areas are facing and how they are linked to local conditions. More territorial approaches and better territorial planning would help to more accurately identify the long-term nutrition trends affecting different household types and identify emerging nutritional issues in advance of their occurrence. This level of disaggregation now needs to be incorporated into nutritional monitoring mechanisms.
Strategies to combat nutritional issues in West Africa could then target specific household types in disaggregated locations. Interventions have traditionally focused on rural areas, and rightly so, given the higher prevalence of under-nourished adults and children in these regions. However, urban areas too, that now host large populations of both under- and over-nourished households, require greater attention, particularly given the double-burden this places on health infrastructures.