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Food and Nutrition Security in the Rural Plains of Nepal: Impact of the Global Food Price Crisis

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Food and Nutrition Security in the Rural Plains of Nepal: Impact of the Global Food Price Crisis Food and nutrition security in the rural plains of Nepal: Impact of the global food price crisis A thesis submitted for the degree of Doctor of Philosophy University College London Nasima Akhter Centre for International Health and Development UCL Institute of Child Health 30 Guildford Street London WC1N 1EH Declaration I, Nasima Akhter, Confirm that the work presented in this thesis is my own. Where information has been derived from other sources, I confirm that this has been indicated in the thesis. ------------------------------------------ Nasima Akhter August 2012 2 Dedication I dedicate my thesis to all brave women who want to stand tall and live a life of aspiration to fulfil their dreams, who encourage others to achieve more in life and help to make the world a better place. 3 Abstract Background: Poverty and food insecurity are often associated and may lead to malnutrition. All three remain high in Nepal and may have been aggravated by the 2008 food price crisis. Methods to measure changes in food and nutrition security and track the localised impact of changes in global food prices required further development so as to provide better guidance to policy makers. Aim: To describe and compare measures of poverty and food security in Dhanusha District, Nepal, derived from the Household Economy Approach (HEA) and Household Surveillance Data (HSD), and assess changes in food prices and the affordability of a nutritionally adequate diet among different wealth groups in before, during, and after the 2008 food price crisis. Methods: HEA baseline data collected in 2006 was used to describe livelihoods, food insecurity, and food prices in Dhanusha. Principal Component Analysis was used to generate asset indices from HEA and HSD data and examine their correlations. Additional surveys collected food prices in 2008 and 2009, and data on income levels in 2005 and 2008. Inflation in food prices was estimated using Dhanusha food and beverage index, calculated for 2005, 2008 and 2009 (Sep-Oct). Linear programming was used to estimate the minimum cost of a nutritionally adequate diet in 2005 and 2008 (Sep-Oct). Results: HEA and HSD asset indices were weakly associated. HEA data provided detailed descriptions of the livelihoods of the wealth groups, but underestimated food insecurity. Annual inflation in food prices was much higher (18.8%) in 2009 than average inflation between 2005 and 2008 (9.5%). The nutritionally adequate diet was unaffordable to poorer households in both 2005 and 2008. The situation did not deteriorate much due to increasing levels of household income that accompanied the rise in food prices. Conclusions: Application of the HEA method is demanding on skill and such skills may not be readily transferable. Poorer households are vulnerable to increased food insecurity and malnutrition due to continued increases in food prices after 2008. 4 Acknowledgements I would like to thank all the participants of this study, who spared their valuable time to participate in the interviews and answer questions for both the Household Economy Approach study and the prospective surveillance in Dhanusha. Without their generous support, it would have been impossible for me to conduct my research on this interesting topic. I sincerely acknowledge the support of my supervisors, Dr Andrew Seal and Dr Naomi Saville, who have both been very supportive, extremely flexible, and without whose support, it would not have been possible for me to carry on and see there is light at the end of the tunnel. My supervisors provided valuable insight to my research, guided me in the right direction, supported me at difficult times, and complemented each other in many respects. I am indebted to them for their enormous support. I would especially like to thank Professor Dharma S Manandhar, Mr Bhim Shrestha, Ms Sweta Choudhury, Ms Bimala Manandhar, the field team in Dhanusha, and many more from the Nepalese non-governmental organisation Mother and Infant Research Activities (MIRA) for giving me the opportunity to work with them, for collecting the data, and for helping me learn about the project activities in Dhanusha. I also thank the data management team at MIRA, and James Beard at the UCL Centre for International Health and Development (CIHD) for the processing and preparation of the surveillance database, which saved me a lot of time. I want to take this opportunity to thank Professor Anthony Costello for welcoming me to the department on the first day, and extending his support to facilitate my work in London and Nepal. My special thanks go to Dr Jolene Skordis-Worrall at the CIHD, who spared her valuable time to help me understand various economic terminologies and methods used in this thesis. I would like to thank my colleagues from Helen Keller International, Nancy Haselow, Chantell Witten, Rumana Akter, Sayeda Sajia Mehjabeen and others who supported me in many ways and kept my morale high in completing this huge task. I gratefully acknowledge the support of my friends Ana Blahue, Lina Ghandourah, and Jae Cheon Jung who helped me at different times in many ways, including taking care of my son when I was in Nepal. I am also thankful to my sister Taslima Akhter, who came to the UK and extended her support to enable me to complete the final phase of writing-up. I thank many other friends and family members who provided all-out support to my endeavour. Finally, I deeply acknowledge the contribution of my family members: my father and father-in-law, husband, and son for their encouragement and support to me, enabling me to start the PhD and complete it. My belated father encouraged me to achieve more and enabled me to take this courageous step. My father-in-law greatly supported my initiative in coming to London to study, but sadly, he passed away before I completed the task. My husband and son, provided unconditional support to me all through, encouraged me, comforted me, continued to believe in me, and made many personal sacrifices. I highly value and acknowledge their support. With all of your support, I have been able to carry on and reach the milestone I wanted to achieve. Thank you so much. 5 Table of contents DEDICATION .................................................................................................................................... 3 ABSTRACT .......................................................................................................................................... 4 ACKNOWLEDGEMENTS ................................................................................................................ 5 TABLE OF CONTENTS .................................................................................................................................... 6 TABLE OF FIGURES........................................................................................................................................ 10 LIST OF TABLES ............................................................................................................................................... 14 ABBREVIATIONS AND ACRONYMS ....................................................................................................... 16 CHAPTER 1. INTRODUCTION AND OBJECTIVES.............................................................17 1.1 INTRODUCTION................................................................................................................................ 17 1.2 AIM ........................................................................................................................................................... 21 1.2.1 Main hypothesis of the study................................................................................................ 22 1.2.2 Specific research questions of the study.................................................................................... 22 1.3 CONCEPTUAL FRAMEWORK OF THE RESEARCH............................................................ 23 1.4 SCOPE OF THE THESIS................................................................................................................... 23 1.5 ROLE OF THE INVESTIGATOR................................................................................................... 25 1.6 POTENTIAL CONTRIBUTION OF THIS RESEARCH.......................................................... 27 1.7 THESIS STRUCTURE ......................................................................................................................... 29 CHAPTER 2. BACKGROUND ...................................................................................................30 2.1 OVERVIEW OF NEPAL.................................................................................................................... 30 2.2 POLITICAL DEVELOPMENTS IN NEPAL ............................................................................... 32 2.3 POVERTY AND FOOD SECURITY IN NEPAL AND ITS REGIONS .............................. 33 2.4 NUTRITIONAL STATUS OF CHILDREN AND MOTHERS IN NEPAL AND ITS REGIONS ............................................................................................................................................................. 37 2.5 ECONOMIC CONCEPTS AND TERMINOLOGIES ............................................................... 40 2.5.1 Demand and its determinants .............................................................................................. 40 2.5.2 Elasticity of demand .........................................................................................................
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