Impact of AIDS on rural livelihoods in Benue State, Nigeria Implications for policymakers KONINKLIJK INSTITUUT VOOR DE TROPEN ROYAL TROPICAL INSTITUTE April 2004 Impact of AIDS on rural livelihoods in Benue State, Nigeria Implications for policymakers Thea Hilhorst, Marti van Liere and Korrie de Koning (KIT), With inputs from Florence Abeda, Toyin Jolayemi and Stella Saror April 2004 Impact of AIDS in Benue State: implications for rural livelihoods, April 2004 The Study Team At the request of the Benue State Agricultural and Rural Development Authority (BNARDA) and the Department For International Development (DFID), Nigeria, this study on the impact of HIV/AIDS on rural livelihoods was carried out from July 2002 until June 2003. The research team consisted of both national and international researchers. The national principal investigators were: Toyin Jolayemi - The Policy Project, Abuja (now with World Bank - MAP) and Chief Stella Saror, the Cooperative Extension Centre, Federal University of Agriculture, Makurdi. The international researchers were: Thea Hilhorst, Marti van Liere and Korrie de Koning The Royal Tropical Institute (KIT), Amsterdam, the Netherlands. The team members were: Florence Abeda, Gregory Abi, Fanen Ade, Rebecca Afatyo, Anyalewa Ajonye, Paul Akpiri, Boniface Bartholomew, Faith Enny, Rosaline Gbadamosi, Lydia Igirigi, Joshua Kon, Lami Nnamonu, Chris Obochi, Andy Ogwuche, Wilson Okwo, Amina Ominyi, Patricia Suswam, Ignatius Tsa, Mbaban Tyokula, Steven Udu, Alice Uta, Agwaza Wundu, Agbe Yaga. Advisors to study design: Tony Barnett, Claire Moran, Georges Tiendrébeogo, Quantitative data management: Timothy Agbidye Management of field studies: John Ortese Resource persons: William Anyabe, Megh Raj, James Zasha Acknowledgements The authors gratefully acknowledge the input of the staff of BNARDA, notably Florence Abeda, as well as the financial support and input on content matters of DFID-Nigeria, in particular Adiya Ode and Claire Moran during the design and implementation of the study. We would also like to extend our thanks to Tony Barnett (UEA, UK) and Natasha Meshko (FAO) for advise and reviewing this work at various stages. We would like to thank Andrew Kidd, and Munirat Ogunlayi (DFID-Nigeria), Jay Gribble and Scott Moreland (Policy Project), Daphne Topouzis and Joanne White for comments on drafts of this report. 3 Impact of AIDS in Benue State: implications for rural livelihoods, April 2004 Contents Contents .....................................................................................................................................4 Glossary .....................................................................................................................................7 Executive Summary ...................................................................................................................8 1 Introduction .......................................................................................................................13 1.1 Why this study?..........................................................................................................13 1.2 Nigeria’s and Benue’s Response to rising HIV/AIDS prevalence..............................14 1.3 Outline of the Report..................................................................................................15 2 Study Design.....................................................................................................................16 2.1 Objectives ..................................................................................................................16 2.2 Livelihoods Framework..............................................................................................16 2.3 Determining methodology, research questions, indicators and variables .................17 2.3.1 Ethical Considerations........................................................................................18 2.3.2 Site Selection and Study Population ..................................................................18 2.3.3 Proxy Indicators of HIV/AIDS .............................................................................20 2.3.4 Data Collection Methods and Analysis...............................................................20 2.4 Wealth ranking methodology and indicators..............................................................22 2.5 Strengths and Limitations of this Study Methodology................................................23 3 Basic services and social structures in Benue State ........................................................26 3.1 Infrastructure and Basic Services in Benue...............................................................26 3.2 Social Organisation....................................................................................................28 3.2.1 Traditional social structures................................................................................28 3.2.2 Community-based organisation..........................................................................28 3.3 Financial services ......................................................................................................29 4 Livelihood activities and assets.........................................................................................31 4.1 Livelihood Activities....................................................................................................31 4.1.1 Overview primary and secondary occupations...................................................31 4.1.2 Farming...............................................................................................................32 4.1.3 Common pool resources ....................................................................................37 4.1.4 Non-farm activities..............................................................................................37 4.1.5 Mobility and Migration.........................................................................................38 4.2 Wealth ranking of the study population .....................................................................39 5 Epidemiology and Demography........................................................................................41 5.1 Different Stages of the Epidemic ...............................................................................41 5.2 Review of Epidemiological Surveys...........................................................................42 5.3 Analyses of Proxy Indicators for AIDS collected during the Domicile Listing............43 5.4 Chronic Illness and Mortality: Trends over time in household survey .......................44 5.5 Household Survey: The number of orphan events over time ....................................45 5.6 Are chronic Illness and Death Related to HIV/AIDS?................................................46 5.7 Demographic Impact..................................................................................................49 5.8 Concluding Remarks .................................................................................................50 6 Responding to Chronic Illness and Death and the Implications for Livelihood Strategies53 6.1 Being affected............................................................................................................53 6.2 Coping or surviving ....................................................................................................54 6.3 Direct Costs of Chronic Illness and Death.................................................................55 6.3.1 Loss of labour .....................................................................................................55 6.3.2 Time spent in mourning and funerals .................................................................56 6.3.3 Responding to labour constraints.......................................................................57 6.3.4 Expenses during illness and after death ............................................................58 6.4 Coping with extra expenditure ...................................................................................60 6.5 Diversity in coping based on ethnic or wealth differences.........................................62 6.5.1 Differences in coping strategies between Idoma and Tiv areas.........................62 6.5.2 Differences in coping according to wealth and gender ......................................63 6.6 Implications of morbidity and mortality for the asset base.........................................65 7 Local support systems ......................................................................................................67 7.1 Community Organised Support and Welfare.............................................................67 4 Impact of AIDS in Benue State: implications for rural livelihoods, April 2004 7.2 Support Systems for the Sick ....................................................................................67 8 Vulnerability of households to the effects of illness and death .........................................71 8.1 Vulnerability of livelihood strategies...........................................................................71 8.2 Orphans, Widows and the Elderly .............................................................................75 8.2.1 Tiv Widowhood ...................................................................................................75 8.2.2 Idoma Widowhood..............................................................................................76