RESEARCH REPORT Urban Livelihoods and Food and Nutrition Security in Greater Accra, Ghana Daniel Maxwell Carol Levin Margaret Armar-Klemesu Marie Ruel Saul Morris Clement Ahiadeke INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE in col labo ra tion with NOGUCHI ME MO RIAL IN STI TUTE FOR MEDI CAL RE SEARCH WORLD HEALTH OR GANI ZA TION IFPRI Board of Trustees 2000 Geoff Miller, Chair, Aus tra lia Re beca Grynspan Ma yufis, Vice Chair, Costa Rica Isher Judge Ahluwalia, India Baba Di oum, Sene gal Wenche Barth Eide, Nor way Arie Kuyvenhoven, Netherlands Susumu Matsuoka, Japan Solita Collas Mon sod, Phil ip pines Benno Ndulu, Tan za nia Sylvia Ostry, Canada G. Ed ward Schuh, U.S.A. Wen Simei, China Per Pinstrup- Andersen, Di rec tor Gen eral, Ex Of fi cio, Den mark he In ter na tional Food Pol icy Re search Institute is a mem ber of the Con sul - T ta tive Group on In ter na tional Ag ri cul tural Re search and re ceives sup port from the Asian Development Bank, Australia, Belgium, Brazil, Canada, CARE, China, Colombia, Denmark, the European Commission, the Food and Agriculture Organization of the United Nations, the Ford Foundation, France, the German Agency for Technical Cooperation, the German Federal Ministry for Economic Cooperation and Development, Honduras, India, the Inter-American Development Bank, the International Fund for Agricultural Development, Ireland, Italy, Japan, Malawi, Mexico, Mozambique, the Netherlands, the Neys-Van Hoogstraten Foundation, Norway, the Philippines, the Rockefeller Foundation, South Africa, Spain, Sweden, Switzerland, Tunisia, the United Kingdom, the United Nations Development Programme, the United Nations Sub-Committee on Nutrition, the United States, Venezuela, the World Bank, the World Resources Institute, and World Vision. IFPRI Research Reports Publications Review Committee 2000 Mark Rosegrant, Chair Howarth Bouis John Hoddinott Mylène Kherallah Nicholas Minot John Pender Emmanuel Skoufias Donald Lippincott (ex officio) David Gately, Secretary Recent IFPRI Research Reports 111 Ex plain ing Child Mal nu tri tion in De vel op ing Coun tries: A Cross- Country Analy sis, by Lisa C. Smith and Law rence Had dad, 2000 110 Link ages be tween Gov ern ment Spend ing, Growth, and Pov erty in Ru ral In dia, by Shenggen Fan, Peter Hazell, and Sukhadeo Thorat, 1999 109 Ag ri cul tural Re search and Pro duc tiv ity Growth in In dia , by Rob ert E. Even son, Carl E. Pray, and Mark W. Rosegrant, 1999 108 Gender Equality and Investments in Adolescents in the Rural Phil ip pines, by Howarth E. Bouis, Marilou Palabrica-Costello, Orville Solon, Daniel Westbrook, and Azucena B. Limbo, 1998 107 Ag ri cul tural Growth Link ages in Sub- Saharan Af rica, by Chris to pher L. Del gado, Jane Hop kins, Vale rie A. Kelly, with Pe ter Ha zell, Anna A. McKenna, Pe ter Gruhn, Beh jat Ho jjati, Jay ashree Sil, and Claude Cour - bois, 1998 106 Wheat Pro duc tion in Bang la desh: Tech no logi cal, Eco nomic, and Pol icy Is sues, by Mi chael L. Mor ris, Nuimud din Chowd hury, and Craig Meis - ner, 1997 105 Ground wa ter Mar kets in Paki stan: Par tici pa tion and Pro ductivity, by Ruth Meinzen- Dick, 1996 104 Role of Farm- Level Di ver si fi ca tion in the Adop tion of Mod ern Tech nol - ogy in Brazil, by Marc Ner love, Ste phen Vosti, and Wesley Basel, 1996 he In ter na tional Food Pol icy Re search In sti tute (IFPRI) was T es tab lished in 1975 to iden tify and ana lyze al ter na tive na - tional and in ter na tional strate gies and poli cies for meet ing food needs of the de vel op ing world on a sus tain able ba sis, with par ticu - lar em pha sis on low- income coun tries and on the poorer groups in those coun tries. While the re search ef fort is geared to the pre cise ob jec tive of con trib ut ing to the re duc tion of hun ger and mal nu tri - tion, the fac tors in volved are many and wide- ranging, re quir ing analy sis of un der ly ing pro cesses and ex tend ing be yond a nar rowly de fined food sec tor. The In sti tute’s re search pro gram re flects world - wide col labo ra tion with gov ern ments and pri vate and pub lic in sti - tu tions in ter ested in in creas ing food pro duc tion and im prov ing the eq uity of its dis tri bu tion. Re search re sults are dis semi nated to policy - makers, opin ion form ers, ad min is tra tors, pol icy ana lysts, re search - ers, and oth ers con cerned with na tional and in ter na tional food and ag ri cul tural pol icy. ll manu scripts sub mit ted for pub li ca tion as IFPRI Re search A Re ports un dergo ex ten sive ex ter nal and in ter nal re views. Prior to sub mis sion to the Pub li ca tions Re view Com mit tee, each manu script is cir cu lated in for mally among the author’s col leagues, pre sented in a for mal semi nar, and re viewed by an IFPRI re viewer. Fol low ing sub mis sion of the manu script to the Com mit tee, three ad di tional re view ers—at least two ex ter nal to IFPRI and one from the Com mit tee—are se lected to re view the manu script. Re view ers are cho sen for their fa mili ar ity with the coun try set ting. The Com - mit tee pro vides the author its re ac tion to the re view ers’ com ments. Af ter re vis ing as nec es sary, the author re sub mits the manu script to the Com mit tee with a writ ten re sponse to the re view ers’ and Com - mit tee’s com ments. The Com mit tee then makes its rec om men da - tions on pub li ca tion of the manu script to the Di rec tor Gen eral of IFPRI. With the Di rec tor Gen er al’s ap proval, the manu script be comes part of the IFPRI Re search Re port se ries, which be gan in 1977. IFPRI is a mem ber of the Con sul ta tive Group on In ter na tional Ag ri cul tural Re search (CGIAR) INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE 2033 K STREET, N.W., WASHINGTON, D.C. 20006-1002 U.S.A. PHONE: 1-202-862-5600 · FAX: 1-202- 467-4439 E-MAIL: [email protected] · WEB: www.ifpri.org DOWNLOAD/ORDER: www.cgiar.org/ifpri/pubs/pubs.htm#rreport Urban Livelihoods and Food and Nutrition Security in Greater Accra, Ghana Daniel Maxwell Carol Levin Margaret Armar-Klemesu Marie Ruel Saul Morris Clement Ahiadeke In ter na tional Food Pol icy Re search In sti tute Noguchi Me mo rial In sti tute for Medi cal Re search World Health Or gani za tion maxwell front 5/9/0 8:32 PM Page ii Copyright 2000 International Food Policy Research Institute All rights reserved. Sections of this report may be reproduced without the express permission of but with acknowledgment to the International Food Policy Research Institute. Library of Congress Cataloging-in-Publication Data Urban livelihoods and food and nutrition security in Greater Accra, Ghana / Daniel Maxwell . [et al.]. p. cm. — (Rearch report ; 112) “The International Food Policy Research Institute; In collaboration with the Noguchi Memorial Insti- tute for Medical Research and The World Health Organization.” “April 2000.” Includes bibliographical references. ISBN 0-89629-115-4 1. Nutrition surveys—Ghana. I. Maxwell, Daniel. II. Research report (International Food Policy Research Institute); 112. TX360.G4 U73 2000 363.8'09667—dc21 99-087101 maxwell front 5/9/0 8:32 PM Page iii Contents List of Tables iv List of Figures vii Foreword viii Acknowledgments ix Summary xi 1. Urban Poverty: A New Priority 1 2. Design and Methodology of the Study 12 3. Accra’s Households and Communities 17 4. Urban Livelihoods: Activities, Income, Shocks, and Coping 26 5. Household Spending, Consumption, and Food Security 52 6. Nutrition and Health of Women and Children 81 7. Caregiving Behaviors and Resources 91 8. Spatial Clustering of Outcomes 105 9. Multivariate Determinants of Food Security, Health, Care, and Nutritional Status 110 10. Urban Livelihood Security: Assets, Vulnerability, Trade-offs, and Coping 138 11. Conclusions and Policy Recommendations 146 Appendix: Indicators of Urban Vulnerability and Food and Nutrition Insecurity 153 References 156 iii maxwell front 5/9/0 8:32 PM Page iv Tables 1. Population and growth rates for greater Accra 4 2. Poverty levels in Ghana 5 3. Contents of questionnaire by module, respondent, and method 15 4. Descriptive characteristics of Accra households, by head of household 20 5. Sex ratios by age group, by head of household 20 6. Distribution of household characteristics by head of household 21 7. Characteristics of migrant households (by longevity in Accra) 23 8. Services and infrastructure by enumeration area grouping 24 9. Employment status, individuals over the age of 10 27 10. Labor classification categories 28 11. All reported jobs, by category and sex of worker 29 12. Labor classification of primary income-generating activity, by sex 29 13. Job category, by labor classification 31 14.