|
Back to Index
Food
Security, Livelihoods & HIV/AIDS
Michael
O'Donnell, Save the Children UK
August 2004
Visit
the Save the Children UK website
Download this
report
- Acrobat
PDF version (381KB)
If you do not have the free Acrobat reader
on your computer, download it from the Adobe website by clicking
here.
Executive
Summary
This paper is intended both for managers and technical staff
working either in food security and livelihoods or in HIV/AIDS and
reproductive health who require an introduction to the linkages
between the two areas, and as a guide to the many issues that need
to be considered when carrying out assessments (or reviewing others'
assessments) and when planning interventions. The focus is specifically
on economic impacts of AIDS, and does not address important emotional,
psychological and social impacts.
HIV/AIDS/
Livelihoods Linkages
HIV/AIDS
affects food security and livelihoods in very different ways for
different households. The impacts will vary according to the assets
of the household, its demographic composition and the circumstances
in question, i.e. whether they are affected by the chronic illness
of a member, the recent death of a member, or whether they are supporting
orphans.
The mechanisms
by which households are affected is best understood using a sustainable
livelihoods framework, and considering impacts on each of the different
types of assets available to the household.
During chronic
illness the main effects are: loss of labour due to illness; loss
of labour due to increased caring; increased requirements for spending
on healthcare.
Death leads
to an immediate loss of labour, but can lead to other changes in
household composition that can positively or negatively affect labour
availability. There can be changes in livelihood patterns as remaining
members try to optimise their available assets. This can lead to
successful coping, or following a period of unsustainable response
(e.g. by selling productive assets) could ultimately result in the
dissolution of the household.
The economic
effects of taking in an orphan depend on the existing composition
of the household and then on the age, gender and skills of the incoming
orphan, which determines the net contribution of the orphan to the
household.
Measuring Impacts
To understand
the impacts of AIDS, we need to know what happens to a household
once it becomes affected, and the extent to which that is related
to HIV/AIDS or to other factors. Ideally there should be two sets
of comparisons, therefore:
- A comparison
of the situation of the household between when they were unaffected
and affected, i.e. the change following illness/ death/ addition
of orphans.
- A comparison
of affected households with unaffected but otherwise similar households,
to try to control for non AIDS-related factors. Studies must specify
the definition of "AIDS-affected" and distinguish between
chronic illness, death and the support of orphans, and must then
use proxy indicators that are relevant to that group and that
can be feasibly collected in the field.
A variety of
methodologies and tools are available for looking at the impacts
of AIDS, including qualitative studies, quantitative household surveys,
the Household Economy Approach and Individual Household HEA. The
relative strengths and weaknesses of each approach are indicated.
The decision on which approach(es) to take should also be guided
by:
- the specific
purpose of the assessment and the type of information that is
sought
- the level
of detail and precision that is required, and
- the use to
which that information will be put (e.g. is it simply to shed
light on a problem, or will it be used for designing interventions?)
Translating
Linkages into Programming Responses
A
proposal to undertake programmes to mitigate the impacts of HIV/AIDS
on livelihoods should first consider how it fits into a broader
programme of prevention care and treatment of HIV/AIDS, and second
whether there are equally pressing food security problems not directly
related to HIV/AIDS which also need to be addressed. Empirical evidence
to date shows that not all AIDS-affected households are food insecure,
and that many unaffected households are food insecure, and therefore
the blanket labelling of AIDS-affected households as a vulnerable
group in need of food security assistance is inappropriate. Targeting
of food aid or other emergency interventions is still best done
using socio-economic/ wealth criteria rather than demographic or
health criteria.
Other issues
to consider when planning food aid interventions in particular are:
- Ability to
identify the target group
- Potential
role of stigma
- Ensuring
participation of women and children in programmes
- Appropriate
siting of distribution points and manageable packaging of rations
- Designing
appropriate rations, in terms of nutritional context, palatability
and digestibility
Proposals for
food- or cash-for-work programmes should particularly assess the
implications for household labour availability and the profitability
of the work in contexts of high HIV prevalence. School feeding is
likely to be harder to justify as a response to HIV/AIDS, particularly
if it is not combined with other interventions. In particular, a
school meal is unlikely to counter-balance the increased demands
on children (particularly girls) to assist at home with caring and
with productive activities, while feeding specifically targeted
at orphans or otherwise-affected children could have a stigmatising
effect.
A wide variety
of potential interventions could be considered in relation to enhancing
livelihoods, and these are categorised according to whether they
primary address human, financial, social, physical or natural capital.
Strong emphasis on monitoring and evaluation and on documenting
experience is necessary to fill in current gaps in knowledge of
what "works" and what doesn't in different contexts. A
well thought out combination of interventions - particularly if
they build upon possible synergies between one another and with
interventions in other sectors relating to prevention, care and
treatment - will be most effective.
Please credit www.kubatana.net if you make use of material from this website.
This work is licensed under a Creative Commons License unless stated otherwise.
TOP
|
