Urban Africa’s Double Burden of Malnutrition and the Ameliorative Potential of Household Food Production
Research project
This project contributes to countering a large city research bias by focusing on the food, farming and health experiences of urban-based households in two secondary cities of Uganda: Mbale and Mbarara. We were interested in exploring whether a shift towards non-communicable diseases (diabetes, obesity, hypertension), and a growing double burden of malnutrition (simultaneous under- and over-nutrition problems) were apparent in these cities.
The project used multiple methods. Findings present evidence of an already present non-communicable disease experience and a city-level double burden malnutrition but without the food- and farm-system change that are commonly suggested as underlying such transition. The work shed light on the differing role of an urban agriculture at this city scale compared to that of many primary/larger cities. Another contribution was the mapping of relational interaction of urban-based people with rural land and rural people, supporting claims of multi-spatiality as an important component of urban African lives. Relations matter; geography matters. In conclusion, the research suggests caution with assumptions of how, and for whom, urban residence might influence diet change. Instead, in this Mbale/Mbarara context, food system, nutritional and epidemiological transitions may be less linked than previously thought, or linked in more complex ways.
This project contributes to countering a large city research bias in urban studies. The project explored whether ideas of food, farming and nutritional transitions purported to occur with urban life and theorised as contributing to a shift towards non-communicable disease were apparent within these cities.
The household survey allowed statistical and spatial analyses of the food, farming and health circumstances across the cities, and explored what might contribute to inequalities. To gain deeper understanding, we also conducted focus group discussions with local healthcare professionals, and in-depth biographic interviews. A feminist geographic perspective was applied to explore the links and intersections of food, farming and health environments with aspects of identity (such as gender, class, tribe), and with place.
The survey revealed the commonness of relatively low dietary diversity and high food insecurity. Food items consumed (staples such as maize, cooking bananas, potatoes or rice with beans), and food sources (central and neighbourhood markets and small shops) remained predominantly traditional, regardless of income. Those who were more food secure had strong relational and reciprocal interaction with rural farms and rural-based family. Most vulnerable to food insecurity and low diet diversity were those who were most dependent on purchasing all their food. Findings suggest there may be other drivers of epidemiological change in these cities.
The research uncovered a dominant patriarchal tendency towards highly classed and gendered assumptions of bodies and behaviours. Yet at the same time, we also exposed the on-going co-constructed nature of discourses, indicating how such can be contested or shaped to reduce inequalities. Geometries of advantage and disadvantage in diet diversity, food security, food access and livelihood circumstances were apparent. Analysis revealed that employment situation, together with active relations with rural land and rural people, were pivotal to urban food and livelihood circumstances.
Mackay, H. (under review). Farming or not farming? Factors influencing the agricultural involvement of households in and around secondary Ugandan Cities