Food and Agriculture Organization of the United Nations. Food and nutrition security and livelihoods support in hyperendemic areas Fadzai Mukonoweshuro Food and Agriculture Organization of the United Nations. Mexico August 2008 Objective of presentation is to share some of the interventions that have been tried in hyper countries, discuss the strengths challenges, lessons learnt and recommendations for programmming

Context Southern Africa (Swa, Zim, Bots, Moz, Les, SA) Home to 60% of PLHIV Agriculture-dependant livelihoods Protracted food insecurity since 2002 Nutrition insecurity Because most hhs depend on rural livelihoods, the presentation will focus mainly on agric based livelihoods Evidence on the strengths of the interventions in hyperendemic countries, possibilities for scale and wider coverage has been drawn from a number of studies, among them, by RENEWAL, RHVP, Community perceptions on these interventions have been interogated and added to the evidence base

Interventions Food aid Community and HH gardens Nutrition education and communication Small livestock Food production (diversified) Collective Labour action Social protection - Cash transfers Life skills Nutrition counselling and care Extension, advisory services & input support HIV strategies for the agriculture sector

Strengths in HIV context Provide immediate support to avert starvation and malnutrition Improved household nutrition through dietary diversification Improved behavior and eating patterns Asset protection Generate income Provide safety nets Less labour intensive Increased knowledge and skills for OVC and youths Availability Access Utilization Achieved impacts lead to the food security pillars of access, utilization and availability. These impacts are beneficial for HIV affected households

Effectiveness and appropriateness of interventions Protect, prevent and promote livelihoods of targeted households Accessible, predictable, affordable, guaranteed and unconditional HOW Target food insecure and nutritionally at risk Integrated interventions e.g. water and sanitation and livelihoods Supported by Institutional frameworks Are gender sensitive Build on community responses Give example of study done in Zimbabwe on community perceptions

Challenges Food and nutrition insecurity is highly political and decisions on kind of interventions may be political Some targeting criteria increase stigma Lack of clear exit strategies Quantities distributed often inadequate Food aid and agricultural inputs dominate responses – little extension support Cash transfers only work in stable economies Designing implementation methods that will translate into a reduction in hunger in Southern Africa Water

Lessons learnt Understanding of the livelihoods of people and their needs is key Interventions to be based on specific contextual environment according to assets, opportunities and aspirations of target – water is key Quality of implementation is important for success Short emergency - little on no impact Partnerships between agriculture, health and social welfare crucial Strong policy framework required to support interventions Cost-effective solutions still a challenge Inheritance regarding productive assets – education critical Improving food and nutrition security: Providing support for food security, nutrition and livelihoods of affected households through improved input supply, improved sustainable agricultural practices and the transmission of local knowledge targeted to the food insecure and vulnerable. Providing training and education relevant to OVCs through Junior Farmer Field and Life Skills (JFFLS) to empower youth and provide agricultural knowledge and life skills such as caring for PLWHA and family nutrition including income generating activities; and Improving access to social welfare and health services, and Be gender sensitive as women bear the highest burden of infection while remaining poorly informed. This includes improving women’s access to and control over productive resources and access to education and awareness on HIV/AIDS related matters. Both are essential to our work of preventing the spread of the pandemic and alleviating its impact.

Recommendations Support and build on existing livelihood strategies Target attitudes and knowledge regarding food and nutrition security options Targeting – Better to target food insecure and nutritionally at risk rather than HIV affected Link emergency relief (food or emergency cash transfers) with development relief (including social protection) Create the right policies in agriculture to help farmers grow more food Document and apply lessons learnt in conducting multi-sectoral interventions – setting up of observatories Roll out the joint FAO/WHO training course for primary care-givers on the nutritional care and support of PLHIV Catch them young- Life skills projects to be expanded Point 1 – eg gardens and livestock projects Point 2 – This will be beneficial for nutrition outcomes Pointt 3- more impact if targeting is widened to larger population

Thank You Fadzai.mukonoweshuro@fao.org