Leveraging Africa’s underutilized crops to combat climate change, water scarcity, and food insecurity in South Africa

Food insecurity in urban South Africa is situated in both historic and contemporary factors. This article argues that there is a need to reimagine and reconceptualise national, socio-ecclesial and theological responses to urban food insecurity in South Africa. We contend that the global and enduring nature of food insecurity is indicative of the violence of hunger and poverty and can be viewed as structural violence. While the church has since its inception been involved in feeding the hungry, the structural and systemic nature of food insecurity requires more nuanced theological responses and reflections. As a prophetic voice, the church and theological reflection and action are important partners in conversations, dialogue, measures and interventions geared towards the eradication of hunger and food insecurity in urban South Africa. A descriptive and evaluative method of enquiry was adopted in order to identify the historic structural and systemic factors that perpetuate food insecurity in South Africa. This article concludes that social inequality, economic disenfranchisement and poverty are as a result of structural inequalities that amount to structural violence inflicted on the most vulnerable of society.

Household Water Insecurity Is Positively Associated With Household Food Insecurity in Low- and Middle-Income Countries

Mental Distress and Resource Insecurity in the Kingdom of Tonga After the 2022 Volcanic Eruption: Associations of Water and Food Insecurity With Mental Distress.

The objective of the study was to assess the impact of land restitution policy on water, energy, and food insecurity in South Africa. The study utilised a cross-sectional survey of 1 184 households from Matatiele, Greater Taung and Magareng Local Municipalities. The Household Water Insecurity Experience, Multidimensional Energy Poverty Index and Household Food In-access Scale were used to analyse water, energy, and food insecurity, respectively, while Propensity Score Matching was used to assess the impact of benefiting from land restitution on insecurities in these resources. The results of the study indicate that beneficiaries of land restitution were relatively more water secure but were however somehow food secure and energy insecure. Furthermore, educational levels, tenure, employment status, household size, gender and main source of income were significant determinants of becoming a beneficiary of land restitution as well as the water, energy, and food insecurities. In addition, benefiting from land restitution increased water and energy insecurities by 15.0% and 24.2%, respectively, while reducing food insecurity by 10.1%. The study concludes that land restitution has improved the food security status of the beneficiaries while it has reduced their water and energy securities. The study recommends augmenting the indigent policy supplementing poor households with free water and energy to improve securities, especially for land restitution beneficiaries. Promotion of renewable energy such as solar, which can provide a nexus in energy for water supply can aid in improving localised water and energy securities for land restitution beneficiaries.

BackgroundWomen living in urban informal settlements may be particularly vulnerable to the detrimental effects of the COVID-19 pandemic because of increased economic and psychosocial stressors in resource-limited environments. ObjectivesThe objective of this study was to assess the associations between food and water insecurity during the pandemic and depression among women living in the urban informal settlements in Makassar, Indonesia. MethodsWe implemented surveys at 3 time points among women enrolled in the Revitalizing Informal Settlements and their Environments trial. Depression was measured using the Center for Epidemiologic Studies Depression Scale—10 (CESD-10) between November and December 2019 and again between February and March 2021. Food insecurity was measured using questions from the Innovation for Poverty Action’s Research for Effective COVID-19 Reponses survey and water insecurity was measured using the Household Water Insecurity Experiences Short Form. Both were measured between August and September 2020. We built 3 multivariate quantile linear regression models to assess the effects of water insecurity, food insecurity, and joint food and water insecurity during the COVID-19 pandemic on CESD-10 score. ResultsIn models with the full sample (n = 323), food insecurity (β: 1.48; 95% CI: 0.79, 2.17), water insecurity (β: 0.13; 95% CI: −0.01, 0.26), and joint food and water insecurity (β: 2.40; 95% CI: 1.43, 3.38) were positively associated with CESD-10 score. In subgroup analyses of respondents for whom we had prepandemic CESD-10 scores (n = 221), joint food and water insecurity (β: 1.96; 95% CI: 0.78, 3.15) maintained the strongest relationship with CESD-10 score. A limitation of this study is that inconsistency in respondents from households across the survey waves reduced the sample size used for this study. ConclusionsOur results find a larger association between depression and joint resource insecurity than with water or food insecurity alone, underlining the importance of addressing food and water insecurity together, particularly as they relate to women’s mental health and well-being.

Drinking water access and water and food insecurity have been linked to mental well-being, but few studies have comprehensively assessed potential pathways linking these associations. Understanding these mediation pathways is particularly important among pregnant women, as prenatal stress and poor mental well-being have been shown to negatively impact fetal development. In this study, we address this gap by analyzing the relationships between drinking water source and water and food insecurity with mental well-being amongst pregnant women living in low-income, urban neighborhoods of Beira, Mozambique. Data for this cross-sectional analysis were collected among third-trimester, pregnant women (n=740) from February 2021 through October 2022 as part of a matched cohort study. Validated, cross-cultural measures of mental well-being and household water and food insecurity were administered in the survey. Drinking water source was determined by presence of a household drinking water source on-premises. We used logistic regression to characterize the associations between drinking water source, water and food insecurity, and mental well-being and causal mediation analysis to determine mediation by food and water insecurity along these pathways. We found evidence that water insecurity (OR 1.44; 95%CI 1.02, 2.02) and food insecurity (OR 2.27; 95%CI 1.57, 3.34) were individually associated with adverse mental well-being. Drinking water source was not associated with mental well-being (OR 1.00; 95%CI 0.71, 1.39), water insecurity (OR 0.86; 95%CI 0.60, 1.24), or food insecurity (OR 1.02; 95%CI 0.71, 1.47). Food insecurity may also mediate the relationship between water insecurity and mental well-being (ACME 0.05; 95%CI 0.02, 0.07; ADE 0.04; 95%CI -0.04, 0.13). Our findings support growing literature that water and food insecurity are important to mental well-being, a key aspect of overall health. Further research is needed to confirm causality along these pathways and determine specific mechanisms through which these interactions take place.

Women in South Asia, like women across the world, face disproportionate water and food insecurity. Aspects such as access to education, income, gender roles, and land ownership are cross-cutting themes influencing women’s water and food insecurity. However, country- and region-specific issues, premised in diverse political, economic, cultural, and environmental conditions, also shape differential water and food insecurity for particular groups of women. Understanding the complex and multidimensional aspects of differential gendered water and food insecurity is a core concern for scholars and policymakers. In this chapter, I review the common aspects as well as country- and region-specific issues impacting women’s water and food insecurity in South Asia. A nuanced understanding of how diverse groups of women are impacted by food and water insecurity is important for developing nuanced and targeted interventions towards achieving SDGs 2 and 6.

Objectives: Household water insecurity, the inability to reliably access sufficient water for domestic use, has been negatively associated with food security and dietary diversity in settings where undernutrition is common, but these relationships are unknown in countries with a high prevalence of overweight and obesity. We therefore aimed to assess whether water and food insecurity are associated with diets that decrease noncommunicable disease (NCD) risk among adults in Mexico. Methods: We used data from a random subsample of adults (≥18 years) from the 2021 Mexican National Health and Nutrition Survey (ENSANUT) who reported dietary intake in the prior seven days using a semiquantitative food frequency questionnaire (n=1,009 men, 1,513 women). Consumed foods were assigned to at least one of 29 groups, which were used to generate dietary indicators according to WHO guidelines: NCD-Protect (consume healthy foods, range: 0-9) and NCD-Risk (avoid foods to limit, range: 0-9). Water insecurity was measured using the Household Water Insecurity Experiences Scale and food insecurity using the Latin American and Caribbean Food Security Scale. We developed multilevel models of each diet indicator that included urbanicity as a fixed effect, adjusted for confounders (region, socioeconomic status, household size, education, and ethnicity), and were stratified by gender. Results: Water and food insecurity scores were positively correlated (r=0.21, p< 0.001). Among men, moderate-to-high water insecurity was associated with 0.26 lower (95% CI: -0.52, -0.01) NCD-Protect scores relative to those with no-to-marginal water insecurity; there was no observed association with food insecurity. Among women, severe food insecurity was associated with 0.38 lower (95% CI: -0.64, -0.12) NCD-Protect scores relative to those with no food insecurity; there was no observed association with water insecurity. Across men and women, neither water nor food insecurity were associated with NCR-Risk scores. Conclusions: Gender may modify how household water and food insecurity are associated with diet healthfulness. Improving water and food insecurity has the potential to reduce the risk of malnutrition and NCDs. Funding Sources: NICHD, NIMH. Data are publicly available from the National Institute of Public Health, Mexico.

Testing the theoretical similarities between food and water insecurity: Buffering hypothesis and effects on mental wellbeing

BackgroundWater and food insecurity often co-occur, and have independently been identified as potential risk factors for poor mental health. Their interlinkages are only just beginning to be explored; even less is known about how the relationships vary by gender. Understanding the independent associations of water and food insecurity with mental health, as well as their joint effects, can help identify which interventions might be most appropriate for improving health. MethodsWe explored how probable depression covaried with water and food insecurity using nationally representative data from the Mexican National Health and Nutrition Survey 2021 (ENSANUT 2021, n = 13,126). Cross-sectional data were collected on household water, food insecurity, and probable depression amongst adults. We used multivariable logistic regression models to examine the association of water insecurity and food insecurity with moderate-to-severe probable depression, and we stratified the models by sex. ResultsHousehold water insecurity was associated with higher odds of probable depression amongst women (1.37 OR, CI: 1.13–1.66) and men (1.30 OR, CI: 0.92–1.83). When controlling for household food insecurity, the association between probable depression and water insecurity was no longer important, however, household food insecurity was associated with higher odds of probable depression. Those experiencing joint water and food insecurity had the highest odds of probable depression (2.70 OR, CI: 2.13–3.40). The associations between water insecurity, food insecurity and mental health did not differ by sex. ConclusionConcurrent water and food insecurity increase the likelihood of probable depression amongst both men and women. Strategies to mitigate both resource insecurities could improve mental health.

Anthropological thinking on water security and scarcity can be traced through four scholarly approaches: political ecology of water scarcity, water insecurity, water economics, and human-water relationality. Political ecologists argue that water scarcity a sociopolitical process and not necessarily related to physical water availability. The political ecological approach is concerned with power, global-local dynamics, and how water scarcity is unevenly distributed within and across communities. Water insecurity research is concerned with how injustice and inequity shape household and individual variability in water insecurity. Inspired by biocultural research, water insecurity scholars have used systematic methods to advance theories of how water insecurity impacts mental health, food insecurity, dehydration, and other human biological outcomes. Economic anthropologists explore how economic dynamics—including formal and capitalist economies, noncapitalist and hybridized economies, reciprocity, social reproduction, and theft—shape water scarcity and insecurity. Research priorities in economic anthropology include water valuation, meanings of water, and water as an economic good. Building from Indigenous scholars’ insights, relational approaches argue that humans have reciprocal obligations to respect and care for water as a living being. Water justice, these scholars argue, requires restoring human-water relations and upholding Indigenous sovereignty and self-determination. All four of these research areas—scarcity, insecurity, economics, and relationality—are producing cutting-edge research, with significant implications for research agendas in the anthropology of water security and scarcity.

PurposeHousehold food insecurity in South Africa is a pervasive public health challenge. Although its link to chronic health conditions is well established, its relationship to mental illness, particularly major depression, is not well-understood. Despite KwaZulu-Natal Province being the epicenter of the drug-resistant tuberculosis (MDR-TB) epidemic, and having the largest share of poverty in South Africa, this relationship remains unexamined. This study investigated the association between major depressive episode (MDE) and household food insecurity among individuals with MDR-TB.MethodsWe enrolled and interviewed 141 newly admitted microbiologically confirmed MDR-TB inpatients at a specialized TB hospital in KwaZulu-Natal Province, South Africa. Logistic regression models were fitted to assess the relationship between MDE and household food insecurity, while accounting for socio-demographic status (e.g., age, gender, education, marital status, social grant status, income, and preference for living in one’s community).ResultsThe prevalence of MDE and household food insecurity was 11.35% and 21.01%, respectively. MDE was significantly associated with household food insecurity (aOR 4.63, 95% CI 1.17–18.38). Individuals who are female (aOR 6.29, 95% CI 1.13–35.03), young (aOR 8.86, 95% CI 1.69–46.34), have low educational attainment (aOR 6.19, 95% CI 1.70–22.59) and receive social grants (aOR 7.60, 95% CI 2.36–24.48) were most at risk of household food insecurity.ConclusionsMDE in individuals with MDR-TB was significantly associated with household food insecurity, independent of socio-economic status. Although MDR-TB is not exclusively a disease of the poor, individuals from socio-economically disadvantaged backgrounds (e.g., female, young adults, low education, and social grant recipients) were more likely to experience household food insecurity. Our study underscores the need to address the co-occurring cycles of food insecurity and untreated MDE in South Africa.

Food and water security are essential components for Panama’s advancement toward the Sustainable Development Goals. This study aimed to quantify the prevalence of household food insecurity and water insecurity, and to explore the association between them using standardized measurement tools. A cross-sectional survey was conducted between January and June 2024 using an online questionnaire administered via Google Forms. The survey collected sociodemographic data and applied the Food Insecurity Experience Scale (FIES) and the Household Water Insecurity Experiences (HWISE) scale to assess water and food insecurity, respectively. A total of 222 adult household heads were included (66.2% female), with a median age of 31.4 years. The prevalence of moderate and severe food insecurity was 29.7% (95% CI: 24.8–34.6%) and 6.1% severe food insecurity (95% CI: 3.7–8.4%), while water insecurity affected 27% of households (10.4% high; 16.7% moderate). Multiple linear regression showed that moderate to severe food insecurity was significantly associated with water insecurity (β = 0.19; 95% CI: 0.08–0.31) and lower income levels. Specifically, food insecurity was associated with households reporting no income (β = 0.25; 95% CI: 0.05–0.44) and those with monthly income between 501 and 1000 USD (β = 0.11; 95% CI: 0.01–0.22), compared to households with income above 1000 USD. The results suggest that food insecurity is significantly associated with water insecurity, supporting the need for integrated approaches in public policy to address basic resource access in vulnerable populations.

This article maps food insecurity in South Africa and plumbs the data to women-headed households at the municipal level. Local contexts provide a better understanding of people's experiences by studying the impact their geographical location has on their economic status, and the impact their raced and gendered identities have on that experience. Localised information could also ensure that more nuanced policies are developed to address inequalities. Food insecurity is a marker of exclusion and poverty in urban and rural areas across South Africa, but women are more likely than men to be food insecure, especially in the rural areas. Data are combined from Statistics South Africa's Income and Expenditure Survey and Community Survey (both 2008) to arrive at a more accurate assessment of food insecurity at municipal level in South Africa. The National Department of Agriculture places food insecurity at 50%, while this study argues that approximately 64% of households in South Africa are food insecure, a result which has policy implications. Our study also uses data that provide a more nuanced approach that shows provincial and municipal variations that are much higher than the national average, which should support provincial and local government policies that address food insecurity more effectively. The article also argues that due to male-biased economic, cultural and community practices, women-headed households are most food insecure. In light of this information, the article provides a nuanced understanding of women's food insecurity in the country. We offer policy recommendations on how women's food insecurity could be reduced in the areas where it is most prevalent. The importance of gender-sensitive development policies, localised contextual knowledge, and innovative strategies that would assist women in their efforts to become food secure, particularly in rural areas across South Africa, are highlighted.

Household food insecurity (FI) and water insecurity (WI) are prevalent public health issues that can co-occur. Few studies have concurrently assessed their associations with health outcomes, particularly among people living with HIV. We aimed to investigate the associations between FI and WI and how they relate to physical and mental health. Food-insecure adult smallholder farmers living with HIV in western Kenya were recruited to participate in a cluster-randomized controlled trial of a multisectoral agricultural and asset loan intervention. We used baseline data on experiences of FI (using the Household Food Insecurity Access Scale, range: 0-27) and WI (using a modified scale developed for this region, range: 0-51) in the prior month (n=716). Outcomes included probable depression (using the Hopkins Symptom Checklist), fatigue and diarrhea in the prior month, and overall mental and physical health (using the Medical Outcomes Study HIV Health Survey, range: 0-100). We first assessed Pearson correlations between FI, WI, and sociodemographic characteristics. We then developed 3 regressions for each health outcome (control variables and FI; control variables and WI; control variables, FI, and WI) and compared model fit indexes. Correlations between household FI, WI, and wealth were low, meaning they measure distinct constructs. FI and WI were associated with numerous physical and mental health outcomes; accounting for both resource insecurities typically provided the best model fit. For instance, when controlling for FI, each 10-point higher WI score was associated with a 6.42-point lower physical health score (P<0.001) and 2.92 times greater odds of probable depression (P<0.001). Assessing both FI and WI is important for correctly estimating their relation with health outcomes. Interventions that address food- and water-related issues among persons living with HIV concurrently will likely be more effective at improving health than those addressing a single resource insecurity. This trial was registered at clinicaltrials.gov as NCT02815579.