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Building the evidence base on the agricultural nutrition nexus: Democratic Republic of Congo

The provinces of North-Kivu and South-Kivu are located in eastern Democratic Republic of Congo (DRC), and both have been marred by conflict over the past two decades. This led to population displacement and instability, which in turn resulted in the abandonment of agriculture, food insecurity and severe malnutrition (UNICEF, 2012).

Food insecurity and malnutrition of children under 5 years old and women, especially pregnant women, is one of the major problems faced by these two provinces, and is often associated with very high infant mortality rates. Some reports have indicated that in South-Kivu malnutrition through wasting affected 7.8% of children, and the province had an infant mortality rate of 125‰. Despite some action being undertaken by the government and some international organisations to improve nutrition in the region, much more remains to be done.

To build evidence on the agricultural-nutrition nexus, a rapid scan was carried out in North-Kivu and South-Kivu provinces between July and November 2015. The following methodology was implemented:

  • Analysis of existing data, including results of local surveys and databases from relevant public, private and humanitarian institutions.
  • Interviews with provincial planners and NGOs dealing with agriculture, food and nutrition security (FNS).
  • Dialogue with local resource persons.
  • Group discussions with target institutions (institutions dealing with agriculture and FNS in the study area).

Preliminary findings were presented at a 1-day workshop in South-Kivu province, entitled ‘Towards a harmonised approach on nutrition-sensitive development’, to aid discussion between representatives of relevant national and international institutions and interested NGOs. A follow-up workshop was planned to be held in Goma, however given the security constraints the Goma workshop was combined with one held in Bukavu, South-Kivu.

In DRC currently, more than 6.4 million people are experiencing acute food insecurity

(almost 10% of the rural population) from 82 territories, including five in North-Kivu. Unemployment is relatively high (6.1%) and very few households are connected to water (16.6%) or electricity (4.3%). Health services are very inadequate: North-Kivu has 47 hospitals, offering 12 beds per 100,000 people and 1 doctor for 24,030 people. This is far from the World Health Organization (WHO) standard which is 1 doctor for 10,000 inhabitants. As for sanitation, 99.8% of households do not receive sewage services for garbage disposal and 7% do not have toilets. The economy of both provinces is based on agriculture, livestock, fishing, forestry, and mining, which involves about 80% of the population and contributes about 49.7% of provincial GDP.

On average the population of Bukavu in South-Kivu consume about 1,027 kcal per person per day, of which 593.5 kcal, 92.4 kcal and 338.9 kcal are provided by products from Rwanda, North-Kivu and from within South-Kivu respectively. The majority of calories consumed in Bukavu city derive mainly from plant matter.

South-Kivu imports most of its food from Rwanda, even for products for which the region holds some comparative advantage, which is further aggravating deficiencies in the local production system. North-Kivu also imports much of its food from Rwanda, with the Rwandan districts of Rusizi and Gisenyi acquiring a strategic position as producers for both regions.

The results of a food security assessment study in North-Kivu and South-Kivu revealed that in 2014, 13% and 10% of rural households respectively were food insecure. Food insecurity in these provinces is linked to a problem of food availability and accessibility. Repeated armed conflicts have undermined the agricultural sector, thus increasing the dependence of the provinces on food imports and vulnerability to price increases. Insecurity has disrupted the functioning of the market system, resulting in frequent shortages and higher prices for basic foodstuffs. Since food insecure households have low purchasing power, they are often unable to compensate for their food deficit by buying food.

One of the problems for both South-Kivu and North-Kivu particularly, and DRC in general, is the inadequate and dilapidated transport infrastructure which makes the movement of people and goods difficult. The persistence of armed conflict and pockets of resistance from local uncontrolled armed groups (Maï Maï and others) and foreign armed groups (including the Liberation Forces of Rwanda (FDLR)), especially in rural areas, has added to this challenge, resulting in decreased agriculture and livestock production.

Moreover, in rural areas, markets are often only organised once or twice a week, preventing access to agricultural products even when a household has money to buy them. This makes access to some fresh products, like fish, difficult.

The issue of sustainability in these provinces is also a challenge due to climate-related problems, depletion of soil, access to and quality of inputs, poor agricultural techniques, pests and diseases, and animals’ diseases related problems like theileriosis, Pest de

petit ruminant, distomatose, African swine fever, new castle disease and the afteuse fever. Banana bacterial wilt and African cassava mosaic virus are also significant hurdles to revitalising agricultural production and the fight against food insecurity. Land reform issues are also important, as large industrial companies and investors are in possession of large amounts of fertile land, which currently remains unexploited.

The agricultural workforce is mainly composed of women and older men. Young people mostly engage in mining and trade, or leave rural areas altogether, which is impacting the availability of agricultural labour.

Results of the 2005 survey show that 11.74% of children born in South-Kivu weigh less than 2.5 kg and are predominantly girls (6.6%). In North-Kivu, however, the rate is 10.69% weighing less than 2.5 kg. A 2007 Demographic and Health Survey (DHS) had indicated a prevalence rate of children weighing less than 2.5 kg at birth of 13% for North-Kivu. This slight improvement was due to the impact of sensitisation and actions of different organisations working in FNS. Children weighing less than 2.5 kg at birth have a lower life expectancy, so a rate of over 10% for both provinces remains alarming. These figures also reflect high malnutrition rates among pregnant women.

The nutritional state of children is critical in North-Kivu and South-Kivu. Very few households have access to drinking water on their plots (14.8%) and even less have access to electricity

(2.5%). Limited access to drinking water increases waterborne diseases which are among the major causes of mortality and morbidity. As for sanitation, 99.5% of households do not receive a road service for garbage disposal and 8% do not have a toilet. Insufficient toilets for excreta disposal further contribute to the spread of infectious diseases, especially diarrheal diseases, which are also one of the main causes of malnutrition.

While the number of women involved in agriculture is on the rise in both provinces, they still face many disadvantages. Women often have limited or no access to land. Males are favoured in land allocation, while women only gain access to land through a male relative or after a husband’s death. Moreover, women’s access to financial services is limited, and they face inequities regarding access to livestock, inputs such as seeds and fertilisers, technology, market information, knowledge, skills and advisory services.

Many projects have been implemented to mitigate the malnutrition problem. The actions have all focused on implementing nutritional centres or supporting existing ones. Local, national and international non-governmental organisations (NGO), are all acting in this area with government organisations such as the National Nutrition Program (PRONANUT), Ministry of Health, and Provincial Inspection of Agriculture, Livestock and Fisheries, among others.

With security and policy challenges on one hand and environmental, agronomic and economic challenges on the other hand, achieving long-term sustainable food security in both provinces will not be easy. It is therefore necessary to:

  • Strengthen agricultural recovery programmes and support livelihoods;
  • Support and protect local small industries in the embryonic stage by implementing adequate trade policies;
  • Developing storage and processing infrastructures for perishable products with high added value;
  • Strengthen the management and maintenance of rural roads;
  • Strengthen security measures in production zones;
  • Strengthen programmes of prevention and management of malnutrition;
  • Develop a system for food security and early warning monitoring.

The complexities of how agricultural policies could effectively address nutrition are not yet well understood. There is considerable conceptual knowledge on this topic, but little understanding of how to carry the concepts and policy objectives into effective implementation and delivery of food-based approaches that impact the nutritional status of populations. Policies and programmes are clearly relevant, but the tangible impact these have on food processing, storage, and transformation into improvements in dietary patterns and nutritional outcomes is fragmented. Debate continues between those who argue that agricultural policy should play a large role in producing nutritious food and those who believe that it is more important for agricultural policy to focus on economic development and bulk calories.