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Food aid and nutrition
Food aid and n~t~ition The case of Botswana
Christopher
Food
aid
is
stimulate
Botswana
to a single
per
and
head
feeding
programmes
very
important
need.
Nevertheless,
ways
miss
a good that
interesting support
recurrent
Dr Stevens 1 O-l 1
the
Percy
poorest
who they
are in have
possibly
not
yet
in fully
represent
of
foreign
an aid
to
Officer
at
expenditure.
is a Research
the Overseas OJB,
While
potentially
deal.
and use
other
of it on
many
are
recognised,
WFP
any
much
for
they
achieved
more
projects. are
groups,
the two
case study.
than
has used
continuous the
Stevens
has received
aid
to
nutrition
the link between
by reference
state,
used
sustain
Christopher
projects. examines
food
widely
and
Development Street,
Institute,
London
Wl P
UK.
’ John Osgood Field, ‘The soft underbelly of applied knowledge: conceptual and in nutrition operational problems planning’. Food Policy. Vol 2 No 3, 1977, pp 228-239. z Ten Years of world Food Programme Deveiopment Aid 7963-72, FAO, Rome, p3: John Shaw, ‘The mechanism and distribution of food aid‘, Journal of World Trade Law. Vol 4 No 2, 1970, pp 22 l-2. Although WFP devotes only a quarter of its resources to vulnerable group and school that concentrate projects feeding exclusively cn nutrition, it also emphasizes the nutrition element in other projects. Overall, IO-15% of food aid from all donors is used in projects with exclusively nutritional objectives.
18
Stevens
The difficulties that arise when turning precepts of nutrition planning into practice have already been aired in this journal.’ An important use of food aid has been to stimulate the inception of nutrition projects and to contribute towards their recurrent costs once they are operative. Arguably, this emphasis on the use of food aid in nutrition projects has nowhere been more marked than in the World Food Programme (WFP).Z This article considers the link between food aid and nutrition in one country, Botswana, which has received more assistance per capita from WFP than any other state.3 A recurring problem when charting either the impact of food aid’or the success of nutrition projects in Africa is the paucity of reliable data. Although this difficulty applies to Botswana, there is at least one chink of light in the form of a recent important rural income distribution survey, reputed to be one of the most thorough of its kind in Africa. Although about the size of France, Botswana has a population of less than 700 000, and its gross domestic product is somewhat under $280 M.4 The nature of both the country’s economy and its climate are sources of VuInerability. Surrounded almost completely by the white ruled states of Southern Africa, Botswana belongs to the Southern African Customs Union along with Lesotho, Swaziland, and South Africa. Until 1976 it also belonged to the Southern African Monetary Area, and used the Rand as legal tender.5 The 1970s have been years of rapid economic advance, but this growth has largely been stimulated by the exploitation of mineral deposits which have transformed the capacity of the government to invest but have not yet reduced the dependence of the majority of the population on traditional means of livelihood. Six Batswana out of seven live in the rural areas, and agriculture directly involves 80% of rural households while contributing 35% of total rural incomes;6 yet Botswana is a net importer of food. The semi-arid climate is subject to periodic droughts which often recur over a number of consecutive years, and it is estimated that a drought of moderate intensity would halve production and consumption in the subsistence sector.’
The organization Botswana
of food aid
has received
substantial
assistance
FOOD
from WFP,
POLICY
February
both in
1978
Food aid and nutrition Table 1. Food aided projects 1.
Development
in Botswana
Projects
WFP project No.
Project title
Begana
Endedb
Food Cost’ ($1
Total WFP co& ($)
Type of activity
323
Community development & tsetse fly control
1966
1967
1 638 400
2 584 700
Drought relief in the form of food for work
324,324 exp.
Feeding of primary school children & vulnerable groups
1966
-
10 775 000
15 296 000
Continuous feeding programme
340
Livestock scheme
1966
1967
288 800
496 000
564Q, 564Q exp.
Community in drought areas
1969
1971
1 579 900
2 118 700
Drought relief in form of food for work
610
Institutional
1971
1976
1604 100
2 174 900
Food to secondary schools hospitals & brigades
2074Q
Agricultural improvements for small farmers threatened by drought
1973
1974
80 000
167 500
Reward to farmers who adopted improved farming practices
2. Emergency
feeding
development stricken
feeding
operations
Date approved
WFP project No.
Title of operation
824 861 861 995
Famine & drought relief Aid to drought phase 1 Aid to drought phase 2 Drought
a
Date food distribution
commenced
b
Date food distribution
terminated.
c Cost on WFP tinuing projects, December 1975. Source: World
valuation: cost is
with conup to 31
1965 1968 1969 1973
Total WFP cost ($1 2 030 801 236 163
400 500 900 900
response to drought-provoked emergencies and on a continuing basis. From 1965 to the end of 1975 WFP committed to Botswana some $26 M to cover food and associated expenses, representing some $40 per capita, and it shipped 15 122 tons of commodities. This aid has been used in three ways:
Food Programme
0 3 WFP is the only major supplier of food aid to Botswana. A major issue to be considered is whether food aid acts as a disincentive to local agricultural production, since such effects have to be set against any nutritional or other benefits. Although the effects of food aid on agricultural production are not considered in this article, they are dealt with in the author’s ‘Food aid: more sinned than sinning?‘, against ODl Review 2. 1977. Both articles are based on the findings of an ODI research project that is investigating the impact of food aid continuedonp20
FOOD
Drought related food to livestock
POLICY
February
1978
0 0
To provide rations for food for work campaigns linked to the periodic droughts. To replace food purchases by institutions such as hospitals and secondary schools. To supply rations to various feeding programmes. (See Table 1)
If these projects are ranked according to the number of beneficiaries, the third group is clearly the most important. In 1975 it reached 2 17 000 people,8 half of whom were primary school children while the remainder comprised three categories of people described as ‘vulnerable groups’, namely pre-school children, pregnant and lactating women and TB outpatients. The present article concentrates on this single WFP project.’
19
Food aid arrdnutritiorr
continued
from page
?9
in Botswana. Lesotho, Upper Volta and Tunisia, and considering in particular how the mode of administration influences consumer prices, agricultural production and nutrition either directly or indirectly government its impact on through policies, The full results of this analysis will be published as a book. The conclusion for Botswana, a food deficit country, is that food aid has not formed a significar~t disincentive to agricultural production. ?he justification for excluding a full discussion of this, and many other corollaries of food aid in this article is the practical one of space. National prices, d At 1973-74 Devel~pfff~ntP~a~ 1976-81, 1977.~6. 5A separate currency, the Pula, was introduced in 1976. However, since the data for this article mainly predates the most figures are change, currency denominated in Rand. The rate of exchange in 1975 averaged R 1 =$l ,4. 5 National Development Plan 1976-81, p 135. ‘Ibid p 44. For further details of the Botswana economy see David Jones, Aid and Development in Southern Africa, ODI/Croom Helm, London, 1977. * In the sense that this number of people benefited at some time, although not necessarily reguiarly. 9 Project no 324 exp Feeding of Primary School ~bi~dr~~ and VuJner~ble Groups. la For a discussion of the relative merits of food aid and financial aid see Christopher Stevens. op tit, Fief 3. ” Figures refer to expenditure by the Institutional Food Programme during financial years 197 I-72-1975-76. ‘*This is illustrated in the current development plan which devotes several paragraphs in the Ministry of Health section to the mother and child health and nutrition programmes without ever mentioning food aid. mixtures of foods r3 Blended are nutritious commodities designed to make full use of foods that are in surplus supply. The most usual blend in Botswana is corn sova milk ICSM) which has formed 69% by’ weight of all the WFP commodities shipped to Botswana by the first quarter of 1977. A further 12% by weight has been in the form of instant corn soya milk (ICSM). Information from WFP.
20
All WFP food aid to Botswana has been provided as a grant, including the cost of transport and administration to the country’s border. The government is responsible for the food once it enters the country, although in practice it has been abie to share the financial implications of this burden with others: many of the warehouses used to store the food were constructed with aid funds from various sources: a WFP internal transport subsidy is under discussion, as is requested UNDP assistance to renew the fleet of food aid vehicles and other ancillary equipment. Nevertheless, the administration of food aid does involve the government in expenses over and above those associated with the same value of financial aid.‘O Between 1971 and I975 Botswana received food aid valued by WFP at R3.9 M, and during the same period spent R854 589 on related administration and logistics,’ i Not all of these expenses are attributable to food aid since they would have been incured administering the project whatever the mode of finance. Of course since food aid is tied both to commodity and to source the notional valuation by WFP may overstate the value of the transfers to Botswana. A rough attempt is made below to untie the aid and estimate its true value for the recipient. This suggests that untying by source although not by commodity reduces the value by some 10%. If this figure, calculated by reference to the commodities supplied to primary school and vulnerable group feeding projects, is accepted for all WFP food aid to Botswana, the total value of the transfer is reduced to R3.S M. Food aid and project costs together thus represent some 24% of receipts. The task of accepting, storing and distributing the food has always fallen to a special self-contained unit which has been known by several names and has fallen within the portfolio of several ministries during its existence, but which has always been an indentifiable organization. Currently known as the Institutional Food Programme (IFP) it comes under the aegis of the Ministry of Local Government and Lands because, when allocating food, it works closely with the District Councils and the decentralized arm of central government, the District Ac~ministration‘ The primary school and vulnerable group feeding projects also involve the Ministries of Health and Education. This split between responsibility for the logistics of supply and for the programmes into which food aid is injected has been an organizational success, with IFP developing an expertise in its field which has not been offset by poor inter-ministerial co-ordination. At a policy level, however, it may have contributed to a certain lack of interest by the specialist ministries in the food aid they are using.‘*
Primary school feeding Primary schools have been receiving food aid continuously since before independence in 1966. The current WFP project is an expansion of a project approved in April 1966 which was itself a natural continuation of the emergency assistance provided during the severe drought of the mid- 1960s. Under the present scheme, primary school children receive a mid-morning meal of blended food’” and vegetable oil. There are 4 categories of primary school in Botswana. 1.
A small group of English language schools provides a high standard of education which is reflected in high fees; they are currently administered directly by the Ministry of Education.
FOOD
POLICY
February
1978
2.
3.
4.
A second group of government financed Setswana fanguage schools are administered by the local councils with the Ministry of Education providing professional advice and supervision. Fees are currently R3 per annum. Private schools registered with the Ministry of Education. Many of these are administered by missions, and some are assisted financially by Government. In 1975 there were 22 such schools compared with 301 in categories I and 2.14 Private schools not registered with the Ministry of Education in which teaching standards are often very low.
Food aid is received by virtually all primary schools in categories 2 and 3 but by none in categories I and 4, Since schools in categories 2 and 3 provide the bulk of primary education, school feeding is clearly an accepted and integral feature of the education system. In 1975, 305 schools and 110 689 pupils received food aid.” The programme has been accorded 3 different, although not mutually exclusive, goals by various observers: 0 0 0
To combat malnutrition and to assist poorer families. To improve scholastic performance. To increase school attendance.
~~‘~it~~tio~
I4 Education Statistics 1975. Gaborone, Table Al. I5 Ibid. Table Al 9. ‘6 World Food Programme document WFP/IGC: 1317 Add 25 (20 March 1968) Rome, para 1; and National Development Plan 7976-87. Gaborone, para 4.63; emphasis in original. ” Given the emphasis on nutrition by the donor, it is surprising that there has been so little work to measure the nutritional effects of the aid. leThe enrollment figures do not include pupils at unregistered private schools. Natioi~al Development Plan 7976~81. Gaborone. Table 6.1. l9 Isolation may be another factor, but it is one that is linked to poverty. First, there is reason to believe that isolated families are especially vulnerable. Secondly, those families living in remote settlements who are not poor are often able to send their children to live with friends or relatives in larger villages so that they may attend school. 20 National Development Plan 1973-78, 7.43. National Gaborone, para Development Plan 1976-81, Gaborone, Table 6.1.
FOOD
POLICY
February
1978
This goal is subscribed to by both WFP and l.he Botswana government. Indeed, according to the former ‘The main purpose of this project is to combat widespread malnutrition and undernourishment . . +’ while in the view of the government ‘The primary sc~ool~ed~~g ~rogru?n~e, as well as ensuring better child nutrition, represents one of the few effective means by which Government can help poorer families directly . ..‘I6 The school meal has sufficient nutrients to make a significant contribution to a child’s daily food needs. However, the impact of the project on nutrition Ievels does not depend only on the size of the ration. School feeding can be said to have alleviated malnutrition only if it reaches children who would otherwise have been malnourished and it results in a net increase in the quantity and/or quality of the food consumed by the child. No surveys have been conducted on the scale needed to ascertain with certainty whether the school meal has in practice made a significant contribution to combatting malnutrition.” However, since primary education is not universal despite a sharp rise in enrolment over the past five years, there must be some doubt ov’er whether the meal reaches those most in need. In 1975 there was a primary school enrolment of 116 293, which represents 89.5% of the 7- 13 year age cohort. This comparison, however, overstates the proportion of school age children at school, since enrolment includes pupils outside the age cohort. The actual enroiment of pupils aged 7-13 (92 763) represents 71% of this age range.18 The precise reasons for nonattendance are not known, but poverty is thought to be the main factor:lV following a decision by government in 1972 to halve the fees for local authority schools from R6 to R3 per annum the number of first year enrolments increased by 58% in the following year, and by 1975 the number of primary school pupils was 34 63 1 more than in 1972 and 18% higher than the original planned target.*O There is reason to suppose that the primary school-age population
21
*’ f3otswane ~~V~~~rn~n~F~U Wnrfd Foad Pro~~~mm~, A Study of Canstraint$ an A~~fcoftoraf De~efapmc~~t in the Republic: of ~ats~en~~ Rome, 1974, pp 5-6. =z Ibid, fable 6. 23 Report on the Pap&tion Census 1971,
Central Statistics Office, Gaborone, 1972, “r&lo 7. 24 The Rural Income Distribution Survey in Botswana 1974-75. Central Statistics Qffice, Gaborone, 1976. 26 fbid, para 8.3.2.
is evenly distributed across income groups. AIt~ougb there is no direct evidence of the relationship between the two, it is possible to make a rough estimate by using participation in food for work as a proxy for income. A survey carried out during 1971-72 interviewed 1021 rural households to discover whether participation in food-foswork was related to decreasing agricultural production. One of its findings was that there existed a positive correlation between the poverty of a househotd and the length of its food-for-work participation- *’ Nowever, it found no signi~cant difference between the age groups represented in ~artic~~at~ng and non~part~c~~ating househoJds: 44% of the population of households that had never participated in food-for-pork were in the 0-14 year age group, compared to 45% for households irt which at least one member had participated for six months or more.z2 These proportions are very close to the national age distribution measured in the most recent (197 1) general census which found 46% of the population to be between the ages 0 and 14.23 The food-for-work survey also found that there was only a small difference between the household size of participating and non-participating families. If it is assumed ~reaiistically} that school-age children are evenly spread over income groups, and also assumed (less real~stically~ that poverty is the so/e determinant of non-attendance at primary school, it may be concluded that the households of the 29% of ?- I3 year olds who do not attend schooi belong to the poorest 29% of the population. An important survey af rural income distributions based on a random sample of IO60 households,24 found a 1974-7.5 median annual income of R630, and a mean of R I 068. It also calculated the annual household income of various percentiles of the population, The income of the poorest households, the first percentile, was R 121 per annum, and that of the thirtieth percentile was R402. On the basis of the above assumptions, it would seem that the primary school population comes from househotds with an annuaf income of R402 and above.‘s Clearly the assumption that poverty is the sole determinant of nonattendance is somewhat suspect, However, even aDowing for a margin of error it appears that the primary school lunch progr~mme misses those families for whom such transfers are likety to form a significant addition to income. The rural income distribution survey report presents a detailed analysis of the source of income of 5 7 households, A summary of the results is given in Table 2 which shows that the income groups most likely to receive primary school lunches obtain
LOWeSt
Highest
: 3 : Source: Survey
Statistics 101.
22
l*hs Rural income Distribution in Batswana 7974/75, Central
Off&+, Gaborone, June 1976, p
Transfers Gathering Employment Farming Housing
Proportion which is in kind 71%
to 50%
ta 99*7%
SO% to 95%
w7%
~RlpfOyment Farming Transfers Gathering Manufacturing
Employment Farming Property Transfers Housing
Livestock Trading Employment Housing Hunting
49%
42%
32%
f5%
Food aid and nutrition less than half their income in kind, and are not heavily dependent on transfers. By contrast, the opposite is the case for the income group least likely to receive the lunch: it is particularly dependent on transfers and income in kind.
26 A typical meal schedule in eastern Botswana is 6.30 9.00
am am
1 .OO pm 4.30 6.30
pm pm
for a household
Tea and bread Breakfast ~ fermented sorghum porridge and milk Fermented sorghum porridge or maize and bean mixture. Tea or sorghum bear Supper ~ fermented sorghum porridge, bean leaves and/or melon, tea and bread.
Andrew G. Hamilton, Rural Consumer Food Preference and Grain Storage Survey ~ an interim report, Gaborone, 1975, p 32. *‘That is, where half a class has lessons during the first part of the morning while the other half is taught during the second part. Of course some of the benefit might be carried over to the following day in cases when the meal is served after lessons have ended. The multiplicity of possible effects merely underlines the need for controlled tests to measure the impact of the meal. Interestingly, the potential of school meals to improve scholastic performance has recently been stressed in the UK by the Association of Assistant Mistresses, although again on the basis of teacher experience rather than controlled experiment. Concentration in School. How it can be helped and hindered. AAM Discussion Document, AAM. 29 Gordon Square, London, WC1 H OPX, Julv 1977. 2*This point is linked to the first of two corollaries of both primary school and vulnerable group feeding that are discussed below: their impact on the family economy. and their implications for the Government’s recurrent budget. ” Pre-school children are defined as those between six months and five years of age.
FOOD
POLICY
February
1978
Scholastic performance The argument here is that by the middle of the morning, school children are hungry and that when they are hungry their capacity to learn suffers. For those pupils who have an inadequate diet at home, the lunch may also provide the additional benefit of improving their resistance to disease and hence of reducing absences from school due to illness. In other words, school lunches, just like books, desks and classrooms, improve the efficiency of learning. Certainly many pupils leave home in the morning without eating breakfast.26 Primary classes typically run from 7.45 am to l-00 pm so that if the children have to travel some distance from their home to school it is likely that they will miss both breakfast and lunch. The overwhelming opinion of teachers consulted during the fieldwork for this article was that school meals do improve performance. Against this, however, the effectiveness of the meal as an aid to learning may be reduced in some schools where there is double streaming2’ and the lunch is not served until after lessons for the day have ended. The timing of meals could, of course, be altered to avoid this difficulty. Unfortunately, no tests or other objective evidence exist to support or undermine the view that school lunches improve performance. According to the Botswana Ministry of Health, such tests could be devised but this has not been done. A tterrdance There are three ways in which food aid may increase school attendance. First, if school food improves the general level of health of the children, they will spend less time away from the classroom due to sickness. Secondly, food aid may act as an incentive for parents to send their children to school. There is no evidence that this is the case in Botswana where education is highly regarded among most social and cultural groups. Indeed, when for administrative or other reasons the supply to schools has broken down leaving them without food, sometimes for several months, no decline in school attendance has been observed. Thirdly, food aid may act, if not as an incentive then as a useful income supplement to those families which, though they are not among the poorest households, can barely afford school fees.28
Vulnerable group feeding Food aid under this heading is supplied to pregnant women, nursing mothers, pre-school childrenZY and TB out-patients on the grounds that they are both vulnerable nutritionally and of potential economic significance. Pre-school children are the labour force of tomorrow and their future contribution to economic development will be affected significantly by any malnutrition in their early years. Young mothers must stay healthy if they are to feed their babies well and produce strong children in future. In a society where the bulk of arable farm labour falls on women, they also have productive years ahead. Rather different considerations apply to TB out-patients. TB is one of the
23
most widespread serious diseases in Botswana and in 19’74 sufferers were the second largest group (6%) of in-patients (after childbirth) in the country. 30 Since a majority of them were under 44 years of age the fight against the disease has a direct effect on the size of the labour force. The main reason for singling out TB patients for free food is, however, that out-patient treatment requires attendance at a clinic over a long period of time, and the food ration is intended as an incentive for regular attendance, although whether it achieves this objective is not known. It may be more effective in encouraging TB patients to attend the clinic than it is in popularizing education, the value of which is much better appreciated by the general public. The food aid programme is not directed towards vulnerable groups with no potential economic significance. The elderly destitute, for example, receive food aid, if at all, only through the emergency food for work campaigns. Like school meals, the ration supplied to vulnerable groups could make a significant contribution to the beneficiaries’ nutritional requirements. However, once again it is not just the size of the ration but also the background of the recipients that determines its impact. To achieve its aims the programme must reach individuals who would otherwise suffer from malnutrition and must actually result in an increase in the quantity and/or quality of their food intake. Clearly, not all pre-school children and mothers are in need of food aid. Those with adequate incomes can look after themselves. Some selection is therefore in order. The programme currently reaches about 62% of expectant and nursing mothers and about 80% of preschool children, although not necessarily on a regular basis. Thus, selection does occur but there are no firm data to indicate its basis.
3o Medical Statistics 1974, Gaborone, Table 14. 31 Report on the ~o~u/e?;on Census I97 I, Gaborone, 197.2, Table 6. 32 In practice, Botswana has shown a considerable degree of initiative in setting up as many feeding points as it has. In many developing countries food for vulnerable groups is distributed from hospitals, clinics and health posts. In Botswana the network of health facilities is very poor. The number has been increased rapidly in recent years, but by 1974 there were still only 266 health facilities, of which 13 were hospitals, 8 health centres, 47 clinics and 198 health posts. The health network has therefore been supplemented for distributing food by voluntary feeding centres, which are run by voluntary groups such as the Botswana Council of Women, YWCA, and village development Red Cross committees, to the extent that only some 14% of the 3 12 feeding centres operate from health facilities. 33 The Rural Income Distribution Survey in Botswana 1974-75, Gaborone. para 8.3.8. M Ghanzi, Kgalagadi, Western Central, Western Kweneng, and Western Ngwaketse. 35 Op cit. Ref 33, para 8.3.6.
24
Who receives the food? It is likely that there is some geographic selection. There are only 3 12 centres from which food is distributed to vulnerable groups? compared with 527 settlements with a population of over 200 people.” Some people will travel from their home to the nearest feeding centre in another village, but this is not always possibie, particularly in the less densely populated west of the country. In the north west in Ngamiland, for example, there are 58 settlements of over 200 people but the regional depot at Maun supplies only 17 feeding centres. It is difficult to see how this sort of coverage could be significantly improved without administrative overheads that are unacceptably high both in terms of money and more especially of manpower particularly in the sparsely populated areas.“2 However. even though it is probably unavoidable, geographic selection will exclude some members of the target population, particularly if it is assumed that people living in remote settlements are likely to be particularly vulnerable. The rural income distribution survey found that the median income in the north and north west (Ngamiland and Chobe) was R446, compared with a national figure of R630, and that the income of the tenth percentile (at R164) was only 70% of the national level. 33 Income levels in other western areas34 were also found to be lower than the national average although to a less marked degree. Another difference was found between residents of large villages (with a median income of R887) and those of small villages, lands areas and cattle posts (with a median of R6 IO).35
FOOD
POLICY
February
1978
There may also be some seif-seiection, with those who do nut need the food not bothering to collect it. Some recipients stopped attenders distribution centres when the present ration was ~ntroduced~ this may have been Linked to the substitution of a blended food for the more versatile dried skim milk that can be reconstituted and, for example, added to tea. Regrettably, experience elsewhere suggests that selfselection IS not normally an adequate basis for concentrating coverage on the needy. There is very little selection by those administering the food. The staff at the voluntary feeding centres are often not trained to apply any selection criteria, but there is no evidence of any more active selection occuring at the health centres. This must be partly due to the absence of any criteria for selection. A WFP evafuation mission in 1970 recommended that the ~o~~rn~e~t establish a set of criteria, but this has not been done. If the food available is sufficient for afl who come to the distribution centres there would seem to be little incentive for government to enforce selection which will not help it to reach vulnerable individuals who were previously missed but will simply exclude those who are not vulnerable. This will be achieved at the expense of precious manpower, and at the risk of exduding deserving cases through poor c~assi~cation and of encouraging people to shift their attendance away from clinics to the voluntary feeding centres where selection is likely to be less rigorous. Xowever, if the demand exceeds the supply, the advantages of selection become much greater. A first step is thus for the authorities to discover whether demand is greater or less than supply, and there are signs that a reporting system to provide this information is being instituted.
36 Misuse in the sense of use other that foreseen by those planning project.
than the
There remains the question of whether the recipients actually consume the food they receive. With primary school feeding this problem does not arise directly since the children are offered a ready cooked meal with the option only of ~~bethe~ to take it or leave it. Food for vulnerable groups is normally distributed uncooked at weekly or even monthi~ intervals. There is therefure no guarantee that it is actually consumed by those to whom it is given. There is no evidence of widespread misuse of food aid, for exampte by seiling it. It is also probable that misuse 36 has declined since blended food was substituted for dried skim milk. On the other hand, it is very probable that the recipient is not the only person who consumes the ration it is most unlikely, for example, that a young mother would return to her home with a sack of food and refuse to share it with other members of her family, Such sharing would appear to be inevitable and it could be argued that it is not necessarily undesirable. The vulnerable group feeding pro~ram~e has two other goals of an ~~c~tio~al nature. One, given considerable emphasis in some countries, is that food aid can be used as an incentive to mothers to attend centres at which they can be given genera1 he&h education talks and demonstrations. Such talks are given regutarty at the clinics from which food is distributed and occasionally from voluntary feeding centres. However, this seems to be a secondary goal in Botswana, as is evident from the use of voluntary feeding centres staffed by untrained personnel. Secondly, the programme has given a boost to voluntary community groups by forming a tangible core activity around which an organization can develop. Many women’s
25
Food aid and nutrifion
groups have been formed around food distribution still their main activity.
Table 3. Primary school and vulnerable group feeding rations established in 1966 Daily ration
Commodity
Unit value @ (RI
Primary school children Dried skim milk Veaetable oil Maize meal Egg powder
2% 150 1509 %I
1.43ikg 0.97lkg O- 1Oikg
3-48lkg
Vulnerable groups Dried skim milk Vegetable oil
209 1OQ
a Calculated for Lesotho Maseru, August 1975. Source: World ment WFP/IGC: 1966, Table 1.
Food 10.12
f .431kg 0,97/kg
by
WFP
Programme docuAdd 9,28 October
Impact on the family economy Food aid in these programmes represents transfer income in kind to the recipient households. This is fairly clear in the case of vulnerable group rations but it also applies to the primary school meal. Although school meals are often considered as additional consumption by the child, this need not be the case, Parents may deliberately reduce the size or quality of meals they provide for their children during periods when they are at school in order to save money. Alternatively, children may simply not desire as much food at home when they are receiving a school meal. There is no firm evidence to indicate whether or not either of these is happening. However, if school meals result in a less than proportional increase in a child’s total consumption, then in addition to improving nutrition or scholastic performance the food aid programme will also result in an income transfer to the child’s family by enabling them to reduce their expenditure on his food. The same is true of rations supplied under vulnerable group feeding. This transfer could have one or more of the following results: 0 l l e l
37 World Food Programme document WFP/IGC:28/11 Add A4, August 1975, para 26. 38 Based on R7.10 per 22.68 kg cif for CSM/CSB and RO.76 kg cif for vegetable oil. 19 No calculations have been made for the locally the purchasing cost of commodities WFP supply. However, such an exercise has been undertaken by WFP for Lesotho where the cost in August 1975 was estimated as R0.25 per kg for blended foods like CSM and R0.97 per kg for vegetable oil. These figures may be used as a rough guide for Botswana. ‘OThe task of identifying - a local substitute is complicated because of disagreement among nutrition experts about whether the beneficiaries of food aid really need the high grade nutrients supplied by WFP food, or whether they merely need additional calories that can be supplied in cheaper foods, notably cereals. The author is not competent to adjudicate between these viewpoints. However, the value of a ration based entirely on cereals and vegetable oil could be 40% less than the national WFP figure.
26
and for some it is
Increased consumption by members of the family other than the direct beneficiaries. Increased wastage of food. The release of home produced food for sale. An increase in family food stocks. A fall in total family expenditure on food.
The scale of these transfers will depend on the degree to which the initial beneficiaries pass on the benefits of their rations to other members of the household, but a ceiling will be set by the value of the food aid supplied. This value can be defined in 3 ways: the notional value of the food according to the donor’s accounting, the cost of purchasing the same commodities locally and the cost of purchasing locally available substitutes. The school ration has varied from one institution to another, but since 1975 the recommended meal has been 150 gm of corn soya milk (CSM) and 15 gm of vegetable oil per child per day.37 The official vulnerable group ration is 80 gm of CSM and 15 gm of vegetable oil per day. The notional WFP value of the primary school ration is a little under 6 cents per day or approx Rl 1 per year assuming a 39 week school year; for the vulnerable group ration the figure is R2 1 for a full year’s suppty. 38 On a local purchase basis the annual value of the ration falls to R IO for school meals and R 19 for vulnerable groups3” CSM is not available through normal retail outlets in Botswana, and it is improbable that either parents or the government would attempt to supply it in the absence of WFP food aid. Locally available products would be supplied in its place. No work has been done in Botswana to identify which local foods would be substituted, and clearly the identification of an acceptable package is a job for a specialist. 4o A rough proxy for the cost of local foods with similar nutritional characteristics is obtainable by refering to the ration used by WFP before the introduction of blended foods. The results are shown in Table 3 and suggest that although CSM is an exotic
FOOD
POLICY
February 1978
Food aid and nutrition
commodity for Botswana it is competitive in cost with more common foods4 i If the figures RIO per annum for school meals and R I9 per upturn forvulnerable groups are used as a rough guide, the value of the food aid transfer may be compared with total household income. The 1971,.72 survey concerning the impact of food for work on agricultural production found an average household size of 6.2 residents.“* If this is taken as a guide, a typical 6 member household might include as potential bene~ciaries of the two food aid projects: I young mother, 1 primary school age child and 1 preschool chitd,4” If all three were receiving food aid, the annual value of the transfer would total R48: if the school age child was not at school this total would be reduced to R38. These figures are compared in Table 4 with the total income of various percentiles of the population taken from the rural income distribution survey. The Table suggests the rations could form an important addition to the income of the poorest houseilolds and a not insignificant contribution for all families receiving less than the median wage.
Impact on the recurrent budget
” Using the estimates made by WFP for Lesotho. the value of the primary schoot ration is actually higher than with CSM at Fill .80 per annum~ although the value of the vulnerable group ration falls to R16. 42 Government of ~otswana/~AO World Food Programme, A Study of Constraints on ~~ricult~rai Development in the Re,oubfic of Botswana, Rome, 1974, Table 4. qJ See The Rural Income Distribution Survey ii, Botswana 1974-75, Appendix 15 for a suggested age distribution of a 6 member household. “Education Statistics 7975. Gaborone, Tabie AZ 9. 48 Ibid. Table 1 1. ” Government of Botswana, 5o~swa~~ Project 324 Expansion: ~uarteriy Progress Report, I July 7975 to 30 September 19 75. 47World Food Programme document, WFP!IGC: 28/l 1 Add A4, August 1975, P 9. a8 Quarterly 46.
Progress
Report,
Op ci?, Ref
School meals have been provided free for over IO years. Food aid has, in effect, underpinned part of the government’s recurrent education budget, and it has done so to a fairly marked degree. In 1975, I 10 869 school children received meals?” If the value of the ration is taken as the local replacement cost (RlO per ann~rn~ this represents a total cost of Rl 108 690 or a full 37% of total central and focal government recurrent expenditure on primary education in 1974.45 In practice, the actual utilization of food tends to be less than the planned level due to administrative problems, and nonconsumption by some pupils. Actual utilization is approximately 85% of planned levels for CSM and 61% for vegetable oi14” If total expenditure is reduced to take account of this, it becomes 30% of total recurrent expenditure. Vulnerable group feeding can also be seen as an addition to the recurrent social welfare budget, although in this case it appears to be less of an addition to the system than the dominant partner. O~~ialiy, there are some 107 507 beneficiaries of this project,J7 but not all attend regularly. Actual utilization of Lhe established ration is approximately one-half for CSM and one-third for vegetable oil.48 Using these figures for beneficiaries and utilization rates, and the local replacement value of the ration, total expenditure is R582 714 per annum. The only other continuous welfare provision made by the government for vulnerabte groups (including those such as the elderly
Table 4. Value of food aid rations as a proportion
11)
Pe~cen~iieof the
~o~uiation a 1st richest.
percentile
=
poorest.
99th
21
Source: The Rural income Distribution Survey in Botswana 1974175. Central Statistics Office, Gaborone, 1976.
FOOD
POLICY
February 1978
1 IO 20 30 50
a
(2)
(31
Annual boosehold income
R48 as % of (21
121 233 325 402 630
12 7
of total household
income
(4) R38 as %
of
(21
31 16 72 -
2f
destitute that fall outside the food aid programme) is in the form of assistance given by District Councils. The most recent figures of total Council expenditure are for 1972. That year the combined expenditure of all Councils on destitute relief was R9 728.49 More recent figures are available only for the Councils’ budget estimates. In 197576 these stood at R65 970. In 1972 actual expenditure was 68% of the budget estimate. If this proportion is assumed to hold good for 1975-76, actual expenditure would be R44 860 or 8% of the value of food aid to vulnerable groups.50
Food aid and nutrition
4g Audited accounts for each district. “-‘This probably overstates the scale of Council relief because the budget estimates for both the preceding and succeeding year are substantially lower. 5’ Op tit, Ref 1. 52Ibid, p 235. 53 One possible reason for the narrow approach to the subject stems from the role of the food aid donor. It is reasonable to conclude that primary school and vulnerable group feeding schemes exist in Botswana today because the World Food Programme offered assistance to initiate and continue them. The projects operate in the way they do because that is how WFP projects operate. The wide gap between the level of welfare provision made for young mothers and children on the one hand, and other vulnerable people, such as elderly or destitute, on the other stems largely from the willingness of foreign donors to provide continuing help for the former and not for the latter. 54 See Robert Wood, Kathryn Morton. ‘Has British aid helped poor countries?’ ODI Review, No 1, 1977, p 58.
28
In his article” on the conceptual and operational problems of nutrition planning John Osgood Field distinguishes between the ‘intellectual establishment’ view and the ‘bureaucratic’ approach. The former is broad and multi-sectoral while the latter is narrowly focussed on specific topics. The use of food aid for nutrition in Botswana clearly falls into the bureaucratic mould. Attention is focussed on the logistics of getting food to the people, rather than on the ultimate nutritional objective of the exercise. The case study provides support for Field’s general contention that although nutritional planning is not an end in itself and must be justified on the basis of what it contributes to improved nutritional status ‘this final link is rarely considered before programmes are launched, and even today it is not always assessed very adequately afterwards’.52 The primary school feeding project is a case in point. Both donor and recipient justify this in terms of combatting malnutrition even though the scheme almost certainly excludes those most in need. There are other desirable objectives that primary school feeding is much better designed to achieve, such as improved scholastic performance. However, because of the emphasis on general nutrition, tests to measure its impact on scholastic performance have not been made, and little attention has been paid to organizing the scheme in a way that maximises its impact on this, for example, by altering the timing of meals. Despite the emphasis on nutrition there has been no attempt to measure adequately the actual impact of food aid on the level of malnutrition in the target groups.5” Nevertheless, although food aid falls into the ‘bureaucratic’ definition of nutrition, it must be admitted that it is a good example of its kind. Although the issue of food aid may more often be seen in terms of logistics than of ultimate objectives, it is certainly the case that the logistics are good for a large and poor country with very weak infrastructure. Again, although food aid undoubtedly misses many of the poorest people, it seems probable that a large number of poorer people do benefit from it. A convincing case can be made that foreign aid in general has biased development spending in favour of lumpy capital projects and therefore away from sectors in which the need is for more recurrent resources.54 Food aid, by contrast, has achieved the opposite effect: it has added to the recurrent resources for education and health.
FOOD
POLICY
February 1978
Christopher
Food
aid
is
stimulate
Botswana
to a single
per
and
head
feeding
programmes
very
important
need.
Nevertheless,
ways
miss
a good that
interesting support
recurrent
Dr Stevens 1 O-l 1
the
Percy
poorest
who they
are in have
possibly
not
yet
in fully
represent
of
foreign
an aid
to
Officer
at
expenditure.
is a Research
the Overseas OJB,
While
potentially
deal.
and use
other
of it on
many
are
recognised,
WFP
any
much
for
they
achieved
more
projects. are
groups,
the two
case study.
than
has used
continuous the
Stevens
has received
aid
to
nutrition
the link between
by reference
state,
used
sustain
Christopher
projects. examines
food
widely
and
Development Street,
Institute,
London
Wl P
UK.
’ John Osgood Field, ‘The soft underbelly of applied knowledge: conceptual and in nutrition operational problems planning’. Food Policy. Vol 2 No 3, 1977, pp 228-239. z Ten Years of world Food Programme Deveiopment Aid 7963-72, FAO, Rome, p3: John Shaw, ‘The mechanism and distribution of food aid‘, Journal of World Trade Law. Vol 4 No 2, 1970, pp 22 l-2. Although WFP devotes only a quarter of its resources to vulnerable group and school that concentrate projects feeding exclusively cn nutrition, it also emphasizes the nutrition element in other projects. Overall, IO-15% of food aid from all donors is used in projects with exclusively nutritional objectives.
18
Stevens
The difficulties that arise when turning precepts of nutrition planning into practice have already been aired in this journal.’ An important use of food aid has been to stimulate the inception of nutrition projects and to contribute towards their recurrent costs once they are operative. Arguably, this emphasis on the use of food aid in nutrition projects has nowhere been more marked than in the World Food Programme (WFP).Z This article considers the link between food aid and nutrition in one country, Botswana, which has received more assistance per capita from WFP than any other state.3 A recurring problem when charting either the impact of food aid’or the success of nutrition projects in Africa is the paucity of reliable data. Although this difficulty applies to Botswana, there is at least one chink of light in the form of a recent important rural income distribution survey, reputed to be one of the most thorough of its kind in Africa. Although about the size of France, Botswana has a population of less than 700 000, and its gross domestic product is somewhat under $280 M.4 The nature of both the country’s economy and its climate are sources of VuInerability. Surrounded almost completely by the white ruled states of Southern Africa, Botswana belongs to the Southern African Customs Union along with Lesotho, Swaziland, and South Africa. Until 1976 it also belonged to the Southern African Monetary Area, and used the Rand as legal tender.5 The 1970s have been years of rapid economic advance, but this growth has largely been stimulated by the exploitation of mineral deposits which have transformed the capacity of the government to invest but have not yet reduced the dependence of the majority of the population on traditional means of livelihood. Six Batswana out of seven live in the rural areas, and agriculture directly involves 80% of rural households while contributing 35% of total rural incomes;6 yet Botswana is a net importer of food. The semi-arid climate is subject to periodic droughts which often recur over a number of consecutive years, and it is estimated that a drought of moderate intensity would halve production and consumption in the subsistence sector.’
The organization Botswana
of food aid
has received
substantial
assistance
FOOD
from WFP,
POLICY
February
both in
1978
Food aid and nutrition Table 1. Food aided projects 1.
Development
in Botswana
Projects
WFP project No.
Project title
Begana
Endedb
Food Cost’ ($1
Total WFP co& ($)
Type of activity
323
Community development & tsetse fly control
1966
1967
1 638 400
2 584 700
Drought relief in the form of food for work
324,324 exp.
Feeding of primary school children & vulnerable groups
1966
-
10 775 000
15 296 000
Continuous feeding programme
340
Livestock scheme
1966
1967
288 800
496 000
564Q, 564Q exp.
Community in drought areas
1969
1971
1 579 900
2 118 700
Drought relief in form of food for work
610
Institutional
1971
1976
1604 100
2 174 900
Food to secondary schools hospitals & brigades
2074Q
Agricultural improvements for small farmers threatened by drought
1973
1974
80 000
167 500
Reward to farmers who adopted improved farming practices
2. Emergency
feeding
development stricken
feeding
operations
Date approved
WFP project No.
Title of operation
824 861 861 995
Famine & drought relief Aid to drought phase 1 Aid to drought phase 2 Drought
a
Date food distribution
commenced
b
Date food distribution
terminated.
c Cost on WFP tinuing projects, December 1975. Source: World
valuation: cost is
with conup to 31
1965 1968 1969 1973
Total WFP cost ($1 2 030 801 236 163
400 500 900 900
response to drought-provoked emergencies and on a continuing basis. From 1965 to the end of 1975 WFP committed to Botswana some $26 M to cover food and associated expenses, representing some $40 per capita, and it shipped 15 122 tons of commodities. This aid has been used in three ways:
Food Programme
0 3 WFP is the only major supplier of food aid to Botswana. A major issue to be considered is whether food aid acts as a disincentive to local agricultural production, since such effects have to be set against any nutritional or other benefits. Although the effects of food aid on agricultural production are not considered in this article, they are dealt with in the author’s ‘Food aid: more sinned than sinning?‘, against ODl Review 2. 1977. Both articles are based on the findings of an ODI research project that is investigating the impact of food aid continuedonp20
FOOD
Drought related food to livestock
POLICY
February
1978
0 0
To provide rations for food for work campaigns linked to the periodic droughts. To replace food purchases by institutions such as hospitals and secondary schools. To supply rations to various feeding programmes. (See Table 1)
If these projects are ranked according to the number of beneficiaries, the third group is clearly the most important. In 1975 it reached 2 17 000 people,8 half of whom were primary school children while the remainder comprised three categories of people described as ‘vulnerable groups’, namely pre-school children, pregnant and lactating women and TB outpatients. The present article concentrates on this single WFP project.’
19
Food aid arrdnutritiorr
continued
from page
?9
in Botswana. Lesotho, Upper Volta and Tunisia, and considering in particular how the mode of administration influences consumer prices, agricultural production and nutrition either directly or indirectly government its impact on through policies, The full results of this analysis will be published as a book. The conclusion for Botswana, a food deficit country, is that food aid has not formed a significar~t disincentive to agricultural production. ?he justification for excluding a full discussion of this, and many other corollaries of food aid in this article is the practical one of space. National prices, d At 1973-74 Devel~pfff~ntP~a~ 1976-81, 1977.~6. 5A separate currency, the Pula, was introduced in 1976. However, since the data for this article mainly predates the most figures are change, currency denominated in Rand. The rate of exchange in 1975 averaged R 1 =$l ,4. 5 National Development Plan 1976-81, p 135. ‘Ibid p 44. For further details of the Botswana economy see David Jones, Aid and Development in Southern Africa, ODI/Croom Helm, London, 1977. * In the sense that this number of people benefited at some time, although not necessarily reguiarly. 9 Project no 324 exp Feeding of Primary School ~bi~dr~~ and VuJner~ble Groups. la For a discussion of the relative merits of food aid and financial aid see Christopher Stevens. op tit, Fief 3. ” Figures refer to expenditure by the Institutional Food Programme during financial years 197 I-72-1975-76. ‘*This is illustrated in the current development plan which devotes several paragraphs in the Ministry of Health section to the mother and child health and nutrition programmes without ever mentioning food aid. mixtures of foods r3 Blended are nutritious commodities designed to make full use of foods that are in surplus supply. The most usual blend in Botswana is corn sova milk ICSM) which has formed 69% by’ weight of all the WFP commodities shipped to Botswana by the first quarter of 1977. A further 12% by weight has been in the form of instant corn soya milk (ICSM). Information from WFP.
20
All WFP food aid to Botswana has been provided as a grant, including the cost of transport and administration to the country’s border. The government is responsible for the food once it enters the country, although in practice it has been abie to share the financial implications of this burden with others: many of the warehouses used to store the food were constructed with aid funds from various sources: a WFP internal transport subsidy is under discussion, as is requested UNDP assistance to renew the fleet of food aid vehicles and other ancillary equipment. Nevertheless, the administration of food aid does involve the government in expenses over and above those associated with the same value of financial aid.‘O Between 1971 and I975 Botswana received food aid valued by WFP at R3.9 M, and during the same period spent R854 589 on related administration and logistics,’ i Not all of these expenses are attributable to food aid since they would have been incured administering the project whatever the mode of finance. Of course since food aid is tied both to commodity and to source the notional valuation by WFP may overstate the value of the transfers to Botswana. A rough attempt is made below to untie the aid and estimate its true value for the recipient. This suggests that untying by source although not by commodity reduces the value by some 10%. If this figure, calculated by reference to the commodities supplied to primary school and vulnerable group feeding projects, is accepted for all WFP food aid to Botswana, the total value of the transfer is reduced to R3.S M. Food aid and project costs together thus represent some 24% of receipts. The task of accepting, storing and distributing the food has always fallen to a special self-contained unit which has been known by several names and has fallen within the portfolio of several ministries during its existence, but which has always been an indentifiable organization. Currently known as the Institutional Food Programme (IFP) it comes under the aegis of the Ministry of Local Government and Lands because, when allocating food, it works closely with the District Councils and the decentralized arm of central government, the District Ac~ministration‘ The primary school and vulnerable group feeding projects also involve the Ministries of Health and Education. This split between responsibility for the logistics of supply and for the programmes into which food aid is injected has been an organizational success, with IFP developing an expertise in its field which has not been offset by poor inter-ministerial co-ordination. At a policy level, however, it may have contributed to a certain lack of interest by the specialist ministries in the food aid they are using.‘*
Primary school feeding Primary schools have been receiving food aid continuously since before independence in 1966. The current WFP project is an expansion of a project approved in April 1966 which was itself a natural continuation of the emergency assistance provided during the severe drought of the mid- 1960s. Under the present scheme, primary school children receive a mid-morning meal of blended food’” and vegetable oil. There are 4 categories of primary school in Botswana. 1.
A small group of English language schools provides a high standard of education which is reflected in high fees; they are currently administered directly by the Ministry of Education.
FOOD
POLICY
February
1978
2.
3.
4.
A second group of government financed Setswana fanguage schools are administered by the local councils with the Ministry of Education providing professional advice and supervision. Fees are currently R3 per annum. Private schools registered with the Ministry of Education. Many of these are administered by missions, and some are assisted financially by Government. In 1975 there were 22 such schools compared with 301 in categories I and 2.14 Private schools not registered with the Ministry of Education in which teaching standards are often very low.
Food aid is received by virtually all primary schools in categories 2 and 3 but by none in categories I and 4, Since schools in categories 2 and 3 provide the bulk of primary education, school feeding is clearly an accepted and integral feature of the education system. In 1975, 305 schools and 110 689 pupils received food aid.” The programme has been accorded 3 different, although not mutually exclusive, goals by various observers: 0 0 0
To combat malnutrition and to assist poorer families. To improve scholastic performance. To increase school attendance.
~~‘~it~~tio~
I4 Education Statistics 1975. Gaborone, Table Al. I5 Ibid. Table Al 9. ‘6 World Food Programme document WFP/IGC: 1317 Add 25 (20 March 1968) Rome, para 1; and National Development Plan 7976-87. Gaborone, para 4.63; emphasis in original. ” Given the emphasis on nutrition by the donor, it is surprising that there has been so little work to measure the nutritional effects of the aid. leThe enrollment figures do not include pupils at unregistered private schools. Natioi~al Development Plan 7976~81. Gaborone. Table 6.1. l9 Isolation may be another factor, but it is one that is linked to poverty. First, there is reason to believe that isolated families are especially vulnerable. Secondly, those families living in remote settlements who are not poor are often able to send their children to live with friends or relatives in larger villages so that they may attend school. 20 National Development Plan 1973-78, 7.43. National Gaborone, para Development Plan 1976-81, Gaborone, Table 6.1.
FOOD
POLICY
February
1978
This goal is subscribed to by both WFP and l.he Botswana government. Indeed, according to the former ‘The main purpose of this project is to combat widespread malnutrition and undernourishment . . +’ while in the view of the government ‘The primary sc~ool~ed~~g ~rogru?n~e, as well as ensuring better child nutrition, represents one of the few effective means by which Government can help poorer families directly . ..‘I6 The school meal has sufficient nutrients to make a significant contribution to a child’s daily food needs. However, the impact of the project on nutrition Ievels does not depend only on the size of the ration. School feeding can be said to have alleviated malnutrition only if it reaches children who would otherwise have been malnourished and it results in a net increase in the quantity and/or quality of the food consumed by the child. No surveys have been conducted on the scale needed to ascertain with certainty whether the school meal has in practice made a significant contribution to combatting malnutrition.” However, since primary education is not universal despite a sharp rise in enrolment over the past five years, there must be some doubt ov’er whether the meal reaches those most in need. In 1975 there was a primary school enrolment of 116 293, which represents 89.5% of the 7- 13 year age cohort. This comparison, however, overstates the proportion of school age children at school, since enrolment includes pupils outside the age cohort. The actual enroiment of pupils aged 7-13 (92 763) represents 71% of this age range.18 The precise reasons for nonattendance are not known, but poverty is thought to be the main factor:lV following a decision by government in 1972 to halve the fees for local authority schools from R6 to R3 per annum the number of first year enrolments increased by 58% in the following year, and by 1975 the number of primary school pupils was 34 63 1 more than in 1972 and 18% higher than the original planned target.*O There is reason to suppose that the primary school-age population
21
*’ f3otswane ~~V~~~rn~n~F~U Wnrfd Foad Pro~~~mm~, A Study of Canstraint$ an A~~fcoftoraf De~efapmc~~t in the Republic: of ~ats~en~~ Rome, 1974, pp 5-6. =z Ibid, fable 6. 23 Report on the Pap&tion Census 1971,
Central Statistics Office, Gaborone, 1972, “r&lo 7. 24 The Rural Income Distribution Survey in Botswana 1974-75. Central Statistics Qffice, Gaborone, 1976. 26 fbid, para 8.3.2.
is evenly distributed across income groups. AIt~ougb there is no direct evidence of the relationship between the two, it is possible to make a rough estimate by using participation in food for work as a proxy for income. A survey carried out during 1971-72 interviewed 1021 rural households to discover whether participation in food-foswork was related to decreasing agricultural production. One of its findings was that there existed a positive correlation between the poverty of a househotd and the length of its food-for-work participation- *’ Nowever, it found no signi~cant difference between the age groups represented in ~artic~~at~ng and non~part~c~~ating househoJds: 44% of the population of households that had never participated in food-for-pork were in the 0-14 year age group, compared to 45% for households irt which at least one member had participated for six months or more.z2 These proportions are very close to the national age distribution measured in the most recent (197 1) general census which found 46% of the population to be between the ages 0 and 14.23 The food-for-work survey also found that there was only a small difference between the household size of participating and non-participating families. If it is assumed ~reaiistically} that school-age children are evenly spread over income groups, and also assumed (less real~stically~ that poverty is the so/e determinant of non-attendance at primary school, it may be concluded that the households of the 29% of ?- I3 year olds who do not attend schooi belong to the poorest 29% of the population. An important survey af rural income distributions based on a random sample of IO60 households,24 found a 1974-7.5 median annual income of R630, and a mean of R I 068. It also calculated the annual household income of various percentiles of the population, The income of the poorest households, the first percentile, was R 121 per annum, and that of the thirtieth percentile was R402. On the basis of the above assumptions, it would seem that the primary school population comes from househotds with an annuaf income of R402 and above.‘s Clearly the assumption that poverty is the sole determinant of nonattendance is somewhat suspect, However, even aDowing for a margin of error it appears that the primary school lunch progr~mme misses those families for whom such transfers are likety to form a significant addition to income. The rural income distribution survey report presents a detailed analysis of the source of income of 5 7 households, A summary of the results is given in Table 2 which shows that the income groups most likely to receive primary school lunches obtain
LOWeSt
Highest
: 3 : Source: Survey
Statistics 101.
22
l*hs Rural income Distribution in Batswana 7974/75, Central
Off&+, Gaborone, June 1976, p
Transfers Gathering Employment Farming Housing
Proportion which is in kind 71%
to 50%
ta 99*7%
SO% to 95%
w7%
~RlpfOyment Farming Transfers Gathering Manufacturing
Employment Farming Property Transfers Housing
Livestock Trading Employment Housing Hunting
49%
42%
32%
f5%
Food aid and nutrition less than half their income in kind, and are not heavily dependent on transfers. By contrast, the opposite is the case for the income group least likely to receive the lunch: it is particularly dependent on transfers and income in kind.
26 A typical meal schedule in eastern Botswana is 6.30 9.00
am am
1 .OO pm 4.30 6.30
pm pm
for a household
Tea and bread Breakfast ~ fermented sorghum porridge and milk Fermented sorghum porridge or maize and bean mixture. Tea or sorghum bear Supper ~ fermented sorghum porridge, bean leaves and/or melon, tea and bread.
Andrew G. Hamilton, Rural Consumer Food Preference and Grain Storage Survey ~ an interim report, Gaborone, 1975, p 32. *‘That is, where half a class has lessons during the first part of the morning while the other half is taught during the second part. Of course some of the benefit might be carried over to the following day in cases when the meal is served after lessons have ended. The multiplicity of possible effects merely underlines the need for controlled tests to measure the impact of the meal. Interestingly, the potential of school meals to improve scholastic performance has recently been stressed in the UK by the Association of Assistant Mistresses, although again on the basis of teacher experience rather than controlled experiment. Concentration in School. How it can be helped and hindered. AAM Discussion Document, AAM. 29 Gordon Square, London, WC1 H OPX, Julv 1977. 2*This point is linked to the first of two corollaries of both primary school and vulnerable group feeding that are discussed below: their impact on the family economy. and their implications for the Government’s recurrent budget. ” Pre-school children are defined as those between six months and five years of age.
FOOD
POLICY
February
1978
Scholastic performance The argument here is that by the middle of the morning, school children are hungry and that when they are hungry their capacity to learn suffers. For those pupils who have an inadequate diet at home, the lunch may also provide the additional benefit of improving their resistance to disease and hence of reducing absences from school due to illness. In other words, school lunches, just like books, desks and classrooms, improve the efficiency of learning. Certainly many pupils leave home in the morning without eating breakfast.26 Primary classes typically run from 7.45 am to l-00 pm so that if the children have to travel some distance from their home to school it is likely that they will miss both breakfast and lunch. The overwhelming opinion of teachers consulted during the fieldwork for this article was that school meals do improve performance. Against this, however, the effectiveness of the meal as an aid to learning may be reduced in some schools where there is double streaming2’ and the lunch is not served until after lessons for the day have ended. The timing of meals could, of course, be altered to avoid this difficulty. Unfortunately, no tests or other objective evidence exist to support or undermine the view that school lunches improve performance. According to the Botswana Ministry of Health, such tests could be devised but this has not been done. A tterrdance There are three ways in which food aid may increase school attendance. First, if school food improves the general level of health of the children, they will spend less time away from the classroom due to sickness. Secondly, food aid may act as an incentive for parents to send their children to school. There is no evidence that this is the case in Botswana where education is highly regarded among most social and cultural groups. Indeed, when for administrative or other reasons the supply to schools has broken down leaving them without food, sometimes for several months, no decline in school attendance has been observed. Thirdly, food aid may act, if not as an incentive then as a useful income supplement to those families which, though they are not among the poorest households, can barely afford school fees.28
Vulnerable group feeding Food aid under this heading is supplied to pregnant women, nursing mothers, pre-school childrenZY and TB out-patients on the grounds that they are both vulnerable nutritionally and of potential economic significance. Pre-school children are the labour force of tomorrow and their future contribution to economic development will be affected significantly by any malnutrition in their early years. Young mothers must stay healthy if they are to feed their babies well and produce strong children in future. In a society where the bulk of arable farm labour falls on women, they also have productive years ahead. Rather different considerations apply to TB out-patients. TB is one of the
23
most widespread serious diseases in Botswana and in 19’74 sufferers were the second largest group (6%) of in-patients (after childbirth) in the country. 30 Since a majority of them were under 44 years of age the fight against the disease has a direct effect on the size of the labour force. The main reason for singling out TB patients for free food is, however, that out-patient treatment requires attendance at a clinic over a long period of time, and the food ration is intended as an incentive for regular attendance, although whether it achieves this objective is not known. It may be more effective in encouraging TB patients to attend the clinic than it is in popularizing education, the value of which is much better appreciated by the general public. The food aid programme is not directed towards vulnerable groups with no potential economic significance. The elderly destitute, for example, receive food aid, if at all, only through the emergency food for work campaigns. Like school meals, the ration supplied to vulnerable groups could make a significant contribution to the beneficiaries’ nutritional requirements. However, once again it is not just the size of the ration but also the background of the recipients that determines its impact. To achieve its aims the programme must reach individuals who would otherwise suffer from malnutrition and must actually result in an increase in the quantity and/or quality of their food intake. Clearly, not all pre-school children and mothers are in need of food aid. Those with adequate incomes can look after themselves. Some selection is therefore in order. The programme currently reaches about 62% of expectant and nursing mothers and about 80% of preschool children, although not necessarily on a regular basis. Thus, selection does occur but there are no firm data to indicate its basis.
3o Medical Statistics 1974, Gaborone, Table 14. 31 Report on the ~o~u/e?;on Census I97 I, Gaborone, 197.2, Table 6. 32 In practice, Botswana has shown a considerable degree of initiative in setting up as many feeding points as it has. In many developing countries food for vulnerable groups is distributed from hospitals, clinics and health posts. In Botswana the network of health facilities is very poor. The number has been increased rapidly in recent years, but by 1974 there were still only 266 health facilities, of which 13 were hospitals, 8 health centres, 47 clinics and 198 health posts. The health network has therefore been supplemented for distributing food by voluntary feeding centres, which are run by voluntary groups such as the Botswana Council of Women, YWCA, and village development Red Cross committees, to the extent that only some 14% of the 3 12 feeding centres operate from health facilities. 33 The Rural Income Distribution Survey in Botswana 1974-75, Gaborone. para 8.3.8. M Ghanzi, Kgalagadi, Western Central, Western Kweneng, and Western Ngwaketse. 35 Op cit. Ref 33, para 8.3.6.
24
Who receives the food? It is likely that there is some geographic selection. There are only 3 12 centres from which food is distributed to vulnerable groups? compared with 527 settlements with a population of over 200 people.” Some people will travel from their home to the nearest feeding centre in another village, but this is not always possibie, particularly in the less densely populated west of the country. In the north west in Ngamiland, for example, there are 58 settlements of over 200 people but the regional depot at Maun supplies only 17 feeding centres. It is difficult to see how this sort of coverage could be significantly improved without administrative overheads that are unacceptably high both in terms of money and more especially of manpower particularly in the sparsely populated areas.“2 However. even though it is probably unavoidable, geographic selection will exclude some members of the target population, particularly if it is assumed that people living in remote settlements are likely to be particularly vulnerable. The rural income distribution survey found that the median income in the north and north west (Ngamiland and Chobe) was R446, compared with a national figure of R630, and that the income of the tenth percentile (at R164) was only 70% of the national level. 33 Income levels in other western areas34 were also found to be lower than the national average although to a less marked degree. Another difference was found between residents of large villages (with a median income of R887) and those of small villages, lands areas and cattle posts (with a median of R6 IO).35
FOOD
POLICY
February
1978
There may also be some seif-seiection, with those who do nut need the food not bothering to collect it. Some recipients stopped attenders distribution centres when the present ration was ~ntroduced~ this may have been Linked to the substitution of a blended food for the more versatile dried skim milk that can be reconstituted and, for example, added to tea. Regrettably, experience elsewhere suggests that selfselection IS not normally an adequate basis for concentrating coverage on the needy. There is very little selection by those administering the food. The staff at the voluntary feeding centres are often not trained to apply any selection criteria, but there is no evidence of any more active selection occuring at the health centres. This must be partly due to the absence of any criteria for selection. A WFP evafuation mission in 1970 recommended that the ~o~~rn~e~t establish a set of criteria, but this has not been done. If the food available is sufficient for afl who come to the distribution centres there would seem to be little incentive for government to enforce selection which will not help it to reach vulnerable individuals who were previously missed but will simply exclude those who are not vulnerable. This will be achieved at the expense of precious manpower, and at the risk of exduding deserving cases through poor c~assi~cation and of encouraging people to shift their attendance away from clinics to the voluntary feeding centres where selection is likely to be less rigorous. Xowever, if the demand exceeds the supply, the advantages of selection become much greater. A first step is thus for the authorities to discover whether demand is greater or less than supply, and there are signs that a reporting system to provide this information is being instituted.
36 Misuse in the sense of use other that foreseen by those planning project.
than the
There remains the question of whether the recipients actually consume the food they receive. With primary school feeding this problem does not arise directly since the children are offered a ready cooked meal with the option only of ~~bethe~ to take it or leave it. Food for vulnerable groups is normally distributed uncooked at weekly or even monthi~ intervals. There is therefure no guarantee that it is actually consumed by those to whom it is given. There is no evidence of widespread misuse of food aid, for exampte by seiling it. It is also probable that misuse 36 has declined since blended food was substituted for dried skim milk. On the other hand, it is very probable that the recipient is not the only person who consumes the ration it is most unlikely, for example, that a young mother would return to her home with a sack of food and refuse to share it with other members of her family, Such sharing would appear to be inevitable and it could be argued that it is not necessarily undesirable. The vulnerable group feeding pro~ram~e has two other goals of an ~~c~tio~al nature. One, given considerable emphasis in some countries, is that food aid can be used as an incentive to mothers to attend centres at which they can be given genera1 he&h education talks and demonstrations. Such talks are given regutarty at the clinics from which food is distributed and occasionally from voluntary feeding centres. However, this seems to be a secondary goal in Botswana, as is evident from the use of voluntary feeding centres staffed by untrained personnel. Secondly, the programme has given a boost to voluntary community groups by forming a tangible core activity around which an organization can develop. Many women’s
25
Food aid and nutrifion
groups have been formed around food distribution still their main activity.
Table 3. Primary school and vulnerable group feeding rations established in 1966 Daily ration
Commodity
Unit value @ (RI
Primary school children Dried skim milk Veaetable oil Maize meal Egg powder
2% 150 1509 %I
1.43ikg 0.97lkg O- 1Oikg
3-48lkg
Vulnerable groups Dried skim milk Vegetable oil
209 1OQ
a Calculated for Lesotho Maseru, August 1975. Source: World ment WFP/IGC: 1966, Table 1.
Food 10.12
f .431kg 0,97/kg
by
WFP
Programme docuAdd 9,28 October
Impact on the family economy Food aid in these programmes represents transfer income in kind to the recipient households. This is fairly clear in the case of vulnerable group rations but it also applies to the primary school meal. Although school meals are often considered as additional consumption by the child, this need not be the case, Parents may deliberately reduce the size or quality of meals they provide for their children during periods when they are at school in order to save money. Alternatively, children may simply not desire as much food at home when they are receiving a school meal. There is no firm evidence to indicate whether or not either of these is happening. However, if school meals result in a less than proportional increase in a child’s total consumption, then in addition to improving nutrition or scholastic performance the food aid programme will also result in an income transfer to the child’s family by enabling them to reduce their expenditure on his food. The same is true of rations supplied under vulnerable group feeding. This transfer could have one or more of the following results: 0 l l e l
37 World Food Programme document WFP/IGC:28/11 Add A4, August 1975, para 26. 38 Based on R7.10 per 22.68 kg cif for CSM/CSB and RO.76 kg cif for vegetable oil. 19 No calculations have been made for the locally the purchasing cost of commodities WFP supply. However, such an exercise has been undertaken by WFP for Lesotho where the cost in August 1975 was estimated as R0.25 per kg for blended foods like CSM and R0.97 per kg for vegetable oil. These figures may be used as a rough guide for Botswana. ‘OThe task of identifying - a local substitute is complicated because of disagreement among nutrition experts about whether the beneficiaries of food aid really need the high grade nutrients supplied by WFP food, or whether they merely need additional calories that can be supplied in cheaper foods, notably cereals. The author is not competent to adjudicate between these viewpoints. However, the value of a ration based entirely on cereals and vegetable oil could be 40% less than the national WFP figure.
26
and for some it is
Increased consumption by members of the family other than the direct beneficiaries. Increased wastage of food. The release of home produced food for sale. An increase in family food stocks. A fall in total family expenditure on food.
The scale of these transfers will depend on the degree to which the initial beneficiaries pass on the benefits of their rations to other members of the household, but a ceiling will be set by the value of the food aid supplied. This value can be defined in 3 ways: the notional value of the food according to the donor’s accounting, the cost of purchasing the same commodities locally and the cost of purchasing locally available substitutes. The school ration has varied from one institution to another, but since 1975 the recommended meal has been 150 gm of corn soya milk (CSM) and 15 gm of vegetable oil per child per day.37 The official vulnerable group ration is 80 gm of CSM and 15 gm of vegetable oil per day. The notional WFP value of the primary school ration is a little under 6 cents per day or approx Rl 1 per year assuming a 39 week school year; for the vulnerable group ration the figure is R2 1 for a full year’s suppty. 38 On a local purchase basis the annual value of the ration falls to R IO for school meals and R 19 for vulnerable groups3” CSM is not available through normal retail outlets in Botswana, and it is improbable that either parents or the government would attempt to supply it in the absence of WFP food aid. Locally available products would be supplied in its place. No work has been done in Botswana to identify which local foods would be substituted, and clearly the identification of an acceptable package is a job for a specialist. 4o A rough proxy for the cost of local foods with similar nutritional characteristics is obtainable by refering to the ration used by WFP before the introduction of blended foods. The results are shown in Table 3 and suggest that although CSM is an exotic
FOOD
POLICY
February 1978
Food aid and nutrition
commodity for Botswana it is competitive in cost with more common foods4 i If the figures RIO per annum for school meals and R I9 per upturn forvulnerable groups are used as a rough guide, the value of the food aid transfer may be compared with total household income. The 1971,.72 survey concerning the impact of food for work on agricultural production found an average household size of 6.2 residents.“* If this is taken as a guide, a typical 6 member household might include as potential bene~ciaries of the two food aid projects: I young mother, 1 primary school age child and 1 preschool chitd,4” If all three were receiving food aid, the annual value of the transfer would total R48: if the school age child was not at school this total would be reduced to R38. These figures are compared in Table 4 with the total income of various percentiles of the population taken from the rural income distribution survey. The Table suggests the rations could form an important addition to the income of the poorest houseilolds and a not insignificant contribution for all families receiving less than the median wage.
Impact on the recurrent budget
” Using the estimates made by WFP for Lesotho. the value of the primary schoot ration is actually higher than with CSM at Fill .80 per annum~ although the value of the vulnerable group ration falls to R16. 42 Government of ~otswana/~AO World Food Programme, A Study of Constraints on ~~ricult~rai Development in the Re,oubfic of Botswana, Rome, 1974, Table 4. qJ See The Rural Income Distribution Survey ii, Botswana 1974-75, Appendix 15 for a suggested age distribution of a 6 member household. “Education Statistics 7975. Gaborone, Tabie AZ 9. 48 Ibid. Table 1 1. ” Government of Botswana, 5o~swa~~ Project 324 Expansion: ~uarteriy Progress Report, I July 7975 to 30 September 19 75. 47World Food Programme document, WFP!IGC: 28/l 1 Add A4, August 1975, P 9. a8 Quarterly 46.
Progress
Report,
Op ci?, Ref
School meals have been provided free for over IO years. Food aid has, in effect, underpinned part of the government’s recurrent education budget, and it has done so to a fairly marked degree. In 1975, I 10 869 school children received meals?” If the value of the ration is taken as the local replacement cost (RlO per ann~rn~ this represents a total cost of Rl 108 690 or a full 37% of total central and focal government recurrent expenditure on primary education in 1974.45 In practice, the actual utilization of food tends to be less than the planned level due to administrative problems, and nonconsumption by some pupils. Actual utilization is approximately 85% of planned levels for CSM and 61% for vegetable oi14” If total expenditure is reduced to take account of this, it becomes 30% of total recurrent expenditure. Vulnerable group feeding can also be seen as an addition to the recurrent social welfare budget, although in this case it appears to be less of an addition to the system than the dominant partner. O~~ialiy, there are some 107 507 beneficiaries of this project,J7 but not all attend regularly. Actual utilization of Lhe established ration is approximately one-half for CSM and one-third for vegetable oil.48 Using these figures for beneficiaries and utilization rates, and the local replacement value of the ration, total expenditure is R582 714 per annum. The only other continuous welfare provision made by the government for vulnerabte groups (including those such as the elderly
Table 4. Value of food aid rations as a proportion
11)
Pe~cen~iieof the
~o~uiation a 1st richest.
percentile
=
poorest.
99th
21
Source: The Rural income Distribution Survey in Botswana 1974175. Central Statistics Office, Gaborone, 1976.
FOOD
POLICY
February 1978
1 IO 20 30 50
a
(2)
(31
Annual boosehold income
R48 as % of (21
121 233 325 402 630
12 7
of total household
income
(4) R38 as %
of
(21
31 16 72 -
2f
destitute that fall outside the food aid programme) is in the form of assistance given by District Councils. The most recent figures of total Council expenditure are for 1972. That year the combined expenditure of all Councils on destitute relief was R9 728.49 More recent figures are available only for the Councils’ budget estimates. In 197576 these stood at R65 970. In 1972 actual expenditure was 68% of the budget estimate. If this proportion is assumed to hold good for 1975-76, actual expenditure would be R44 860 or 8% of the value of food aid to vulnerable groups.50
Food aid and nutrition
4g Audited accounts for each district. “-‘This probably overstates the scale of Council relief because the budget estimates for both the preceding and succeeding year are substantially lower. 5’ Op tit, Ref 1. 52Ibid, p 235. 53 One possible reason for the narrow approach to the subject stems from the role of the food aid donor. It is reasonable to conclude that primary school and vulnerable group feeding schemes exist in Botswana today because the World Food Programme offered assistance to initiate and continue them. The projects operate in the way they do because that is how WFP projects operate. The wide gap between the level of welfare provision made for young mothers and children on the one hand, and other vulnerable people, such as elderly or destitute, on the other stems largely from the willingness of foreign donors to provide continuing help for the former and not for the latter. 54 See Robert Wood, Kathryn Morton. ‘Has British aid helped poor countries?’ ODI Review, No 1, 1977, p 58.
28
In his article” on the conceptual and operational problems of nutrition planning John Osgood Field distinguishes between the ‘intellectual establishment’ view and the ‘bureaucratic’ approach. The former is broad and multi-sectoral while the latter is narrowly focussed on specific topics. The use of food aid for nutrition in Botswana clearly falls into the bureaucratic mould. Attention is focussed on the logistics of getting food to the people, rather than on the ultimate nutritional objective of the exercise. The case study provides support for Field’s general contention that although nutritional planning is not an end in itself and must be justified on the basis of what it contributes to improved nutritional status ‘this final link is rarely considered before programmes are launched, and even today it is not always assessed very adequately afterwards’.52 The primary school feeding project is a case in point. Both donor and recipient justify this in terms of combatting malnutrition even though the scheme almost certainly excludes those most in need. There are other desirable objectives that primary school feeding is much better designed to achieve, such as improved scholastic performance. However, because of the emphasis on general nutrition, tests to measure its impact on scholastic performance have not been made, and little attention has been paid to organizing the scheme in a way that maximises its impact on this, for example, by altering the timing of meals. Despite the emphasis on nutrition there has been no attempt to measure adequately the actual impact of food aid on the level of malnutrition in the target groups.5” Nevertheless, although food aid falls into the ‘bureaucratic’ definition of nutrition, it must be admitted that it is a good example of its kind. Although the issue of food aid may more often be seen in terms of logistics than of ultimate objectives, it is certainly the case that the logistics are good for a large and poor country with very weak infrastructure. Again, although food aid undoubtedly misses many of the poorest people, it seems probable that a large number of poorer people do benefit from it. A convincing case can be made that foreign aid in general has biased development spending in favour of lumpy capital projects and therefore away from sectors in which the need is for more recurrent resources.54 Food aid, by contrast, has achieved the opposite effect: it has added to the recurrent resources for education and health.
FOOD
POLICY
February 1978