AFRICA

Benin
Botswana
Burkina Faso
Chad
Ethiopia
Gambia
Ghana
Lesotho
Madagascar
Mali
Mauritania
Niger
Rwanda
Sudan
Tanzania
Togo

AFRICA

Benin

The people's Republic of Benin (formerly Dahomey) has an area of 112,622 sq km, with a population estimated at 4.3 million (mid-'87). Over three quarters of these live in the Southern region leading to a locally high - by West African standards -population density of around 120 per sq. km., as compared with 38 per sq. km. nationally. The population is growing annually at a rate of 3.2%. The south of the country has an equatorial climate, while the north is tropical. On average, both north and south have around 1,300 mm of rainfall per year, although the north has a distinct wet season, while in the south the rainfall is more evenly distributed throughout the year.

Until recently, Benin has experienced difficulties in establishing and maintaining a steady rate of development. Factors which contributed to this include north-south divisions, significant underemployment of a well educated and substantial middle class, and a slow rate of growth in the economy. In 1974 the then regime undertook a programme of nationalization. Relations with Western nations, especially France, deteriorated subsequently. However, since the beginning of this decade, the Government has turned more to the West for aid, financial support and investment.

Agriculture

The agriculture sector accounts for 49% of GDP and employs around 64% of the labour force. Normally Benin is reasonably self-sufficient in the production of staples. The latter is supplemented by significant live-stock and fishing industries. However, Benin suffered drought conditions from 1981 through to 1984. This had a considerable impact on the production of food crops (see Food Production Index). Cereal imports rose during this period; cereal aid peaked in 1985 (Cereals: Aid & Imports). Harvests in 1984, '85 and '86 showed a full recovery, although shortages were again felt in 1987 (Food Shortages) after early indications of a good year. Cereal production for 1987 was some 20% less than in 1986 (Cereals) - this was ascribed to badly distributed rains compounded by above normal storage losses. Cereal availability followed the production pattern closely. Food availability (as per capita Kcals, see Kcals per day) shows a marked drop in 1983 following the poor harvests of the two preceding years. Improvements occurred in 1984 as a result of the adequate harvest. Because of the poor maize crop in 1987, FAO reported an urgent need for exceptional food aid in 1988, particularly in the maritime region, which suffered a severe maize shortfall in 1987.

The Economy

The economy has experienced a number of difficult years during this decade, in spite of improving revenues from petroleum in the early eighties. Benin's economic growth is strongly linked with that of neighbouring Nigeria, her major trading partner, both in terms of recorded and unrecorded trade. However, Nigeria has been experiencing an economic recession which depressed Benin's economy. This was further exacerbated by the closure of the border between the two countries for 3 years between 1984 and 1986. GNP (measured in local currency at constant prices) grew by 19% between 1980 and 1986 (GNP), an annual growth rate of just under 3%. The average annual inflation rate for this period was 8.6%. Debt outstanding and disbursed (Debt) and the total debt service as a percentage of exported goods and services (Debt Ratio) have been rising continuously. The latest estimates for the debt ratio is 28.8% (1986), up from 9.2% in 1983. To counteract these trends, the Government announced in 1984 a series of austerity measures. In 1985 discussions began with the IMF. In the same year the exchange rate reversed its long and substantial decline (Exchange Rate). By January 1987 the rate for the CFA Franc¹ had increased by 74% over the Jan. '85 rate. In 1986 Benin requested and obtained a rescheduling of its foreign debt and increased financial aid.

¹ The Communaute Financiere Africaine franc is the common hard currency for most of France-speaking Africa and has been tied to the French franc since 1948.

Health-centre based weight-for-age data on children under five were provided by the Catholic Relief Services/Benin. These data are collected by the Ministry of Labour and Social Affairs in collaboration with CRS. Monthly prevalences of children below 80% reference weight-for-age are graphed from May 1982 to Dec. 1987 (Underweight Children). The de-seasonalized prevalences are also shown. Overall, a trend of gradually declining prevalence of low weight-for-age is evident in these data until mid-'86. Relatively good harvests in late 1984, which were sustained in 1985 and '86, coincide with this decline in prevalence of underweight. However, a sharp rise from 35% to 42% prevalence is seen in the latter half of 1983 through to mid-1984 following prolonged poor food production and availability figures. Prevalence also rose strongly in mid-1986 and continue upwards through to late 1987. This reversal again coincides with poor production and recorded food shortages.

The pattern seen in the national data is repeated - with minor variations - in the regional figures (shown de-seasonalized) which are reproduced (Regional Prevalences). The prevalence data also show a strong seasonal component (Seasonality). The lowest prevalence of under-weight children is generally observed from August-September, which corresponds to the harvest period, while the highest prevalence is usually seen from April-June.

BENIN

POPULATION: 4.3 M	IMR: 111
POPULATION DENSITY: 38 per sq. km.	U5MR: 188
POP. GROWTH RATE: 3.2% per annum	GNP (PER CAPITA): US$270
PERCENTAGE URBAN POP.: 38%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 20% - 30%

GRAPHICS

GRAPHICS

Botswana

Botswana's food and nutrition situation is unusual in many respects. With normal rainfall (which has been rare recently) only about one quarter of staple food needs can be met from domestic production. In fact, livestock accounts for much more rural income than cropping agriculture. Secondly, Botswana's economic growth had been particularly rapid until the 1980's. Foreign exchange from diamond production, and beef to a lesser extent, allows substantial cereal imports to meet domestic needs; recently this has been supplemented by food aid. But even more important perhaps, organization of rural programmes to provide income and food distribution is exceptionally effective. Among these is a widespread system of nutritional surveillance, based on weights of pre-school children attending clinics.

Before 1988, there were six consecutive years of severe drought. The previous "normal" pattern of rainfall and production was in 1980-81. Prevalences of underweight children (see Underweight Children) show the seasonal pattern for 1980-81, increasing towards the end of the year (by around 5 percentage points), then falling again after the harvest around March-April. With the onset of drought in 1982, the pattern changed, seasonality largely disappearing with a slight upward trend in prevalence through 1984 - seen also in the de-seasonalized plot (Prev. De-seasonalized). These data, derived from health centres, are particularly subject to changing coverage, since attendance rates rise sharply in times of drought because of food distribution through the health system.

The reporting system was modified at the end of 1984, and the data must (at present) be treated as a discontinuous series. It is almost certain that malnutrition did not rise between 1984-85, but at least part of the apparent fall is related to the reporting change.

From 1985 through 1987, therefore, malnutrition probably fell slightly, despite the drought - a result of the effective relief measures. Overall, there is little doubt that a major crisis was averted, and hunger and malnutrition in many of the rural areas contained.

The effects of the drought can be judged indirectly from the food production index (Food Production Index) - which includes estimates from livestock and from total cereal production (Cereals: Production). The drought struck in 1982; cereal production, for example, declined from nearly 50,000 MT in 1982 to only 6,000 MT in 1984. The numbers of head of cattle was reported to fall by about a quarter, from around 3 million to about 2.2 million, between 1982 and 86-87. Cereal imports and food aid increased over the next two years, so that by 1984 total cereal availability and calorie availability (from food balance sheet data) were in fact higher than before the drought. The relative cost of food (FPI/CPI) increased from 1980, but was largely stabilized by 1984.

Since 1983 the reported annual (and monthly, for Lobatse Region) incidence of measles had been rising; these peaked in 1984 and declined thereafter.

Restoring the overall availability of food in the face of drought was only part of the battle. Access to food in rural areas was also tackled through compensating for income loss by labour-based relief programmes and food distribution. It was estimated that in 1985/86 nearly 700,000 people (of a population of around 1.2 million) benefited from the drought feeding programme, and some 74,000 workers participated in labour based relief. The equivalent of nearly $40 per head of beneficiary, for all the 1985-86 drought relief programmes, was spent, split about equally between government and donors¹. The success of this effort is no doubt reflected in the malnutrition figures.

¹ Quinn, V., Cohen, M., Mason, J., Kgosidintsi, B.N., 1988. "Crisis-proofing the Economy: The Response of Botswana to Economic Recession and Drought", In: Cornia et al (Eds.) "Adjustment with a Human Face, Volume 2: Ten Country Case Studies", Oxford University Press, 1988.

Reports of prevalence of underweight for the 1st. quarter of 1988 are: 15%, 14% and 14%, for Jan. to March, respectively.

BOTSWANA

POPULATION: 1.2 M	IMR: 68
POPULATION DENSITY: 2 per sq. km.	U5MR: 95
POP. GROWTH RATE: 3.5 per annum	GNP (PER CAPITA): US$840
PERCENTAGE URBAN POP.: 21%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 20% - 30%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

MEASLES

NUMBER OF CASES - Reported annual incidence of measles nationally

NUMBER OF CASES - Reported monthly incidence of measles in Lobatse Region

Burkina Faso

Burkina Faso (before August 1984, Upper Volta) is one of the poorest countries in the world. It is ranked third lowest in a list of 129 countries compiled by the World Bank on the basis of their per capita GNP. Annual rainfall is low at between 600 and 1,100 mm. The total land area is 274,000 sq. km., of which only around 10% may be cultivated.

More than 85% of the working population depend on agriculture for their livelihood. This sector contributes nearly 45% of GDP. The northern part of the country is ecologically Sahel (the country as a whole is included in the Sahel group) and Burkina Faso has experienced the recurrent droughts that affect this region of Sub-Saharan Africa. Thus, the droughts of 1968-74 caused widespread destitution, particularly from livestock losses for the population depending on animal husbandry. Normal rainfall returned in 1975/6 and led to a recovery which lasted for a few years. But rainfall became erratic again in 1981. In 1983 the rains were late and harvests were again reduced (see Food Production Index and Cereals). Neither imports nor food aid could increase fast enough, and consequently the estimated food available fell from 2019 kcals/caput/day in 1982 to 1952 kcals in 1983 (Kcals per day). The seasonal peak of child malnutrition was more pronounced in 1983, and did not fall to the previous year's post-harvest low (Underweight Children); the raised level of malnutrition lasted for 2-3 years.

In 1984 the rains were worse, particularly in the drier northern areas. Reported measles incidence peaked (Measles). Crop production was somewhat lower than even 1983, and food availability (Kcals per day) fell further, despite an increase in imports. Food aid had not yet built up. Food prices increased by 20% (FPI). Malnutrition prevalences (as % Wt/Age) recorded by health centres remained at the 1983 level overall. Holding the prevalences down to 1983 levels in clinics may have been helped by effective food distribution.

By May 1985, it was reported that some 1.5 million of the population were affected by famine. By late 1985 more food aid and imports was arriving in quantity (Cereals). Rainfall was better in 1985, and food production from the harvest in September-November was 40-45% higher than the previous two years. Total cereal availability for 1985 increased sharply. Food balance sheet calculations indicate that kcal availability was restored to pre-drought (e.g. 1981) levels, around 2200 kcals. Prevalences of underweight children remained high (perhaps related by this time to longer-term effects on children -stunting), but began to fall by the beginning of 1986 (Prev. De-seasonalized). Underweight prevalences here closely reflected food prices (FPI) at national average level.

Following the good harvest in 1985, underweight prevalences in 1986 fell to the lowest level on average since 1982 (when data started to be available). But dry conditions continued in the North, where no recovery in nutritional status was seen. Average food prices, absolute (FPI) and relative (FPI/CPI) also came down after the 1985 harvest. It is notable that the reported annual incidence of measles rose continuously between 1980 and 1984, but fell in 1985 (Measles).

Rains were even more favourable in 1986, and a record harvest was produced, better than 1985 - but again the north was dry. The post-harvest (September) prevalence of underweight children dropped to 41%, the lowest level since these data began to be recorded.

In 1987 rainfall was normal for most of the country. The north however was still suffering from drought. Villages were reported to have been abandoned, and pasture non-existent in some areas. Surplus food from the two good harvests of '84 and '85 were causing storage problems in the south and centre, but by December 1987 food prices were reported rising in the north, which continued into April 1988. Disaggregated figures for three northern centres for 1985 through 1987 are shown (Regional Prevalence) with the seasonal precipitation levels. Seno is in the Sahelian Zone and has the lowest rainfall and the highest prevalence of underweight children. In Yatenga and Mou Houn the prevalences are stable or rising slightly between '85 and '87. Seno, starting around 40 percentage points higher, begins to drop in the latter half of '85 and continues downward until the 1st. quarter of '87.

The nutrition situation seems to show increasing differences between the north and elsewhere, and the prospect is for this to get worse. The south and centre appear to show a stable underlying trend, with a marked seasonal pattern. FAO reported (October 1988) that heavy rains had exacerbated the transport of food to the deficit area in the north, where there are indications that malnutrition prevalences are already exceptionally high.

BURKINA FASO

POPULATION: 8.3 M	IMR: 139
POPULATION DENSITY: 30 per sq. km.	U5MR: 237
POP. GROWTH RATE: 2.5% per annum	GNP (PER CAPITA): US$150
PERCENTAGE URBAN POP.: 8%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 20% - 30%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

REGIONAL TRENDS IN PREVALENCE & PRECIPITATION

Prevalence of underweight (<80% Wt/Age) children aged under 5 years by region. Health centre data. Average levels of precipitation are also shown.

% PREVALENCE - YATENGA - PRECIPITATION (mm) - MEAN PER 10 DAYS

% PREVALENCE - MOU HOUN - PRECIPITATION (mm) - MEAN PER 10 DAYS

% PREVALENCE - SENO - PRECIPITATION (mm) - MEAN PER 10 DAYS

MEASLES

NUMBER OF CASES - Reported annual incidence of Measles

Chad

Chad is large and sparsely populated. The land area is in excess of 1.28 million sq. km. Estimated for 1987, the population is just over 5.3 million. The average population density is therefore only 4 per sq. km., although the bulk of the population is concentrated in the south of the country. Ecologically, the country may be divided into 3 zones. The South is the richest in agricultural production terms and produces the main cash crops of cotton and groundnuts. Average rainfall increases from 500 mm to 1200 mm per annum from north to south. The Middle zone is mainly pastoral and has a rainfall gradient of 250 mm to 500 mm, north to south. This is part of the Sahel Region of Africa which has been severely affected by drought since the early 70's. The North has less that 25 mm of rain annually and is largely desert. The natural difficulties faced by Chad have been exacerbated by civil war and persistent drought.

Chad became independent in 1960, but remains one of the least developed states in Africa. A North-South divide, based on cultural, religious and economic grounds, has given rise to a prolonged civil war which has been ruinous to an already strained economy. The northern territories were occupied by Libya for over 4 years until 1987.

Agriculture

Crop farming and nomadic cattle-raising represent the major contributions to GDP. Between 1980 and 1984, domestic production supplied between 70% - 80% of the country's food needs (see Food Production Index & Cereals). Cereal imports and cereal aid have been increasing steadily through this period (Cereals). Nevertheless, cereal availability (Cereal Availability) and per capita calorie availability (Kcals per day) indicate the extent of the problem during the drought, until 1985 (Food Shortages). The harvest in 1985 was adequate and improved further in 1986 to produce a record crop. Due to poor growing conditions in the north, 1987 saw an overall fall off in production over the 1986 figures resulting in national food shortages (Cereals). Fortunately, substantial residual stocks existed in the south and so cereal availability was reported as remaining high for 1987. On average therefore, the 1987 per capita food availability figure was comparable with that for 1986.

The Economy

Fluctuating world prices for cotton, the civil war and drought have seriously affected Chad's economy. GNP declined sharply between 1981 and 1984 (GNP). Following a chronic trade deficit in the 1970's, there was an improvement at the beginning of this decade which continued until 1985/'86. The public debt was reduced as the result of major loans taking the form of grant aid (Debt & Debt Ratio). Cotton - which accounts for around 75% of export earnings - underwent considerable price changes during the early eighties and this is reflected in the ratio of debt to exported goods and services (Debt Ratio). The trade deficit rose again during 1986 as cotton prices were depressed. The exchange rate (US$ per CFA Franc) as with the other members of the Franc Zone, reversed its long and substantial decline in 1985 (Exchange Rate).

In addition to sizable amounts of emergency food aid during the drought period, Chad also received substantial financial aid - on average $114 million per year. In more recent years aid has exceeded the value of total export earnings and grown to a substantial percentage of GDP. In late 1985 pledges were obtained from several donor countries and development agencies, including $100 million from the World Bank and $50 from the African Development Bank, in support of the 1986-1990 Development Programme. Further discussions took place with international financial institutions and donors in late 1986 which resulted in an agreement to hold the budget deficit down, reduce spending and to increase taxes.

Nutrition

Nutritional data are largely unavailable for Chad. One exception relates to a survey conducted by Guha-Sapir, Lechat, and Phambu ('Risk Factors and Vulnerability of Children to Drought Related Famines', unpublished report, personal communication) during October 1985 when the population had begun to recover from the main effects of the famine which ended in late 1984. The study covered children under 5 years of age in selected areas of the province of Batha. Sampling was designed to include pastoralists as well as established local village settlements. The prevalence of less than 80% reference weight-for-height was recorded as 12.2% across all groups, with slight differences between the displaced and non-displaced populations (Additional Nutrition-Related Indicators). Guha-Sapir et al. report on significant differences in prevalence of wasting between the various ethnic groups with percentages ranging from a low of 5.3% (for the Miseri Noir) to a high of 15.7% for the Arabe.

The reported annual incidence of measles rose from somewhat over 1,000 cases in 1982 to around 5,000 in 1983, and 7,000 in 1984 - increasing dramatically as the famine developed. In 1985 and '86 the numbers started to fall back to pre-drought levels.

CHAD

POPULATION: 5.3 M	IMR: 133
POPULATION DENSITY: 4 per sq. km.	U5MR: 227
POP. GROWTH RATE: 2.3% per annum	GNP (PER CAPITA): US$400
PERCENTAGE URBAN POP.: 30%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 30% - 40%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

ADDITIONAL PREVALENCE INDICATORS

% PREVALENCE - Prevalence of wasting (<80% Wt/Ht) in children under 110 cm height by displaced or non-displaced population in one province in 1985.

MEASLES

NUMBER OF CASES - Reported annual incidence of Measles

Ethiopia

Ethiopia, with around 45 million people, is the second most populous country in Africa. The high altitude and mountainous terrain profoundly affects the pattern of settlements, production and communication. Substantial numbers of rural people live many days travel-time away from the nearest road. The majority of the population are in the highlands, above 1800 metres, where rainfall is most reliable. The country is ranked as having the lowest per capita GNP in the World Bank's list of 97 developing countries.

Ethiopia is extremely vulnerable to drought. Much of the agricultural production depends on two rainy periods per year, the spring rains often providing seed for the main cropping season in the latter part of the year. The revolution in September 1974 introduced structural changes and a consolidation of the new regions. With suitable external economic factors positive economic growth occurred until around 1980. Deteriorating terms of trade - with falling prices for coffee, the main export crop - increasing import costs as well as international recession, began to take their toll in the eighties.

Food production fell overall in the latter 1970's, with extensive land reform and increasing internal strife. But some fragile economic recovery showed briefly in 1978 to '81. The deepening crisis, causing outright famine in several areas, came mainly from worsening internal conflict, with drought again taking lives from 1980-81. Conditions vary locally in the diverse ecology of Ethiopia and communications are restrictive for purposes of marketing, and for disseminating and gathering information. This can give rise to localized severe hardships. The national data, as shown in the panels, do not reflect the very real geographic variation. Government re-emphasis on agricultural production in the late 70's had a brief effect, until drought cut into the advances. Overall production had recovered somewhat in 1982 despite drought, but declined drastically in 1983 (see Food Production Index). By late 1982 some three and a half million people were reported facing severe food shortage. From 1982 onwards, the drought spread. Increasing numbers of the affected population, in the northern half of the country (Wollo, Tigray) and parts of the south, were both being destituted, and were not easily accessible to relief efforts. In October 1983, it was estimated that relief was reaching only one million of the three million people severely threatened. By August 1984, some six million were facing famine. Both the spring and main crops in 1984 were very poor. During this period, about three-quarters of the population were not in such desperate straits, but suffered attrition of their living standards. Internal conflict intensified, with major population movements. Food prices started to rise rapidly in 1984, and accelerated in 1985 with the cumulative effects of drought and internal disruptions on food supplies (FPI).

By mid-1985, grain prices were reported as double the normal level in some areas - in a situation where perhaps three-quarters of income goes on food. Finally, better rains returned for the late 1985 harvest, bringing some relief. Nonetheless, lack of draft oxen, seed and other factors reduced the possible food crop production. Imports and food aid built up by 1985, and the overall food supply improved. However, a substantial part of the affected population was still not accessible. Throughout 1982 to 1985 estimated total food available for consumption - already at a very low to average level of around 1750 - declined, reaching a minimum of about 1600 in 1985, an average well below requirement. From late 1985 and through 1986 rainfall improved, and the numbers of famine victims fell. Threats of locust and grasshopper plagues came, were partially realized, but held back by control measures. The spreading internal conflict increasingly disrupted production and marketing. Pastoral lowland areas, often particularly affected by drought and with longer-term effects because of severe herd losses, have continued to suffer to the present time. While late 1985 and 1986 may have given some respite, the combination of internal conflict and drought have continued again in 1987 and 1988. By late 1987, widespread famine was again impending. Air-lifting of relief supplies helped somewhat in the towns but overall limited food supplies and internal distribution problems meant that millions of people were again faced with starvation, especially in Tigray and Eritrea. During 1988 emergency relief distribution continued in Eritrea, Tigray, Wollo and Gondar. While food aid pledges in excess of 1 million tons had been met by the end of the year, FAO reported that delivery to the affected provinces was again disrupted by civil strife.

Against this background, the extensive but still piecemeal information on nutritional status can be pieced together. We have extracted some information from reports available to us - many produced by collaboration between NGO's and the Ethiopian Government to investigate effects on child nutrition. The results (Mean Weight-for-Length) are from surveys carried out in one part of Wollo province in 1982-84. They illustrate some seasonally associated with harvest periods. We do not have exactly comparable data for the area beyond end-1984, but further surveys in the same region in 1987 referred mean weight-for-length values as having risen to 93-95%, a satisfactory level according to the Relief and Rehabilitation Commission (RRC). Recent results from NGO surveys in the same region for Feb-April 1988, show a range of 91 to 94.1%, with indications of a trend to deterioration at that time: (RRC standards) a satisfactory to poor nutrition situation, but not yet considered as an emergency in that area.

It is notable that the reported incidence of measles shot up in 1985, just as some recovery was evident in terms of food production, although not, as yet evident in the availability of Kcals per capita. Numbers of cases reported returned to the pre-'85 level during 1986.

ETHIOPIA

POPULATION: 43.8 M	IMR: 155
POPULATION DENSITY: 36 per sq. km.	U5MR: 261
POP. GROWTH RATE: 2.4% per annum	GNP (PER CAPITA): US$120
PERCENTAGE URBAN POP.: 12%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 25% - 35%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

MEASLES

NUMBER OF CASES - Reported annual incidence of Measles

Gambia

Following independence in 1965 the Gambia became a constitutional monarchy. Five years later the present republic was established. The country is one of the smallest in Africa, both in terms of area -11,295 sq. km. - and population -estimated at 0.8 million in 1987, giving a population density of 72 per sq. km. Most economic activity is centred on the river Gambia which bisects the country as it flows into the Atlantic. Annual rainfall averages 1,150 mm per annum.

Agriculture

The agricultural sector contributes half the country's GDP and employs eighty percent of the workforce. The main cash crop is groundnuts and its cultivation and processing is central to this sector and accounts for 50% of export earnings. Food production rose very substantially during the crop years 1981 and '82, only to fall sharply during the drought in 1983 (see Food Production Index). 1984 through 1986 saw a recovery; 1987 brought a slight reversal. Cereal production had three good harvests in succession after the drought ended in 1984 - 1987's being a record (Cereals). While commercial cereal imports have been low and falling (Cereals:Imports), cereal in the form of structural aid has fluctuated around 16,000 MT (Cereals:Aid). Food production remains well short of demand. Cereal imports and cereal aid are estimated by FAO at 15,000 MT each for 1988.

The Economy

The economy has suffered considerably in recent times, partly as a result of the drought and partly because of the high cost of inputs. By 1985, GNP had fallen to 50% of its 1980 value (GNP). Conversely, the foreign debt (as debt outstanding and disbursed) had more than doubled over this period (Debt). The IMF were approached in 1981 and a loan secured for purposes of stabilizing the economy. This proved to be infeasible because of the depression during and following the drought period. A further loan was negotiated but was subsequently suspended by the IMF in 1985 due to the country's level of indebtedness. Following a successful donors' conference in 1985 at which pledges were secured to assist in the restructuring of the agricultural and economic sectors, the IMF loan was restored in 1986. A number of austerity measures were introduced at this time, including tax increases.

Nutrition

The Nutrition Unit of the Medical and Health Department in Banjul reports on the prevalence of malnutrition based on surveys conducted during 1985 through 1988. These surveys were carried out over several seasons. The seasonal change in the prevalence of wasting (recorded as < 90% reference weight-for-height) over this period is shown in the figure (Wasted Children). The August levels are higher as would be anticipated, as this corresponds to the rainy season and is immediately prior to the annual harvest. These levels may be compared with those from previous broadly comparable surveys undertaken since 1985 by the Department of Health (Regional Prevalence). Both national and regional levels show a slight decrease in the August values in 1986 over the previous year. The same month for 1987 is up on both previous years. Prevalences in the Central and Eastern regions are comparable and significantly higher than those of the Western region. This difference appears to be consistent over the 4 years.

The presence of an ongoing British Medical Research Council's nutrition programme in West Kiang since the middle seventies, permits an examination of maternal weight changes between 1978 and 1987 (Maternal Weights). The study is based on 3 villages in the region, following weight changes in 444 women over the course of the 10 years. The subjects were studied mainly during pregnancy and early lactation. A study of the figure - based on 12,954 observations - indicates a strong seasonal component and evidence for a slight upward trend in mean weight. From June to October (the harvest period) there is a consistent loss in weight of 2.9 kgs. or 5.5% on average, between 1978 and 1985. The same pattern is also present in 1986 and '87, but its magnitude is much reduced. Hard physical labour in the fields, combined with diminishing food stocks prior to harvest are believed to account for this regular pattern. The general improvement in local facilities, including medical and water supply, are most likely responsible for the overall positive trend. It is tempting also to ascribe the reduction of the seasonal weight loss in 1986 and '87 to the excellent cereal harvests since 1985.

GAMBIA

POPULATION: 0.8 M	IMR: 153
POPULATION DENSITY: 72 per sq. km.	U5MR: 264
POP. GROWTH RATE: 1.5% per annum	GDP (PER CAPITA): US$230
PERCENTAGE URBAN POP.: 18.4%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 15% -25%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

TRENDS IN REGIONAL PREVALENCE

% PREVALENCE - Prevalence of wasting (< 90% Wt/Ht) in children aged under 5 years by region. Nutritional Surveillance Programme data.

MATERNAL WEIGHT CHANGE

WEIGHT (KG) - Change in mean weight of mothers in West Kiang

Ghana

From the latter half of the 1960's until the 1980's Ghana experienced a period of prolonged economic stagnation, as a result of the combined effects of poor economic management and severely adverse external circumstances, notably world recession affecting many developing countries.

By 1982 estimated per capita food availability was extremely low (with Chad, the lowest in Africa). This was when no commercial imports or food aid were available in adequate volume (see Food Production Index & Kcals per day). It was with this already deteriorated economy that the country faced acute drought from 1982 to 1984. Prolonged drought, the worst in living memory, and the accompanying bush-fires aggravated the already low food crop production and created the worst food shortages since independence in 1957. In January 1983 about one million Ghanaians, expelled from Nigeria, arrived to put a severe strain on the critical food and employment situation.

The Economy

In the early 1980's economic difficulties, with heavy spending on imports, and regular budget deficits led to spiraling inflation. These factors, combined with an overvalued currency (Exchange Rate), reliance on energy imports and falling export earnings, contributed to an average annual decline of 0.2% in real GDP over the period 1970-1980. The situation worsened sharply in 1984 owing to the effects of the severe drought and chronic shortages of foreign exchange. Between 1980 and 1983, GNP fell by 13% compared with 1980 (GNP).

By 1983, the need for drastic reforms was recognized by the Ghanaian government. In April 1983, the government negotiated an agreement with the IMF, which entitled Ghana to a structural adjustment loan of up to $500 million. Ghana's economic recovery program (ERP) was launched that year, probably the year of greatest hardships in the decade, given the drought, returnees and bushfires. Policy reforms supported by the IMF and the World Bank, introduced during 1983 as the 3-year (1983-86) Economic Recovery Programme, included a massive devaluation of the Cedi (Exchange Rate), tight monetary and fiscal controls and increases in the official prices paid to producers.

Phase I of the Economic Recovery Program, which lasted from 1983-86, was a period of economic stabilization. The objectives were to halt and reverse declines in the productive sectors, to re-establish fiscal and monetary discipline, to rehabilitate the economic and social infrastructure, and to encourage private savings and investment. A key component of the stabilization was the major devaluation.

Failure of the past governments to adjust the exchange value of the domestic currency to reflect the decline in its purchasing power, was regarded as one major reason for the economic crisis the country was facing in the 1980s. Devaluation of the Cedi had taken place only twice in the 1970s (December '71 and August 78). In early 1983 the government began to depreciate the Cedi in the form of an export/import currency bonus system and later in the form of conventional devaluations. Between November 1983 and January 1986, the exchange rate of the Ghanaian currency against US Dollars depreciated from C2.75 to C90, i.e. by 97%. In September 1986 a two-tier exchange rate system was introduced as a condition for support in the form of a $90m stand-by arrangement from the IMF. In February 1987 the fixed rate was abolished and all transactions were determined by a weekly auction rate which in April 1987 stood at about US$1 equals C150-155. The IMF provided stand-by funds to enable purchases of petroleum to be made at the floating rate.

The percentage of debt outstanding and disbursed (Debt) over export of goods and services kept increasing from 1980 with a peak in 1983 but decreased again in 1984 and 1985 (Debt Ratio), indicating some lessening of the debt burden.

The initial devaluation in April 1983, in addition to the price control system - not yet waived by the government - led to widespread hoarding of consumer goods. Basic commodities were no longer to be found on the open market. This hoarding compounded the effects of the drought-induced shortages in 1983. Now goods are again readily available in the marketplace, but they are beyond the reach of most consumers.

During this period, indicators of child malnutrition (discussed below) showed a rapid rise in the prevalence of underweight children (Underweight Children), with an exacerbated seasonal peak of 46% in mid-1982, rising again to nearly 50% in mid-1983. Since that time, in line with the improving economic situation and recovery from the 1983 drought, prevalences of children underweight have been falling slowly, to around pre-crisis level.

Production incentives were adopted under the Economic Recovery Programme, particularly in regard to export commodities. Producer prices for cocoa were raised substantially. While the producer received 12,000 Cedis per ton in the '82-'83 harvest, an equal quantity fetched 140,000 Cedis in the '87-'88 harvest.

Certain macro-economic indicators suggest improvements since 1983. The inflation rate was down to an annual average of 23% from 1985-87, a marked fall from the 70% average from 1980-84. Increases in production have been achieved in the mining, mineral and timber industries. Export earnings, which were $430 million in 1983, reached $632 million in 1985, and $700 million in 1986.

In 1983 Ghana had 3 digit inflation, with the inflation rate rising to 123%, higher even than the rates in 1977 and 1981. The inflation rate began to level out at around 40 to 44% during 1984. Government estimates put the 1985 inflation rate at a much improved 15% though prices of most consumer goods including many items whose prices are fixed by the Prices and Incomes Board fluctuated considerably, owing to supply shortages. The inflation rate in 1986 increased to 25%. In 1984 the CPI and FPI reversed briefly from June through to the end of November, before resuming an upward trend.

Agriculture

Production of cocoa, Ghana's most important export crop, providing on average about 65% of total export earnings, declined during the 1970s and 1980s owing to a combination of factors, exacerbated by drought, bush fires and smuggling. The 1983/84 crop production fell from 557,000 tons in 1964 to less than 160,000 tons after drought and fires destroyed about 40% of cocoa farms.

In October 1983, the government launched a $130m campaign to revitalize the cocoa sector. Producer prices were increased by 67% followed by a further 50% increase in mid - 1984. A grant of US$2.4m from the EEC was used for improving transport and distribution services. Measures were taken, including buying essential inputs, insecticides, building materials and sprayers, offering cash incentives to farmers to replant cocoa to increase the output to 175.000 tons in 1984-85. Financial assistance from the World Bank enabled continuation of cocoa revitalization in 1985.

In May 1985 a further 90% increase in producer price and reducing cocoa smuggling led to increased production to 210,000 tons in 1985/86 and to 240,000 tons in late 1986. This was however still only 57% of the 1964 level. Producer prices were raised again in 1986 to C85,000/ton compared to C30,000/ton in 1984. Cocoa revitalization continued in 1986 as a condition of a US$ 490m standby facility from the IMF in September.

Food production statistics showed a poor performance, similar to cocoa (Food Production Index & Kcals per day). Total cereal production from 1976-81 showed a 14% decline, compared with 1971-75 figures; production of starchy staples declined by 35% over the same period. In 1981, per capita calorie consumption was estimated to be only 68% of requirement, a level lower than in any other African country but Chad. The situation may have been even more difficult for the food purchaser than the producer. The consumer, whether a net producer or purchaser of food, faced severe hardships in the late 1970's and early '80s. The difficulties caused by rising prices did not subside with the end of the drought in 1984 (FPI).

After acute food shortages of 1983 by the end of which the government requested 250,000 MT of emergency food aid, favourable weather conditions combined with new price incentives also helped to increase crop yields (other than cocoa) considerably; e.g. maize, rice, cassava, yam, beans, groundnuts and millet. With an average annual population growth rate of 3.3% for the whole country from 1980 to 1985, the rise in food production was not sufficient to meet total demand and 175,000 metric tons of food aid was needed in early 1984. A price-support structure to combat fluctuating producer prices was introduced in 1985. After some decline in food production indices in 1985, it was increased again in 1986.

Nutrition

Nutrition surveillance data have been compiled by Catholic Relief Services in Ghana since 1980. The statistics are collected at maternal and child health clinics located throughout the country. The clinics are operated by the Ministry of Health and private agencies. The data reported here are for children 7-42 months of age, for the years 1980 to 1987. Comparable data for the 1970s are not available. The CRS data provide a profile of the nutritional trends in Ghana over the eight year period. Both the acute hardship of 1982-83, and the post-drought recovery, are evident in the nutritional profile.

Throughout the period, food prices and especially the relative price of food (FPI/CPI) corresponded closely with prevalences of malnutrition. However it appears, here as elsewhere, that while increasing FPI/CPI corresponds with increasing prevalences of underweight children, a falling FPI/CPI occurs without a corresponding rate of fall in underweight prevalence. This may be because increases in prevalence begin with wasting, but prolonged low intake produces stunting. Thus a residue of stunted children remain, e.g. in 1985 in Ghana, and the prevalence falls more slowly that it rises. This in turn is presumably due to a cohort effect, to possible gradual recovery from stunting, and to more rapid (but diluted) reduction in the prevalence of wasting. This is in contrast to the seasonal effect, where prevalences return to 'trough' values, presumably because the peak is mostly wasting. There are implications for long-term effects here.

In 1980, levels of underweight were estimated at around 35%. In 1981 they ranged from 33 to nearly 40% prevalence of low weight-for-age. By 1982, a marked deterioration was evident. Malnutrition levels started to increase in November 1981, and continued to rise through June 1982. On average, they were 5% higher in 1982 than in 1981. The failure of the 1982 rains may explain much of the deterioration. The decline continued into 1983. Malnutrition levels were an average of 3-4% higher in 1983 than in 1982.

The CRS data for 1984 and 1985 are unfortunately not strictly comparable to that of the other years. A major turn-over in the population of children being monitored resulted from the initiation of an emergency relief program, in early 1984. Families that had not previously attended the clinics regularly began to participate, in order to receive relief food aid. In addition, more severely malnourished children were monitored bimonthly, and their statistics were not included in the CRS compilation. Consequently, the 1984 and 1985 data are not fully comparable with those of the other years; 1982-83 and 1986-87 can be used to view the pre- and post-drought trends.

Seasonal trends are evident in the Ghana nutritional profile. Prevalence of malnutrition peaks from April-July, the pre-harvest lean season. By August, the prevalence of malnutrition usually begins to fall, with the improvement continuing through to January or February, the post-harvest period of plenty.

Where the seasonal element has been removed to show the underlying trend (Prev. De-seasonalized) it is evident that in 1986 and for much of 1987, nutritional levels had returned to the 1981 level. We also see that the latter half of 1986 was an exceptionally good period.

The apparent sharp rise in malnutrition from October through December 1987 in the data is related to a re-targeting of the CRS program. Activities were discontinued in five of the regions (based mainly on the prevailing degree of underweight in the target-group) as of October 1987. Thus these data do not necessarily reflect changes in nutrition in the population.

The available data suggest that nutritionally, 1982 and '83 were the worst years for Ghana. While valid comparable data do not exist for 1984-85 to monitor the improvement, 1986 and '87 figures indicate a return to the pre-drought 1981 nutritional levels. Nevertheless, considerable cause for concern remains. A national nutrition survey, conducted by UNICEF Ghana in 1986, confirmed that serious nutritional problems remained in Ghana.

Combating the impact of structural adjustment on the country's poor is on the government of Ghana's agenda. With the support of UNICEF, the government presented a Program of Action to Mitigate the Social Costs of Adjustment (PAMSCAD) to a donors' conference in February 1988. The program includes projects for employment generation, to compensate for the lay-offs in the civil service and para-statal firms.

PAMSCAD also includes community-based projects for infra-structural improvements, including road repair, school and clinic reconstruction, and the de-silting of dams. A range of basic needs projects was also presented; they included hand-dug wells, essential drugs, the de-worming of primary school children, and supplementary feeding schemes for preschool children. While the projects do not all represent activities that would not have occurred outside of PAMSCAD, the portfolio represents a first in the presentation of a package of socially-oriented projects in tandem with a structural adjustment program.

The total cost of the PAMSCAD package is $83.9 million, with $11 million in the form of food aid. Initial commitments have been made by the donor community in response to the hardships facing the Ghanaian population, and the government's commitment to responding to the long-term economic problems of the country. Continuing nutritional surveillance during the second phase of the economic recovery program will help enable the government and donors monitor how well the vulnerable have been protected from the impact of economic restructuring.

GHANA

POPULATION: 13.7M	IMR: 91
POPULATION DENSITY: 57 per sq. km.	U5MR: 149
POP. GROWTH RATE: 3.5% per annum	GNP (PER CAPITA): US$390
PERCENTAGE URBAN POP.: 32%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 25% - 35%

GRAPHICS

GRAPHICS

Lesotho

Lesotho is small and land-locked, being surrounded on all sides by South Africa. Less than 13% of the land is cultivable, but the mountainous terrain provides good grasslands for livestock development. However, since nearly all the available land is cultivated, only more efficient use could increase production. The livestock industry has been hindered by poor management, low quality animals, and disease. These problems are reflected in a poor economic situation which has been deteriorating in the 1980's and was exacerbated by drought in 1983/84.

Agriculture

Although agriculture is still the single largest contributor to GDP, it's share declined from 47% in 1970 to 22% by 1988. This decline was gradual in the beginning but accelerated 1983/84, with the impact of the drought. Indicators of food production suggest problems for Lesotho even before the drought reached its peak in 1984; food production (see Food Production Index) and cereal production took the sharpest decline sometime earlier between 1980 and '82, followed by further slowdowns in 1983/84. Total cereal production went from a high of 194,000 MT in 1980 to a low of 125,000 MT in 1982 (Cereals: Production). The food production index declined rapidly from 104 in 1981 to 92 in 1984. Information on food shortages and unfavourable crop conditions confirm a problem by mid-1980, which continued through 1987 with only two "relief" periods in mid-1981 and mid-1985 (Food Shortages). The reduced harvest in 1986 was reported to be 20% below that of 1985 and did not return to normal until the harvest period in 1988. Thus, it is expected that production and food availability should have improved by 1988.

Overlapping food shortage with the ratio of food price and consumer price indices (FPI/CPI & Food Shortages) shows that the two periods with no reported shortages correspond with a decline in the ratio, suggesting that in periods of adequate food supply, food prices are down relative to overall consumer prices.

Despite the deteriorating trends in production in the early 1980's, the amount of food available, expressed as kcals/caput/day (Kcals per day), showed a marked improvement in 1982-83 after an initial decline in 1980-81. This was likely the result of the increased import of cereal from 70,000 to 129,000 from 1981 to 1983 (Cereals:Imports), which offset the fall in production. Imports then decreased after 1983 even though production remained low, but at this point cereal aid climbed by 42,000 MT which nearly offset the difference (Cereals:Aid). Improvement was apparent in 1985 for all indicators, but it was short-lived, and in 1986 although cereal imports increased slightly it was not enough to offset a decline in cereal aid and production. By June 1988, FAO were reporting that the recently harvested cereal crop was above normal and substantially above the poor 1987 crop.

The Economy

In 1981 it was estimated that 23% of the economically active population of Lesotho worked in South Africa (one half of the adult male labour force), reflecting limited opportunities at home due mainly to land shortage and the poor state of agriculture. Lesotho faces substantial economic problems. The trade gap widened in 1983 as a result of the drought, with exports decreasing and imports rising (primarily food). Total debt outstanding and disbursed, as reported by the World Bank (Debt), shows a steady increase after 1980, and the continued widening of the budget deficit led the government to reach a preliminary agreement with the IMF in June 1987. Before that time, Lesotho was one of the few African countries without IMF credit.

At home, the exchange rate declined 64% from 1980 to 1987. A sharp fall in the exchange rate occurred from 1981-82, and again in 1984-85. The largest decline occurred in 1984-85 of over 40% in the value of the Loti, the local currency (Exchange Rate). Food and consumer prices rose steadily from 1980 to 1986 with no marked acceleration due to the drought (FPI, CPI).

Nutrition

The prevalence of malnutrition showed a consistent seasonal fluctuation¹ combined with a sharp increase after 1984, corresponding to the drought (Underweight Children). The acceleration in underweight prevalences began in 1984, during the "pre-harvest" hungry period (October to December), with a mean prevalence 4-5% above the mean for the same quarter in 1982 and 1983. This deterioration can best be seen after removing the seasonal component (Prev. Deseasonalized). The 1985-87 prevalences stabilized but remained high throughout the year, still following a seasonal pattern, but with no return to pre-drought levels. Exactly the same pattern appeared in exchange rates with a sharp decline in 1984-85 followed by three years of stability. Although this cannot imply causality, the relationships between certain economic indicators and prevalence estimates are quite evident and consistent. It is however different from a number of other countries (e.g. Ghana) with general price increases (CPI) rather that the relative price of food (FPI/CPI) related to underweight prevalence.

¹ Also noted for data from the seventies, as reported by Cohen, N, and Clayden, A.D., "Seasonal Variation in weight of children attending an under-fives clinic in Lesotho", Acta Paediatr Scand, Vol. 67: 25-31, 1978.

A striking similarity exists in the seasonal effect in diarrhoea and the prevalence of malnutrition - compare the seasonal component of prevalence of underweight to number of cases of diarrhoea reported (Seasonality) - to the extent that the two plots are almost indistinguishable. Peak prevalences of diarrhoea occur in January-March, reach their lowest point in August-October, then increase again. Diarrhoea very likely contributes significantly to the decline in nutritional status which is further aggravated by low food availability in the pre-harvest period.

It is accepted that the two major influences on nutrition are 1) infection and 2) food intake. The monthly trends in underweight prevalences and diarrhoea clearly demonstrate the former association. However, unlike malnutrition prevalences, the diarrhoea patterns do not show an increase after 1984 but maintain a consistent seasonal trend with the lowest and highest number of cases reaching the same level year after year. Thus, although the seasonal nutrition component may be more related to diarrhoea than food availability, the overall increase after 1984 must be related to another factor. The link between prevalences and the harvest period suggests an effect of food availability, although actual intake cannot be determined from these data. More obvious are trends in food production and economic indicators which clearly show a severe downward trend due to the 1983/84 drought, corresponding to this increase in malnutrition.

LESOTHO

POPULATION: 1.6 M	IMR: 101
POPULATION DENSITY: 53 per sq. km.	U5MR: 139
POP. GROWTH RATE: 2.7% per annum	GNP (PER CAPITA): US$370
PERCENTAGE URBAN POP.: 18%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 15% - 25%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

SEASONALITY

SEASONALITY FACTOR - Seasonal effects in percentage prevalence of underweight children

NUMBER OF CASES - Diarrhoea: monthly reported cases

Madagascar

Madagascar has had accumulating economic problems since at least the late seventies, periodically worsened by cyclones and localized drought. The political and financial system has been evolving, notably since the country's withdrawal from the Franc Zone in 1973 and reform of the fiscal system in 1978. In 1980 per capita debt was more than $70, and negotiations with bilateral financial supporters and the IMF secured loans to deal temporarily with accelerating budgetary and balance-of-payments problems. But in 1981 credit and investment continued to drop sharply, reducing needed imports including food (see Cereals:Imports). Food production (Cereals:Production) and GNP fell (GNP), and the debt burden increased rapidly (Debt). Food and consumer prices started a substantial upward trend, which is still continuing (FPI & CPI).

In 1982 a culmination of troubles beset Madagascar. Political uncertainty and unsettled debt negotiations hit living standards, and cyclones in January devastated rural production in many areas. Cereal (mainly rice) and overall food production (Cereals: Production & Food Production Index) were less than 1980-1981, and food availability was reduced (Kcals per day). Child nutrition data, available from 1982, show particularly high prevalences of underweight children in Madagascar of around 45-50% in clinics participating in CRS programmes, with marked seasonality matching the pre-harvest shortages with subsequent post-harvest recovery (harvest is April-May) (Underweight Children).

Structural adjustment, in particular policy changes related to the borrowing, took major effect in 1983. Consumer subsidies were cut and producer prices raised, and devaluation of the Malagasy franc continued, accelerating in 1982 (Exchange Rate). Public spending was reduced. The relative price of food (FPI/CPI) fluctuated markedly, but in general price rises slowed. Malnutrition prevalences showed a rise above the trend (Prev. Deseasonalized), possibly more in the urban (capital) area than elsewhere (Regional Prevalence), in line with changing producer-consumer price differentials. Nonetheless, production and food availability (Food Production Index & Kcals per day) rose a little in 1983.

But unrest in rural areas, then urban areas, spread in 1983 and 1984, associated with substantial migration from the countryside. Prices continued to rise and the currency to devalue; wages remained static; and although there was no acute food supply shortage, food available and consumed (Kcals per day) was estimated to decline again. By 1985 production was down, and food availability hit its lowest point.

Rice has a particular importance in Madagascar (having among the highest per capita rice consumption in the world), and control of the rice trade was considered a factor in economic problems - partly because of heavy rice imports. As part of the structural adjustment, most state control over the internal rice trade was abolished in 1986. At the same time, rural disruptions were continuing, and drought struck the southern part of the island badly affecting the harvest in early 1986 (notably for maize and cassava in the south-west).

Prevalences of malnutrition estimated from the CRS data showed an overall upward jump in 1986 (Prev. Deseasonalized). Comparing examples from the more urban area of the capital, Antananarivo, with the rural south (Tulear), it seems that nutrition deteriorated gradually in the capital area in 1985-86, but more sharply in 1986 in the south (Regional Prevalence). Famines and food shortages in the rural south were reported in 1986-87 - in fact in October 1986 it was announced that some tens of thousands had died from famine.

Some recovery in the rural south in 1987 is indicated by the nutritional data, but malnutrition overall remains at the raised level of 1986 (Prev. Deseasonalized). The economic difficulties continued in 1987, with prices again rising sharply by the end of the year (FPI, CPI). (The falling FPI/CPI at end-87 is probably misleading since both indices were rising so fast). Total 1987 cereal production was up on 1986's. Despite a renewed drought in the south-west which threatened the harvest, FAO reported an above average output of paddy rice for 1988, although short of total consumption requirements. Logistical problems in delivery had resulted in some supply problems in the south of the island during the latter part of the year.

Major shifts in government policies related to the national staple, rice, were included in the agreement with the IMF. The policy changes included major cut-backs in the level of rice importation. The over-valued Malagasy franc and the collapse of the internal distribution network made it more attractive to import rice than purchase local supplies. Government price controls on the consumer price of rice were gradually removed, thus legitimizing the already flourishing parallel market in rice. Farmgate prices were increased to stimulate production.

The Malagasy government also agreed to phase-out the distribution of rice, from the government-supported urban outlets, by 1990. Neighbourhood shops provided basic commodities such as rice, soap, and cooking oil, at subsidized prices. All urban dwellers were eligible to participate. There was a government-stipulated daily allocation; in reality, distributions were carried out two or three times per week, usually with a ration considerably below the approved level. It was argued that government policies had encouraged the Malagasy people to consume rice at a level that the country could not presently support. The demand for other low-priced staples such as maize and cassava may have been kept low because of the rice subsidy. The system was costly for the rice-growing farmer and the government.

Large increases in the market price of rice, in the urban areas, following the removal of price controls, led several donors to establish a reserve buffer stock. A portion of the stocks was to be released on the market when the price exceeded an agreed upon trigger price. When the price fell below the trigger level, allocations from the reserve were discontinued. This system first operated in 1987. It was a significant attempt to protect the urban consumer from some of the negative effects of the adjustment program. The buffer stock only controlled rice prices, and it did not attempt to target by need. Its impact on nutritional levels has yet to be studied.

A consistent seasonal trend in child underweight prevalences is evident from 1982-87. Malnutrition levels peak from October to February-March, the pre-harvest "hungry" season; improvement usually begins in March, and continues through the June-August post-harvest period. Seasonal differences in prevalence are often as high as eight to ten percentage points.

CRS program coverage increased in 1985 and 1986. It was possible that the time trends in prevalence resulted from changes in coverage, however, statistical modelling has indicated that observed trends remain significant after taking account of this increased coverage.

MADAGASCAR

POPULATION: 10.9 M	IMR: 121
POPULATION DENSITY: 18 per sq. km.	U5MR: 187
POP. GROWTH RATE: 3.3% per annum	GNP (PER CAPITA): US$230
PERCENTAGE URBAN POP.: 23%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 15% -25%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

TRENDS IN REGIONAL PREVALENCE

% PREVALENCE - Prevalence of underweight (<80% Wt/Age) children aged under 5 years. By Region. Health Centre data.

SEASONALITY

SEASONAL FACTOR - Seasonal effects in prevalence of underweight (National)

Mali

With 1.24 million sq. km., Mali is the second largest state in West Africa. The estimated (mid-1987) population is 8.6 million, with an annual growth rate of 2.3%. The inhabitants are 10% nomadic, 19% urban and 71% rural. Average population density is low at 7 persons per sq. km. The Niger river plays a similar role in Mali as does the Nile in the Sudan. Most agricultural and economic activity in the country is associated with the river. Rainfall is limited. In the south of the country it amounts to 1,120 mm per annum on average, delivered during a 4 - 5 month rainy season. The north of the country -comprising about 50% of the land area - is semi-desert, with an average of below 250 mm rainfall per annum. The country is landlocked and goods have to travel around 1,300 km. to and from port.

After independence in 1960, the first civilian government was socialist and embarked on an extensive nationalization programme. In 1968, in the midst of severe economic problems, the army took over. Efforts were initiated to reverse the nationalization of the economy which had already taken place, particularly in the public sector which had expanded rapidly. However, this proved to be difficult to accomplish. The protracted drought in the 70's inevitably contributed substantially to the depression of the economy.

By 1981, and with the financial backing of Western governments, moves were well afoot to introduce a free market style economy. The poor rainfall in the early eighties, followed by the severe drought in 1983 and 1984 (see Food Shortages & Unfavourable Crop Conditions) prevented any significant recovery of the economy. Mali remains one of the poorest nations in Africa today, with a per capita GNP of US$ 180, and an estimated under-5 year's mortality rate of 296 - the highest in Africa and one of the highest rates in the world.

Agriculture

Over 80% of the labour force is engaged in agriculture and fishing. This percentage is diminishing as the effects of drought and low prices for agricultural produce encourage a move to urban centres. Normally self-sufficient in staple foods in years of adequate rainfall, Mali has been heavily dependent on cereal imports (Cereals: Imports) and cereal aid (Cereals: Aid) to compensate for poor production during 1984 and 1985 (Food Production Index & Cereals: Production). The important livestock herds were reduced by 50% as a result of the drought. With improved rains in 1985, there was an upturn in production, although this was again reversed in 1987. After the sharp drop in 1984, cereal availability (Cereal Availability) peaked in 1985 as a result of a reasonable harvest and emergency commercial and food aid imports. Per capita calorie availability had been rising throughout the period from 1981 to 1985, although starting from a very low base of 1,720 kilocalories per capita per day (Kcals per day).

1988 has been confirmed by FAO as a record crop year. Following early rains, planting was underway in the south-west by late May. Planted area was up by 5%. However, prospects became less optimistic following the heavy infestation by desert locusts of the Niger Delta. Extensive control operations were implemented, and these were largely successful. Crop damage was confined and did not seriously affect the aggregated harvest outrun. Serious local food deficits did occur in many northern areas and stocks were distributed, with donor assistance.

The Economy

The economy is severely constrained by the large and growing foreign debt (Debt) which doubled between 1980 and 1985, and by the country's ability to service it (Debt Ratio). The contraction in trade resulting from the impact of the drought on agricultural and livestock exports, and the fluctuating international price for cotton, has been responsible for the very high trade deficit. In consequence, 1985 saw a significant jump in the already climbing debt-service ratio (Debt Ratio). The GNP fell overall between 1980 and 1985. The 1986 figure, in keeping with the better production figures, represented a marginal improvement on the previous years. Use of IMF credit has been rising steadily during the first half of the decade (IMF) and in 1986 France provided 1,000 million CFA francs in support of the structural adjustment programme undertaken with the assistance of IMF and the World Bank. Mali obtained a re-scheduling of its debts in 1987, but its IMF standby facility expired early in 1988. Further institutional financial assistance has been made contingent on fiscal and budgetary adjustment.

Nutrition

No nationally representative or time series data are available on nutritional status in Mali for the early 1980's. A number of small local surveys have been conducted periodically by NGO's, which are not directly comparable. Data for the middle '70's indicate a prevalence of wasting of 4%-11%, depending on year and season (Wasted Children). Some indication of the current level of the problem may be had by quoting the results of a survey undertaken by Medecins sans Frontieres in collaboration with the Ministry of Health. The results (Wasted Children) relate to Timboctou for July 1986 and show the prevalence of wasting. The most severely affected are those between 5 and 23 months. These percentages are high, especially for a non-drought year, and give cause for continuing concern.

MALI

POPULATION: 8.6 M	IMR: 170
POPULATION DENSITY: 7 per sq. km.	U5MR: 296
POP. GROWTH RATE: 2.3% per annum	GNP (PER CAPITA); US$180
PERCENTAGE URBAN POP.: 19%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 25% - 35%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

WASTED CHILDREN

% PREVALENCE - Prevalence of wasting (<80% Wt/Ht) in children aged 6-71 months: 1974-76.

% PREVALENCE - Prevalence of wasting (< -2 S.D. Wt/Ht) in children aged under 5 years in Timboctou, July 1986

Mauritania

The average population density of Mauritania is only around 2 inhabitants per sq. km. - the lowest for West Africa. Population is estimated to be increasing at the rate of 2.6% per annum. Around one sixth of the population are nomadic. As a result of the droughts during the seventies and again in the eighties, there was substantial movement away from the rural areas to the urban. Just over one third of the population now live in towns.

The northern two thirds of the country is classed as Saharan, with very low rainfall. The remaining third - the Sahelian zone -has an average of 600 mm rainfall per year. During the early eighties rainfall was under 30% of the average of the preceding 3 decades, and Saharan conditions began encroaching on the more fertile Sahelian.

The Economy

Since independence in 1960, Mauritania had several changes of government and been involved in a war (between 1976 and 1979) over the formerly Spanish 'Western Sahara'. The take over of 1984 deposed the civilian government established at the end of 1980. There followed a number of major economic reforms which attracted new investment and bilateral support. The 1960's had seen a rapid expansion of the economy as a result of the exploitation of the country's mineral resources. Growth fluctuated widely during the '70's as a consequence of the war and the drought experienced in first half of the decade, however, by the late 1970's economic growth was impressive. Unfortunately, within a few years the economy had begun to contract. As in the previous decade, the drought during the early '80's (see Food Shortages & Unfavourable Crop Conditions) was partially responsible for poor and uneven growth (GNP). This was aggravated by the high level of foreign debt (Debt) which jumped from US$700 million in 1980 to just under US$1400 million in 1985, although, during this time, the debt service ratio remained reasonably steady (Debt Ratio).

Mauritania had reached agreement with the IMF in 1980 to restrain budget spending and to increase revenues. The budget deficit subsequently fell in 1982 and 1983, but rose again in 1984 as a result of the rising cost of servicing the foreign debt (Debt Ratio) and the impact of the drought. Debt re-scheduling was necessary in 1985, '86 and '87. The IMF required a currency devaluation in 1984 (Exchange Rate). A further substantial adjustment of around 16% took place in 1985 before stabilizing. From the early to mid-1980's, the CPI rose by nearly 60% - with a sharp upturn following the '84 devaluation (CPI). FPI are unavailable beyond early 1982 (FPI) but it can be seen that in late 1980 the index jumped by about 13 points, as did CPI.

Agriculture

Although the agricultural sector accounts for over half of the workforce, its contribution to GDP has decreased substantially since the '60's - from 44% to around 11%. This reflects decreasing production by virtue of drought and the increasing importance of mineral resources to the economy. By 1982/'83 only some 10% of domestic demand for food could be met with local production, falling dramatically from the 1980 level. There was no sign of an overall recovery by 1987 (Food Production Index), although cereal production was on the upturn by 1985 (Cereals: Production). To compensate for poor domestic production, cereal imports (Cereals: Imports) and cereal aid (Cereals: Aid) were high during the drought period. Correspondingly, cereal availability (Cereal Availability) and food availability (expressed as Kcals per caput) show positive trends over the same period, with brief reversals in '82 and '84. Assessment of cereal-crop prospects for 1988 (the harvest period is Oct./Nov.) following an on-the-ground inspection by FAO staff indicates a record harvest. This may need to be revised depending on the damage caused by a recent heavy infestation by desert locults. FAO also reports that the country still found it necessary to import half its cereal consumption requirements for the period from Nov. 1987 to Ovt. 1988.

Nutrition

Prevalence of malnutrition as measured by percentage less than 80% reference weight-for-age is available for the capital Nouakchott from Catholic Relief Services. These are shown for December 1986 through to February 1988 (Underweight Children). The range is narrow - between 29% and 32%. While the span is too short for any definitive assessment, there would appear to be evidence for some seasonality, with prevalence peaking in August immediately prior to the harvest.

Warrack-Goldman et al., report levels of wasting (based on < 80% median weight-for-height of NCHS reference) in under fives ranging from 8.2% to 17.1% (Wasted Children) for 3 regions of the country during the drought year of 1983¹. This was considered a significantly higher prevalence than that recorded during the drought in the early seventies. The authors also reported that between one quarter and one third of the children examined were stunted; concluding that the problem of malnutrition was not only immediate but also chronic.

¹ Warrack-Goldman, H., Brown, B.H., Binkin, N.J., 1986. Nutritional Status of Mauritanian Children During a Drought Emergency. Ecol. Food & Nutr., Vol 18, pp221-229.

POPULATION: 1.9 M	IMR: 128
POPULATION DENSITY: 2 per sq. km.	U5MR: 223
POP. GROWTH RATE: 2.6% per annum	GNP (PER CAPITA): US$420
PERCENTAGE URBAN POP.: 38%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 20% - 30%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

WASTED CHILDREN

% PREVALENCE - Prevalence of wasting (<80% Wt/Ht) in 3 regions in children aged 6 months to 5 years. 1983

% PREVALENCE - Prevalence of wasting (<80% Wt/Ht) in children aged 6 months to 5 years, by age group. 1983

Niger

Niger is located in the heart of the Sahara Desert. The north-eastern region is almost uninhabited, while the central area of Agadez receives only 180 mm of rain during two months. Further south in the Sahel region, along the Nigerian border, enough rain falls to cultivate groundnuts and millet. Moving west towards the south-western corner, the climate changes again with seasonal flooding followed by nine months of drought. This is where most of the population, and the capital, Niamey, is located.

Agriculture

It is believed that Niger was one of the most severely affected countries as a result of the 1984 drought, and this is reflected in all indicators of production. Food production (see Food Production Index) and total cereal production (Cereals: Production) plummeted in 1984, causing a decline in food availability (as Kcals per day). A prolonged food shortage was reported starting in 1983 with the harvest period in September, and continuing through to November 1985 (Food Shortages). The response to this crisis showed cereal imports increasing by 300% (Cereals: Imports), and cereal aid (Cereals: Aid) by a factor of 17 from 12,900 to 221,300 MT. However, this relief did not peak until 1985, when production had already increased by the end of the year with the return of the rains in August. Excellent growing conditions were also reported in 1986, but the 1987 harvest declined by 20% from the previous year and donor assistance was requested. Kcal availability reflected this reprieve from the drought showing an improvement after 1984 and continuing through 1986, however following the poor harvest of 1987, energy availability would be expected to have declined again. Food aid requirements for 1988, as estimated by FAO at the end of 1987, were some 350% of normal. This situation has been reversed dramatically following the above normal and well distributed rains during 1988, which has resulted in a record cereal harvest in November 1988.

The Economy

Traditional farming and livestock raising contribute about one third to the GDP, and by the end of the seventies the contribution of mining had increased to 13% (1980) with the production of uranium. The trend in GNP showed a downturn in 1982, which continued to decline until 1984 (GNP). The fall in uranium prices in 1980/81 triggered a decline in production which likely had a major influence on the downward trend in GNP in the early '80's. Exports in Niger are only partly recorded, but a substantial trade existed with the export of livestock to Nigeria. This was disrupted in 1984/85 with the temporary closing of Nigeria's land borders. Prior to this, in 1975 uranium accounted for two-thirds of all export earnings, with the latter reaching a peak in 1980. However, export earnings declined markedly in 1981/82 as uranium exports declined in volume (as a result of lowered production) and price (lowered worldwide demand). As in many African countries, debt outstanding and disbursed (Debt), has been increasing since 1980 in Niger. The combination of increased debt with decreased export earnings has caused a significant increase in the debt service ratio (Debt Ratio) from a low of 6% in 1980 to 30% in 1982 - one of the highest ratios in the world. At this time the IMF and World Bank recommended a series of adjustment strategies; the use of IMF credit (IMF) began to rise, and the latest figures (for 1985) show a continued increase. The economic difficulties which began in 1980 are reflected in a rise in consumer price index from 90 to a high of 140 in 1982 (CPI). Subsequent trends in CPI have been more sporadic with a seasonal component becoming more evident by 1984; but the overall trend seems to be one of a continued but more gradual increase in prices peaking in 1984 followed by stabilization and a possible lowering of prices by the end of 1987. Food prices are not available until 1983, but like CPI, a sharp increase occurred around July/August 1984 (probably due to the drought) followed by an apparent overall decline, but maintaining a strong seasonality (FPI).

Nutrition

Prevalences of below 80% weight-for-age were recorded monthly from 1981 to 1987 in the capital Niamey (Underweight Children). Prevalence estimates tend to fluctuate within any given year, but when the seasonal component is removed, the trend appears upward since 1981 with the sharpest increase from 1982 to 1983 (Prev. Deseasonalized). It is surprising that the impact of the drought on production and thus food availability in 1984 did not seem to have a more serious affect on increasing prevalences of malnutrition. However, prevalences did begin to rise again in 1984 and 1985, albeit more slowly than in 1982, after a short period of stabilization. It is possible that the earlier rise in malnutrition was a result of the deteriorating economic situation, lower GNP, increased prices, etc., while the latter more gradual increase was due to the drought. The fluctuations seen in prevalences within any given year show a seasonal component (this is the factor by which prevalence increases or decreases as a result of seasonality which is superimposed on any long-run trend; see Seasonality) which agrees with the harvest calendar. There is a single harvest in Niger, September to November, which occurs just after the major peak in prevalences in about July/August. Following the harvest period, prevalence estimates decline from about December through March of the next year. These seasonal trends are evident in other indicators including economic and health. The most striking seasonal associations occur with prevalences of malnutrition (Seasonality) and the food price index (FPI). The peak in FPI occurs at exactly the same time as the peak prevalence, just before the harvest period. The apparent overall decline in food prices in 1986-87 may have contributed to the concomitant improvement in nutritional status in this year.

NIGER

POPULATION: 6.5 M	IMR: 136
POPULATION DENSITY: 5 per sq. km.	U5MR: 232
POP. GROWTH RATE: 3% per annum	GNP (PER CAPITA): US$260
PERCENTAGE URBAN POP.: 18%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 15% - 25%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

SEASONALITY

SEASONALITY FACTOR - Seasonal component of underweight prevalence

FPI

Rwanda

Rwanda is one of the smallest and most densely populated states in Africa. The population is in excess of 6.5 million (mid-1987), and growing at an estimated 3.3% per annum. Population density is approximately 250 persons/sq. km. The rate of increase in cultivable land is only about 1.5% per annum. This increase - not adequate to keep pace with population needs - is itself being offset by deforestation and soil erosion. These factors contribute to existing environmental constraints on agricultural production. To meet the continuing strain on food resources, the third 5-Year Plan (1982-'86) targeted self-sufficiency in food as a major priority. Food production was relatively stable during this 5-year period (see Food Production), if 1984 - a drought year - is excluded. The main 1984 harvest was reduced by 50% as a result of drought. There was a partial recovery in 1985, only to be reversed in 1986. 1987 fell far short of previous years at only 74% of the 1980 production figure, and the intended annual growth rate of 3.3% since 1982 has not been achieved.

Agriculture

Although the main provider of employment (at 90% of the labour force) and the principal export earner, agriculture contributes only 42% to GDP. A very high percentage of total production is in the form of subsistence crops. Coffee is the main cash crop and accounts for on average 70-80% of the value of exports. The food production index (Food Production Index), in line with the trend in cereal production (Cereals: Production) show similar profiles: rising until 1982, declining in 1983/'84, recovering in 1985, followed by further reductions in 1986 and '87. Cereal imports (Cereals: Imports) and cereals provided as food aid (Cereals: Aid) rose substantially in 1984/'85 and declined thereafter. As a consequence, cereal availability (Cereal Availability) peaked in 1985 with an additional 50,000 MT, before returning to its previous level of around 330,000 MT. Food availability as indicated by the Food Balance Sheet, and expressed as kcals/caput/day decreased markedly from 2130 kcals in 1982 to 1920 kcals in 1983 and continued downwards to 1830 kcals in 1986 (Kcals per day). This reflects the trend in the indices of total food production and cereal production already described, and is a notably low level.

The Economy

Rwanda, being land-locked, depends on rail links through neighbouring countries to get its goods to port. The civil strife in Uganda in 1984 and 1985 created difficulties which significantly increased the cost of imported goods, including food, which amounts to some 15% of the value of total imports. This exacerbated the effects of the drought during that period. The economy has suffered further as a result of recent fluctuating coffee prices on the world market as this commodity accounts for as much as 80% of the value of the country's exports. GNP rose between 1980 and 1981, remained steady until 1983 and declined in 1984. Some recovery is evident in 1984 and '85 (GNP). Debt outstanding and disbursed and total debt as a percentage of goods and services exported (Debt & Debt Ratio, respectively) have been rising continuously, the former by 150% between 1980 and '86. The exchange rate (US$ per Rwd. franc) was constant until the third quarter of 1983, at which point it declined until the beginning of the second quarter of '85. By January 1987 the rate had increased again by 26% (Exchange Rate). Austerity measures were announced in 1984 and maintained since, which resulted in raised prices for agricultural products, and the control of imports. The consumer price index had been increasing steadily until late '84, at which point it stabilized for a period. By mid-'86 it had begun to rise again (CPI). Over the period 1980-1986 consumer prices rose by 40% - modest in comparison with many other countries in the region.

Nutrition

The nutritional data were collected from a nation-wide system of nutrition centres managed by the government and supported by Catholic Relief Services. Data are available from January 1982 to December 1986. Subsequently, the programme selected only underweight children, so prevalence data cannot be interpreted. The five-year Rwandan nutritional profile is most notable for the comparative consistency of prevalence levels, during a time of ecological and economic distress for most of sub-Saharan Africa. The prevalence of underweight children varied by less than 3% over the entire period; it ranged from 29% to 32% below 80% weight-for-age of the reference population (Underweight Children, % Prevalence). The nutritional data do not show any drought-related deterioration (Food Shortages). However, the overall trend is very gradually upwards, which is cause for some concern (Prev. Deseasonalized). The two harvests per year may provide some stabilization of food availability. The first in January-February, and the second, in June. While there is a minor seasonal pattern in the prevalence data, it is however not particularly pronounced, and this is consistent with the two harvests per year.

The reported annual incidence of measles remained high during 1980 and '81, decreasing strongly in 1982 and more gradually until 1985. 1896 saw an upturn once more, which may well reflect the well established periodicity of measles epidemics.

RWANDA

POPULATION: 6.5 M	IMR: 123
POPULATION DENSITY: 250 per sq. km.	U5MR: 209
POP. GROWTH RATE: 3.3% per annum	GNP (PER CAPITA): US$290
PERCENTAGE URBAN POP.: 7%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 20% - 30%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

MEASLES

NUMBER OF CASES - Reported annual incidence of Measles

Sudan

With an area in excess of 2.5 million sq. km., the Sudan is the largest country in Africa. Comparatively featureless throughout, there are nevertheless a number of distinct ecological zones. The north of the country is desert with negligible rainfall. Rainfall gradually increases moving southwards to around 1,000 mm per annum, although this figure varies from year to year, with critical economic and health consequences. The rainy season lasts from April to October in the South, but contracts to the months of July and August in the north. The Nile River (with major tributaries the Blue and While Niles) is at the heart of most economic and agricultural activity in the country. The Blue Nile supports over 40% of the irrigated land which is used primarily for the production of cotton - the only cash crop of significance in the Sudan. The river floods towards the end of July and waters remain high until the end of October.

The census of 1983 enumerated the population at 20.5 million, (estimated in 1987 at 23.1 million), with just over 79% rural, 11 % nomadic and the balance urban and semi-urban. The bulk of the population is concentrated within the Central Region giving a local density of approximately 28 persons per sq. km. compared with 9 per sq. km., nationally. The rate of increase in the population is estimated at 2.8% per annum.

Since its independence in 1956 the country has experienced a number of turbulent years. There have been 6 separate regimes during this period, the last of which - a civilian coalition - changed as recently as late 1987. The main difficulties faced by successive governments have been both political and economic. The former arises from the continuing civil war engendered by the determination of the South to have some form of independence from Khartoum. The cost of this long struggle has been enormous in both human and economic terms. The principal economic difficulties are related to Sudan's dependence on cotton as its major foreign currency earner. Fluctuating prices on the international markets for cotton, compounded by quality control problems and further aggravated by periodic droughts, have proved very damaging to the economy.

Agriculture

The agricultural sector contributes as much as 40% of GDP during non-drought years and is the major source of foreign earnings. However, at the height of the recent drought in 1984 and 1985, its contribution dropped to 28%. Eighty percent of the workforce is involved in this sector, the majority being subsistence farmers. Around one third of the total land area is suitable for some form of agricultural production, yet only 15% of available arable land may be cropped because of the need for water, whether as rain or through irrigation schemes. While the bulk of the cash crop is produced on the irrigated land comprising the Gezira Scheme - one of the largest farms in the world - the rainfed lands account for most of the staple grain production and a significant percentage of meat, milk and vegetables. This is usually adequate to meet demand during normal years. From a peak in 1981, overall food production fell by over 20% by 1984 (see Food Production Index) and by 65% for cereals for the same period (Cereals: Production); much of this decline happening in 1984 due to drought (Food Shortages & Unfavourable Crop Conditions). This was followed by a partial recovery in 1985 and '86, but 1987 proved another disastrous year with the grain harvest down by over 50% on the previous year. This follows a reduction in the area sown, inadequate and unreliable rainfall - particularly in the western regions - and loss of grain to pests. Local surpluses of grain were available in 1987, but resources for distribution to areas with shortfalls did not exist. The shortfall in 1987 was largely made up for by reasonable harvests in the preceding two years and helped by cereal imports and cereal aid (Cereals: Imports & Aid). In consequence, available cereals for 1987 remained reasonably high (Cereal Availability) as did available calories (Kcals per day).

FAO reported in Nov. '88 that the food supply situation continues to be problematic. The South is particularly badly affected due to food shortages arising largely due to the disruption caused by the continuing civil war. Reports of deaths and starvation have come from many towns in the South. International assistance was required to purchase and airlift local surpluses for distribution to famine-affected areas. In the North, 1988's end-of-year crop is believed to be appreciably better than 1987's, inspite of severe flood damage earlier in the season and conditional on further damage by desert locusts being contained. FAO reported that localized shortages persist in the Red Sea province and in Darfur and Kordofan. Domestic production is still far short of requirements and food imports, both commercial and as structural food aid, will continue to be needed for the forseeable future.

The Economy

As over 90% of its export earnings derive from primary agricultural products, the drought's impact has been substantial. As measured in local currency, GNP, after rising between 1981 and 1983, fell very sharply in 1984 and again in 1985 (GNP). Sudan's current trade deficit stands in excess of S£ 1,000 million and its external debt, which has continued to rise rapidly, at around $13 billion. Debt expressed as a proportion of services and goods exported (Debt Ratio) began to increase again in 1985 after a significant decline from a high in 1982.

Negotiations with IMF in May 1979 and subsequent years brought about in a series of currency devaluations (Exchange Rate), reduction in food and other subsidies, substantial price rises (CPI) and cut-backs in public expenditure and imports. Sudan maintains one of the largest outstanding debts of any nation with respect to the IMF. Strong public feelings generated in response to the impact (CPI & FPI) of adjustment policies contributed to the change in government in 1985. Nevertheless, increased austerity measures were undertaken by the government in January '86, following the beginning of a new round of talks with international financial institutions. In spite of certain difficulties - notably the government's continuation of food subsidies - agreement was reached for additional credit toward the end of 1987. This resulted in another devaluation of the currency (Exchange Rate) and price increases on certain nonfood items.

Nutrition

During the drought period, numerous nutritional status studies were conducted, primarily by relief agencies. These were typically small-scale, based in different geographic areas, often of different age groups and using different measures. However, in mid-'86 the Ministry of Health, with funding from US AID, undertook a series of 4 studies of under fives in 6 regions of the country (Sudan Emergency and Recovery Information and Surveillance System - SERISS, 1986¹).

¹ Sudan Emergency and Recovery Information and Surveillance System, Report No. 1, November 1986. Ministry of Health, Khartoum.

The peak wasting prevalences seen in 1986 - reaching nearly 30% in the Red Sea province - are very substantial and indicated a very serious nutritional situation.

From the first panel it will be seen that for these provinces, prevalences peak in Oct/Nov., decline in Jan/March and then show an upswing in May/July '87. For the provinces shown in the second panel there is no evidence of a peak in Oct/Nov. This is also the case for the prevalences shown in the third panel. The minimums occur, as before, in Jan/March - following the main coarse grains harvest in Nov. to Dec. - and the upturn is also evident in May/July '87. (The wheat harvest occurs in March.)

The Gezira province has the lowest prevalence rates generally, and approached the expected rate of around 2.5% - as would be expected based on a Gaussian curve - in January 1987. After Khartoum, the Gezira is the second most developed region in the country.

There is some evidence of a decrease in the mean prevalence, allowing for seasonal shifts, between 1986 and 1987; 10 of the 12 provinces show better May '87 figures than for the preceding May. However, this conclusion remains tentative, based, as it is, on only 4 time points. Maximums and minimums for the 4 time points are tabulated below.

Table of seasonal differences in prevalences of undernourished (< - 2 S.D's. reference weight-for-height)

	(May/Jun '86)	(Oct/Nov '86)	(Jan/Mar '87)	(May/Jul '87)
Max.	23.5%	26.9%	14.0%	16.9%
Min.	13.4%	8.7%	2.3%	9.0%
Mean	18.2%	15.8%	8.4%	12.5%

SUDAN

POPULATION: 23.1 M	IMR: 109
POPULATION DENSITY: 9 per sq. km.	U5MR: 184
POP. GROWTH RATE: 2.8% per annum	GNP (PER CAPITA): US$320
PERCENTAGE URBAN POP.: 21%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 20% - 30%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

REGIONAL PREVALENCE OF WASTING

% PREVALENCE - Prevalence of wasting (<-2 S.D. Wt/Ht) in children aged under 5 years for selected provinces

% PREVALENCE

% PREVALENCE

Tanzania

Three years after their independence in 1961 from British Trusteeship, Tanganyika and the island of Zanzibar formed the United Republic of Tanzania. Population was estimated at mid-1987 to be 24.5 m. The land area is just under 1 million sq. km., and the population density is 26 per sq. km. Growth in population is 3.5% per annum. The temperature and rainfall vary widely over the country as a consequence of its diverse relief, from tropical to temperate conditions, with rainfall differing from a high of 1250 mm to a low of under 500 mm. Soil fertility is not particularly high, except in Zanzibar and the environs of Kilimanjaro and Mwanze, which have the highest population density. Considerable efforts have been made to develop a measure of self-sufficiency based on a principle of village socialism. The droughts in the 1970's and '80's, border disputes with neighbouring countries during the early to mid-'70's, and fluctuating market prices for Tanzania's cash crops, have contributed to only moderate economic performance since independence.

Agriculture

Agriculture contributes 80% of export earnings and employs around 90% of the labour force. Its share of the GDP has dropped from 47% between 1971 and 1973 to just under 40% a decade later. Currently, it stands at around 50% of GDP. As a result of the high costs of inputs and poor returns, the production of cash crops - coffee, cloves, cotton and tea -fell during the late seventies. Farmers moved out of cash crops and into subsistence farming. This decline was reversed in 1983 as a result of price increases of the order of 40% for the main cash crops. There have been further increases during the period since, which is in line with the agreement signed between the government and the IMF in 1986. Poor rains in 1982, and drought in 1983 and 1984, have contributed to the fall-off in total food produced (see Food Production Index). Unfavourable crop conditions were recorded in 1980, 1981, 1983 and 1984, and food shortages each year between 1980 and 1985 (Unfavourable Crop Conditions & Food Shortages). Cereal production fell by 9% between 1980 and 1983; the 1984/85 crop year saw an improved harvest, which continued through 1986 (Cereals: Production). A record cereal harvest was recorded for 1987. Commercial cereal imports decreased until 1984, although there is a corresponding increase in cereal aid (Cereals: Imports & Aid). Overall, the trends in cereal availability (Cereal Availability) - which contributes an estimated 40% of the Tanzanian diet - and per capita food supply (as Kcals per day) became positive in 1984 in line with cereal production.

The Economy

Over the 6-year period 1980 through 1985, debt outstanding and disbursed had increased (from a base of $2.04 bn) by 46% (Debt). In 1985 the total external debt had reached a figure of $3.5 bn. Debt (as debt outstanding and disbursed) as a percentage of GNP had climbed from 39% in 1980 to 52% in 1985. Poor production and the comparatively low value of its trade goods (particularly the cash crops) resulted in a negative balance of trade of some $747m by 1985. The government started negotiations with the IMF in 1979. An agreement was signed in 1980 and the first tranche was advanced before the agreement fell through in 1981 (IMF). Further negotiations continued on and off until another agreement was reached in late 1986 covering standby credit and a structural adjustment facility as part of the 3-year Economic Recovery Programme. Agreement was also reached with the World Bank and linked to the funding by the IMF. As a direct consequence, debt rescheduling was provided by the major donors in 1986 and additional financial assistance approved. Part of the agreement with the IMF involved a substantial currency devaluation in 1986 (Exchange Rate). Further smaller and frequent devaluations have taken place since. Price controls were also to be removed in stages and subsidies removed on maize. To counteract the inflationary effects (CPI & FPI) - running at 33% in 1985 - of these measures, wages of civil servants were raised by around 20% in 1987. The GNP fell slightly in 1983, but recovered thereafter (GNP). The agreement with the IMF seeks improve export earnings and to increase the GDP by 4.5% per annum. In the last year or two, the signs are that the government has apparently managed to halt a prolonged economic decline. Following devaluation of the shilling to more competitive levels, and the controls on government spending and borrowing, improved performance of the economy is anticipated. To a degree, this depends on increasing the value of foreign trade, which in turn requires an increasing return from the country's main cash crops - coffee and cloves. Unfortunately, world prices for both these products have been low in 1987 and remain unreliable.

Nutrition

As is the case with many African countries, a number of nutritional surveys have been conducted during the course of the last two decades. However, by-and-large successive surveys have not been designed with comparability over time in mind. Seasonality, target population, ecological zone, choice of age groups and indicators have varied from study-to-study. While concentrating on the Iringa region, data collected by the Joint Nutrition Support Programme (a WHO/UNICEF collaborative project supported by the Italian government) - as part of a multisectoral nutrition intervention programme - have enabled some comparisons of nutritional status over time to be made. It must be stressed that the evident and significant improvement in the prevalence of underweight in under fives (Quarterly Prevalence) in Iringa is most likely due to intervention activities and is not thought to be applicable to the rest of the country.

TANZANIA

POPULATION: 24.5 M	IMR: 107
POPULATION DENSITY: 26 per sq. km.	U5MR: 179
POP. GROWTH RATE: 3.5% per annum	GNP (PER CAPITA): US$250
PERCENTAGE URBAN POP.: 28%	ESTIMATED PREVALENCE LEVEL UNDERWEIGHT CHILDREN: 15% - 25%

GRAPHICS

ADDITIONAL FOOD & ECONOMIC INDICATORS

CEREALS (1,000 MT)

IMF CREDIT - (US $ MILLIONS)

FPI

QUARTERLY PREVALENCE OF UNDERWEIGHT CHILDREN

% PREVALENCE - Prevalence of underweight (<80% Wt/Age) in children aged under 5 years for the 2nd Quarter of 1984 to the last Quarter of 1987. JNSP Programme in Iringa Province.

Togo

Togo has a land area of 56,785 sq. km., with a population estimated in mid-'87 at 3.1 million, and increasing at a rate of 3.4% per annum. The population density is around 54 per sq. km. One quarter of the population is urban, with a particularly high proportion of these in the capital Lomé. The average annual rainfall is only 780 mm.

A civilian government was established after independence in 1960. However, between 1967 and 1979 the country was governed directly by the military. A new constitution was passed in 1979 and the "Third Republic" declared in 1980. The country is now headed by a constitutional president, supported by a national assembly. Togo has experienced a number of difficulties both directly and indirectly as a result of civil and economic upheavals in neighbouring countries. At various times trade embargoes and border closures have been experienced. Recently, however, these particular difficulties have been overcome, and Togo now enjoys the role of facilitator in respect of developing cultural and trading links between anglophone and francophone West African countries.

Agriculture

The agricultural sector contributes a modest 25% of GDP, but around 50% of export earnings. Sixty five percent of the labour force is employed in this sector. Togo shows inevitable similarities with neighbouring Benin in the recent period as far as the agricultural sector is concerned, sharing basically the same (if somewhat drier) climate, and experiencing the drought from 1981/82 through 1983T'84. In non-drought years, Togo is also self-sufficient in staples. Food production dropped dramatically during the drought years (see Food Production Index), recovering somewhat in '84, but then suffering a further decline which continued through to '87. Cereal production rose by 50% in the 1984 harvest over the previous year (Cereals: Production); unfortunately, it was down by 16% in 1985 on the bumper harvest of '84, and has continued at about this level since. Food shortages were seen again in 1987 as a result of badly distributed rains (Food Shortages). Cereal imports and aid in the form of cereals (Cereals: Imports & Aid, respectively) peaked in 1985 and have declined since. Cereal availability mirrors the production pattern closely: low between 1980 and '83, peak in 1984, falling off in successive years (Cereal Availability). Food availability (as kcals/caput/day) reflects the above trends (Kcals per day), particularly the sharp drop in 1983.

The Economy

In spite of a modest rate of growth in the economy since independence, the period 1980 - 1983 shows a sharp decline in real GNP expressed in local currency (GNP). Following 1984, there was a marginal increase which continued in 1985 and 1986. The Development Plan covering the years 1981 - 1985 had targeted a growth of 6.5% per annum in GDP. The failure to achieve this may be accounted for, at least in part, by the 3 years of drought and the slump in phosphate (a major export earner) production. These factors contributed further to a general economic recession embracing most countries in the region. The turn-around between '84 and '85 may be attributed to a reversal of these factors, i.e. the ending of the drought and an increase in phosphate production. However, the economy showed further deterioration during the last quarter of 1987, as weather conditions affected crop production, trading stagnated and investment fell. External public debt peaked in 1980 at just under $925 million; it declined thereafter until 1984 from which it has again risen sharply (Debt). The ratio of total debt to goods and services exported has risen from 0.08 in 1980, to just under 0.30 in 1985. The increase was particularly noticeable in 1984 and '85 (Debt Ratio) as the dollar strengthened. Debt rescheduling took place in 1979, 1981 and 1983 and it is anticipated that further rescheduling will be required during the latter half of the '80's. Against this background, the Government introduced measures of fiscal austerity as early as 1979. At that time the IMF was consulted and support sought. More recently, a series of 3-year rolling programmes were devised beginning in 1984 with increasing support from the IMF. The exchange rate (US$ per CFA Franc) reversed its long and substantial decline in 1985 (Exchange Rate). This series is the same as that for Benin, as both are tied to the French currency. The consumer price index (CPI) and food price index (FPI) are evidently highly correlated. Both rise sharply to peak in mid-1983 and after an immediate reduction show moderate fluctuation thereafter. The ratio of FPI to CPI rose until mid-1983 and declined subsequently (FPI/CPI).

Nutrition

Nutritional surveillance data from Togo has been collected by Catholic Relief Services, from approximately eighty government social welfare centres, located throughout the country. Weight-for-age data are collected monthly for children 6-60 months of age.

The monthly prevalence of children below 80% weight-for-age is summarized in the figure (Underweight Children) and shown deseasonalized in Prev. Deseasonalized. A serious nutrition situation existed in 1983, with the prevalence of underweight children varying from 39% to 51% over the course of the year. This rise coincided with a sharp decline in food availability on a national level in 1983, and with FPI and CPI reaching their maxima. Since 1983, there has been a steady