SUMMARY
Survey method and sources of information
The EFSA was conducted in June 2008
in 7 towns of Tajikistan, including the capital city Dushanbe, Khujand
and Taboshar in Sughd region, Kulyab, Kurgan-Tyube and Sarband in Khatlon
region, and Khorog in Gorno-Badakhshan region. The towns were selected
on the basis of their varying size and geographical dispersion in the country.
Their total population is estimated at 1.032 million, so around 75% of
the total urban population of Tajikistan (1).
In each town, maps (2) were used to
delineate neighbourhood boundaries and draw a grid or clusters of approximate
size. A total of 10 clusters and 10 households per cluster were randomly
selected for each town. Questions were asked about living conditions, food
consumption, income sources, expenditures, coping strategies and access
to assistance. The weight, height and mid-upper arm circumference of all
under-5 year old children living in the households were measured to assess
the nutritional status, and information on child feeding practices and
health was also collected. A total of 700 households and about 350 children
were included.
Focus group discussions were organized
with groups of men and women in each town (total 70 discussions), to enquire
about livelihoods dynamics, income levels and coping strategies. Participants
were selected by the local authority representative in the neighbourhood
and were supposed to represent the average inhabitants of the neighbourhood.
Separate interviews were conducted with the authority representatives themselves
(total 70) focusing on health, education, main difficulties and priorities,
and assistance programmes. Some 243 local traders and shop-keepers in the
various neighbourhoods were also visited to collect information on prices,
changes in food supply and demand, credit and trade-related difficulties.
While the household sample is limited,
the multiplication of information sources enabled a comprehensive analysis
and triangulation of findings. However, large variations were observed
between towns in terms of proportions of food insecure people and malnourished
children, types of livelihoods, coping strategies and main problems. This
renders difficult the extrapolation of results to towns that were not included
in the sample.
How many are food insecure in urban
areas?
In the 7 sampled towns, an average of
21% of the households were severely food insecure, 34% moderately food
insecure, and 45% food secure. When extrapolated to the remaining towns,
the estimated proportions for the whole urban areas (3) are 15% severely
food insecure, 22% moderately food insecure and 64% food secure. These
figures are similar to the estimates in rural areas done in May 2008 at
the peak of the lean season (12%, 22% and 66% respectively). The numbers
represent an estimation of 200,756 severely food insecure people and 295,355
moderately food insecure, hence almost half a million food insecure urban
people.
Who are the urban food insecure?
The socio-economic characteristics of
the food insecure households are relatively comparable across
towns.
The severely food insecure households
typically consume a poor diet consisting of bread, pasta and/or potatoes
on a daily basis, very rarely complemented with vegetables (once a week).
Pulses and animal products are practically not consumed. Oil is added irregularly,
and sugar is consumed 2-3 times a week. The number of meals per day of
both adults and children is low (less than 2 for adults, 2 for children).
The average food expenditures on a weekly basis are less than the cost
of a basic food basket including only wheat, oil and sugar. Bread, potatoes,
oil and sugar are the main posts of food expenditures, while health is
the main non-food expenditure (9% of total expenditures).
Some 60% of the severely food insecure
households have only 1 member able to earn an income. Almost 30% depend
on pensions/allowances as their main income source, 21% depend on remittances,
21% rely on day time/casual work, 20% receive government salaries. The
rest is combining these various sources which tend to provide low, irregular
and uncertain earnings. Severely food insecure households also typically
own very few assets and very few have any cash or other savings. Most of
them do not have access to a home garden and for the 15% who have, the
average acreage cultivated is small (0.02 ha). As a result, self-sufficiency
in vegetables or fruits does not go beyond one month for most of them.
Only 8% own some sheep/goats and a few poultry.
Almost half of the severely food insecure
households are female-headed households, twice as much as the food secure
households. The severely food insecure households are also smaller (4.4
members versus 6 in other households) and have a higher dependency ratio
(4) .
Moderately food insecure households
have a slightly better diet but still inadequate. They consume bread, pasta
or potatoes, with oil and sugar daily or almost daily, but vegetables only
3-4 times a week, fruits 2 times and very seldom pulses or animal products.
Combined with a low average of 2 meals a day for adults and children, this
diet entails risk of minerals and vitamin deficiencies on the short or
medium term. The average food expenditures are marginally above the cost
of a basic minimum food basket that includes only staples.
About 64% of the moderately food insecure
households have only 1 member earning an income and rely on just one source
of income. Almost 40% receive government salaries, 32% depend on remittances,
10% rely on day time/casual work and the rest is engaged in petty trade,
self-employment or combination of activities. The asset base remains low.
Only 13% have cash or other savings. Few have access to a home garden (17%)
and the acreage is small (0.022 ha). However, slightly more than half of
them manage to secure 1 to 3 months of self-sufficiency in fruits, vegetables
and/or potatoes (yet, they represent only 9% of the whole moderately food
insecure households). About 15% of the moderately food insecure households
raise animals (mostly sheep/goats and poultry). One third of the moderately
food insecure are headed by a woman.
The food secure households consume a
balanced diet and their food expenditures are twice the cost of the basic
staple food basket. They also own more assets. The better situation reflects
their higher number of income-earning members (2 for almost half of these
households) and income sources. Although apparently similar in nature,
the positions occupied and levels of income obtained are likely to explain
their better economic situation. Almost 30% of the food secure households
rely essentially on government salaries and 20% on remittances. Self-employment
and petty trading are relatively frequent (18% and 20% respectively).
Almost 30% of the food secure households
have access to a home garden (twice as many as the other households) and
they cultivate a larger acreage (0.032 ha). More than 70% of them are selfsufficient
in fruits/vegetables and/or potatoes for 1-3 months. Some 26% raise animals
and they are more likely to own cattle than the food insecure. The proportion
of female-headed households is lower.
Why are they food insecure?
Most of the food security differences
between households are related to variations of income levels, which themselves
reflect the type and number of income sources and number of members able
to earn an income, receive pension/allowances, or migrate and send remittances.
The level of income is a key determinant to urban food security given the
almost total dependence on market/shop purchases for their food. Very few
households can produce their own food, and even those who cultivate or
raise animals do not cover their consumption requirements for more than
a few months.
Focus Group discussions indicated wide
ranges of monthly incomes for similar types of activities. While pensions
were quite systematically valued at a low 20 to 40 somoni/month, casual
labour earnings varied from 10 to 250 somoni/month, small business from
10 to 200 somoni/month, government salaries from 40 to 250 somoni/month,
and remittances from 100 to 700 somoni/month. The lower ranges of these
incomes would barely enable to cover the food expenses reported by the
food insecure households.
All households dedicated on average
two thirds of their expenses to food but the food insecure spent less than
the food secure, reflecting their lower absolute income. Nutritionally-dense
foods such as vegetables, fruits and animal products were the first ones
left out. The large share of food expenditures also means that there is
little margin to further increase food expenditures unless other essential
expenditures are decreased, including health, schooling, clothing and heating
fuel in winter.
The food insecure households were more
likely to use cash resources for illness and health-related expenses as
well as education expenses. They also faced more unemployment problems.
The moderately food insecure seemed somewhat capable to incur debts (one
third of them were indebted), most of which were to buy food, but they
also needed to dedicate a larger share of their expenditures to debt reimbursement
as a result.
Households activated several coping
mechanisms to respond to their difficulties. The food insecure were more
frequently engaged in strategies which entail negative effects on health
and livelihoods in the short or medium term:
- almost 80% incurred new debts or credits in the previous 6 months essentially for food;
- at least 3/4th decreased the amount consumed at meals and/or reduced the number of meals
eaten per day; a similar proportion borrowed food or relied on help from others;
- a staggering 40% of the severely food insecure spent entire days without eating, and 20% of
the moderately food insecure (compared to 7% of the food secure);
- almost half decreased their health expenditures (compared to 1/4th of the food secure);
- some 10-12% took children out of school (versus 4% of the food secure).
Only one third of the food insecure
households were able to use more positive strategies -though not necessarily
successful - such as seeking alternative/additional jobs. Increased migration
was feasible for about 20% of the moderately food insecure, but only 9%
of the others. Also, food insecure households were more likely to receive
food support from relatives in case of need and indeed about half of them
had benefited from it in the past 6 months. Some increase of the level
of government salaries and higher gains from petty trade were reported,
but less than 20% of the food insecure households benefited from this improvement.
Transitory and chronic food insecurity
The characteristics of the severely food insecure urban households are mostly 'structural' (lack of working-able members, poor income-earning activities, no access to credit or other capital for incomeearning activities, old age, disease), and thus reflect a chronic, rather than transitory, situation.
However, food prices rise has clearly worsened their situation (see below). The extremely low level of food consumption requires an emergency response in addition to longer-term interventions.
The main shocks that affected households over the past year include increased food prices, electricity/gas cuts as a result of the harsh winter, and decreased employment and/or lower salaries. Drinking water shortages and higher fuel/transportation costs were less frequently mentioned.
Amongst the moderately food insecure, some have become food insecure as a result of the rise of food prices and loss of purchasing power. The proportion of moderately food insecure who increased the number of migrants recently (about 19%) may be taken as a rough indication of those who have the best chances and capacity to recover from the current crisis by themselves, hence the 'transitory' food insecure. On this basis, about 80% of the moderately food insecure would be chronically so, requiring therefore more than punctual assistance. Short-term relief, however, would help to alleviate their precarious economic situation (including limit further indebtedness) and prevent further decrease in food consumption, health treatment and enrolment of children at school.
Nutritional situation
Acute and chronic malnutrition rates (5) amongst under-5 children were indicative of a 'poor' situation according to international standards: 7.8% were wasted and 20.5% stunted. The acute malnutrition figure is higher than in rural areas (4.7%) while chronic malnutrition is lower (27.5%) but differences are not significant. Because of the small sample, differences are also not significant when compared to the figures obtained in the nation-wide survey of 2005. The combination of household food insecurity, inadequate complementary feeding practices and
children's frequent sicknesses is a likely explanation for the high proportions of malnourished children.
Where are the urban food insecure?
Only 7 towns were included in the assessment and no firm conclusion can be established on the nonsampled ones. The highest proportions of severely food insecure households were found in Khujand (45%) and Taboshar (46%) which are both in Sughd region. The highest proportions of moderately food insecure households were in Sarband (59%), Taboshar (43%), Kurgan-Tuybe (42%) and Khujand (37%). As a result, the highest proportions of total food insecure households were in Taboshar (89%), Khujand (82%), Sarband (71%) and Kurgan-Tuybe (58%).
No clear pattern emerges to explain the high food insecurity in these towns except for the fact that high proportions of households were living in multi-storey buildings and generally few had access to a home garden or were raising animals. This heterogeneity makes it difficult to extrapolate the results of the assessments to the other towns that were not sampled and which represent 25% of the total urban population. It was therefore decided to use the average proportion of severely and moderately food insecure estimated for the 7 sampled towns to estimate the total numbers of food insecure in the nonsampled towns. A rapid household survey focusing on the key characteristics of the food insecure households in the non-sampled towns is recommended to refine the estimates and for programming purposes.(5)
What assistance is required?
The most food insecure people include female-headed households, pensioners, and households hosting sick members. The youngest and school-age children living in these households are particularly at risk from a nutritional and educational point of view.
The situation of the chronically food insecure households (6) (33%, some 437,050 people) is not expected to improve in the short or longer term unless prices decrease dramatically and/or pensions and casual labour wages are increased to reflect inflation and food price rises. Considering that these measures may not be taken rapidly or at all, short-term interventions are necessary to:
- improve the very poor diet of the severely food insecure, and prevent a further degradation of
the diet of the moderately food insecure;
- restore the nutritional status of malnourished individuals and prevent further malnutrition;
- stop the drop in the use of health care services and treatment and restore access;
- prevent decrease of children's enrolment at school, particularly for the start of the school year;
- limit further indebtedness.
These may take the form of time-bound
food/cash/voucher (or combinations) transfers, targeted supplementary feeding
linked with communication/sensitization activities, school feeding, and
exemption of fees or cash/vouchers for health care and school expenses
targeted to the poorest households.
At the same time, parallel and longer-term
interventions should take place to:
- set up safety nets for the chronically food insecure with only one income-earner, using
cash/vouchers
transfers; .. advocate for an adjustment of pensions, allowances and of
casual labour wages (minimal
wage?);
- support or launch public works/employment programmes (essentially for the food insecure
households who include members actively looking for work);
- provide start-up grants/credit and technical assistance for small businesses.
For the estimated moderately transitory
food insecure (4%, about 59,070 people) no interventions
may be needed in the short term. However,
as the main reason for expecting a spontaneous
improvement in their situation is the
receipt of fresh remittances from the new migrants, identifying and
eliminating these households from the
above-mentioned interventions is likely to be difficult. Options
include:
- self-targeting - This may be the most cost-effective, and could involve the provision of food
vouchers
for less preferred commodities e.g. low-grade wheat (but such limitations
would
have the serious disadvantage of preventing
the inclusion of nutritious food lacking in the diet),
or setting the wages of public works
at a low level (but this may then bring too little benefits to
targeted households).
- conditional transfers - Cash or vouchers against attendance to health centres or schools
may deter some households who would not have real needs for them (to be checked).