From the editor

This Field Exchange special issue on Urban Food Security and Nutrition aims to provide some insights into the learning and experience of a broad range of agencies, and highlight some of the remaining gaps in knowledge and areas for research and development. This special edition focuses on programmes responding to rapid and slow onset natural disasters and displacement. The research, evaluations, news and views have been carefully selected to showcase the type of work that is being developed, but it is not a comprehensive body of work; rather a snapshot of current thinking and practice. In a couple of editions time, ENN will produce a special Syria edition, elaborated in a news piece on page 48, which will deal with refugee urban populations and host communities caught up in crisis.

As of 2008, the majority of the world’s population lives in urban areas*. By 2030, over 60% of the world’s population will live and work in urban environments. The speed and scale of urbanisation today are far greater than ever in the past, overstretching governments and the international community’s capacities. This implies overwhelming new challenges for cities in poorer countries; they will need to build new urban infrastructure - houses, power, water, sanitation, roads, commercial and productive facilities - more rapidly than cities anywhere before. The bulk of urban population growth is likely to be in smaller towns and cities, which lack the political capital, capacities and resources to cope with rapid urbanisation.

Sub-Saharan Africa is the world’s fastest urbanising region and has the highest proportion of slum** dwellers (72% of its urban population). Asia is the region that will host the highest number of new urban dwellers, rising from 1.36 billion to 2.64 billion by 2030. In Latin America and the Caribbean, rapid urbanisation started in the 1960’s and it is now the most urbanised region in the world, with 78% of its population living in urban areas¹.

Urban poverty and vulnerability are concentrated in slums. One billion people already live in slums (15% of the total of the worlds’ population of 7 billion); by 2030, this number will double. The United Nations Millennium Declaration articulates the commitment to improve the lives of at least 100 million slum dwellers by the year 2020 - Target 11 of Goal No 7.

As population and poverty urbanises, so do disaster risks and humanitarian crises. The global assessment report on disaster risk reduction identifies urbanisation as one of the three key drivers of future disaster risk². Whereas rapid and uncontrolled urbanisation is constructing escalating risks, the number and vulnerability of at-risk populations are also rising. Haiti’s earthquake has demonstrated that urban disasters’ scale and complexity defy humanitarian actors, with their accumulated experience in rural areas, to renovate their strategies and tools.

This growth is in the context of a global economic downturn, sustained food price rises and reoccurring complex emergencies. Urban food insecurity and malnutrition are rarely monitored or captured by early warning systems, and data is not disaggregated at the level of urban slums. Although urban food security and nutrition programmes are emerging, they are struggling to raise their profile and strategically engage donors.

Urban emergencies over the last 10 years have included:

• conflict in Syria and Mogadishu
• earthquakes in Gujarat, Bam and Port au Prince
• floods in Manila, Dhaka and Sindh
• organised urban gang crime in Guatemala city, Honduras and El Salvador
• massive IDP and refugee influxes in Beirut, Amman, Bamako due to conflict, and in Nairobi and Addis due to the indirect effect of climate change and drought
• political unrest in Harare and Gaza
• landslides in La Paz and Guatemala city

In the coming years, there are both rapid and slow onset urban emergencies predicted, including an earthquake that will affect the Kathmandu valley and beyond, and a burgeoning slum population across Sub-Saharan Africa.

However, cities are also engines of growth and loci of social, cultural and political dynamics that can leverage rural, national and global level change - as demonstrated by the democratisation movements during the Arab Spring in 2011, in Africa in the 1990’s or in Latin American in the 1980’s. Cities are economic and cultural magnets for migrants in search of economic opportunities or freedom from oppressive social or gender norms. Cities are the markets where food consumption, distribution and processing patterns set the rules for food producers. Cities are the first contributors to, and potential first victims of, climate change and environmental depredation.

Many international non-governmental organisations (INGOs) have been running small scale urban programmes over the last 10 years, but approaches, skills, learning, policy and funding is in its infancy compared to the rural programmes where there is experience and learning from the last 70 years. There have been the assumptions that markets are integrated, labour opportunities are widely available, urban spaces enable access and there is availability of food and health care. This may be the case for some urban dwellers, but as urban slums grow (they make up around 60% of Nairobi as described in the field articles from Kenya in this edition), and population densities rise (around a million people live in 1 square mile in cities like Mumbai and Manila), there are vulnerable households that cannot meet their immediate needs and as a result become acutely food insecure and malnourished. The Save the Children/NutritionWorks (2012) review of food security and nutrition in the urban poor is reviewed in this edition and further discusses these issues (page 28).

Challenges

There have been a large number of papers written on the challenges of urban programming and how it differs from rural programming in its complexity. However, there are very few guidelines that translate the challenges into adapted approaches to urban programme and policy. What is clear is that we must adapt rural approaches to differing urban contexts, understanding that ‘communities’ do not exist in the same way as in rural areas, that there are multiple stakeholders and that we cannot hope to scale up to meet the needs of the whole city. Therefore, we need to invest more in strengthening partners and states capacity to respond, to work hand in hand with development actors, utilising skills that humanitarian agencies do not typically possess such as power analysis and governance skills, as well as strengthening our risk analysis and disaster preparedness to ensure that we can best organise our meagre resources over large and complex spaces. These issues are touched upon in a 2012 review by ALNAP of lessons learned from urban emergencies, summarised in this issue (page 47).

Preparedness

Although preparedness is not a recognised strength of humanitarian agencies, it is essential in working alongside communities to build resilience and ensure a division of resources, labour and prioritisation for vulnerable urban communities. Good risk analysis should include a full power analysis and will provide the opportunity to link humanitarian and development programming in a ‘one programme approaches’ that reduce silos and ensures more effective programming. The complexities of power relations in urban settings can be immense, a great insight is provided in an article about ‘gatekeepers’ to aid in Mogadishu by the Somalia Cash Consortium (page 25). Few organisations have urban strategies, but where they do exist (e.g. Oxfam GB 2012) there is generally agreement that there should be a governance framework for interventions with a strong focus on working with the state rather than direct service provision.

Slow onset & triggers

Although humanitarian imperatives dictate that humanitarian responses reflect need, this has not been the case for slow onset or hidden urban emergencies. Rapid onset urban emergencies normally receive good media coverage and funding, but urban contexts affected by food price rises, an influx of refugees or internally displaced people (IDPs), or where there is a subtlety changing political or conflict situation, have seen little or no urban specific funding. Current early warning systems or national data often does not capture the vulnerability and seasonality of changing food insecurity and malnutrition in slums, and this lack of data makes it difficult to demonstrate humanitarian need. The nature of slums means that they are often not formally recognised by Governments, as doing so would require the state to provide services, infrastructure and safe habitats. So capturing this data will be both political and also require a change in triggers or cut-offs applied in rural areas. For example, a global acute malnutrition (GAM) rate of 8% in a slum may not exceed the threshold for emergency response, but due to the population concentration, may mean that there is the same number of malnourished children as in a rural area. These issues are further discussed in a review of urban food security targeting methodology and emergency triggers (Oxford Policy Management (OPM), Oxfam GB, Concern International, ACF International) on page 30.

Assessments and analysis

Although ACF have developed guidelines for the assessment of sustainable livelihoods and urban vulnerabilities (summarised in this issue), they have not been widely utilised by the international community. Analysis is severely hampered by the lack of disaggregated data for food security and nutritional indices, although where data does exist it is clear that there are some urban slums where vulnerability is as bad as or worse than rural areas within the same countries. The Food Security Cluster Urban Working Group is reviewing tools and guidelines and working to coordinate different agency approaches, but in the meantime there is no consensus on assessment approaches or triggers for analysis and this urgently needs addressing. An article by Concern Worldwide and the African Population and Health Research Centre (APHRC) Kenya shares the findings of operational research in Kenya to identify indicators that can help detect the ‘tipping point’ from chronic need to crisis in vulnerable urban populations. Their experience demonstrates how unpredictable and heterogeneous urban populations are. This work has been undertaken as part of the Indicator Develop-ment for Surveillance of Urban Emergencies (IDSUE) project, a five year research study funded by the USAID Office of U.S Foreign Disaster Assistance (OFDA).

Targeting

Evaluations have shown that community based targeting, which is commonly used in rural areas, has a high exclusion error when used in urban areas, as outlined by the Oxfam evaluation from Nairobi, Gaza and Port au Prince PAGE 30 This is for a number of reasons including the lack of homogeneity, high population concentrations, multiple stakeholders, and distances within cities is further complicated by criminal gangs, corrupt bureaucracy and business people, and groups that do not wish to be identified such as IDP’s and refugees. Initial work by ACF, Concern and Oxfam has explored other approaches to targeting in urban contexts (page 30). This is another area that needs urgent attention and consensus to ensure a multi-agency approach can be reached.

Interventions

From urban interventions, analysis and programme evaluations over the last 10 years, it is clear that cash transfers are very effective means of meeting immediate needs in urban contexts where everything from access to toilets, water, rent, transport, electricity, education and health needs to be purchased (Oxfam evaluation, page X). For example, vulnerable households in Nairobi will spend up to 85% on food, water and energy purchases, leaving little for rental, health, sanitation and education. Cash transfers can be effective vehicles for piloting social protection models alongside Governments and enabling this modelling to influence policy and provision of social protection to a broader group of urban poor. This has been done in the Oxfam Nairobi programme in urban settlements, shared in a field article (see page X). Urban evaluations show that regular cash transfers not only improve food security but also boost social capital and can empower women during cash transfer programmes to play a more active financial role within the household. This shift in the gender dynamic can be maintained if the programme incorporates strategies to do so.

Nutrition and food security

The main determinants of food, livelihood and nutrition security are the same for urban and rural areas. However, there is a wide variation in the factors that affect these determinants. For example, urban households are more dependent on food purchase, which, if they have sufficient purchasing power, can lead to a more varied diet and higher reliance on ‘ready-made’ and fast foods, compared to rural households. Food access has a direct impact on dietary diversity and has been seriously affected by rising food and fuel prices, conflict, and the primary or secondary effect of natural disasters in urban areas across the globe.

Poor female-headed urban households or those with high dependency ratios tend to have a dietary diversity equal to that of the rural poor, however existing tools for analysis, such as food consumption scores, tend to be misleading in urban areas where diets may appear diverse, but quantities of dairy products or meat consumed might be negligible. As the urban poor tend to be dependent on income from precarious informal sector jobs that rarely meets their consumption needs, they are more likely to employ risky coping mechanisms, including high levels of debt. Women are more likely than men to have less secure and irregular jobs that are not subject to labour laws and do not offer social or medical benefits. This affects breastfeeding, infant feeding and child care practices, especially for those without family support who must adapt their work patterns or use poor quality childcare. A gender aware perspective is reflected in a research article by the Royal Tropical Institute (Netherlands) and the Bondo University College (BUC) that describes a study to profile the causes of undernutrition in a Kenyan urban slum (Kisumu) identifying needs and strategies to improve child nutrition from women’s perspective especially.

Over-crowding, poor water and sanitation, pollution, open sewerage and contamination are commonplace in informal settlements and slums. They have a significant impact on child and household health. Where urban data has been disaggregated by wealth group or studies have focused on the urban poor, high rates of undernutrition (both acute and chronic malnutrition) have been recorded for children under 5 years of age, which are comparable with or higher than the rates in rural under 5 year olds. Data that exists for urban poor women reveals high rates of undernutrition combined with rising levels of overweight or obesity in some cases, reflecting the ‘double burden of malnutrition’ (this is reflected in the Save the Children/NutritionWorks review cited earlier that includes a summary case study from Bangladesh). Rising to the challenge, the increased volume of humanitarian programmes in urban settings has been met by innovative and varied programming in many diverse contexts from cash and voucher programmes in Haiti, Democratic Republic of Congo (DRC) and the Philippines (reflected in articles by ACF) to rooftop gardening and aquaponics in Gaza (shared by FAO) to rabbit rearing in Gaza (Oxfam programming).

Malnutrition - wasting and stunting - is a daily reality of impoverished urban populations. This is often a ‘hidden’ problem, as reflected in an article by ALIMA on their early experiences of an urban programme in Chad that has been inundated with admissions for treatment of malnutrition (page 68). Routine screening for stunting as well as wasting is one recommendation from MSF emerging from research in an urban slum in Bangladesh (page 24). Rollout of integrated management of acute malnutrition in urban contexts is increasingly a priority for governments, such as in Kenya (see the news piece by UNICEF, Ministry of Health Kenya and Concern), and reflected in service expansion (as reflected in an article by Concern Worldwide). An article by the Coverage Monitoring Network ‘debunks’ some of the myths that surround access and coverage of severe acute malnutrition treatment in urban contexts, while a research piece by Ernest Guevarra, Saul Guerrero and Mark Myatt explores considerations around coverage standards for selective feeding prog-rammes. These all point to the significant caseload of malnutrition in urban settlements and slums that often remains below the ‘emergency’ radar.

Donors

Currently donors are primarily funding rapid onset short term urban responses, but are reluctant to engage in slow onset crisis as they feel that urban vulnerability is primarily chronic. The large donors are yet to develop urban funding strategies and although there is interest in this area, progress is slow. This is another key area for focus, as without clear consensus on what constitutes an urban emergency and what the exit strategy will be, then urban interventions will continue to be patchy and disconnected. An interesting article in this edition shares experiences from a donor perspective (Swedish International Development Cooperation Agency (SIDA)), through an evaluation by Development Initiatives of a SIDA funded emergency programme in Kenya. One of the key lessons was the need to link humanitarian funding to extend the gains of emergency projects.

Urban programmes require a much greater focus on political literacy, power analysis, negotiation skills, security analysis and management, land policies, informal tenure, urban planning, knowledge of urban markets, private sector engagement, and use of information communication technology, social media and mass communication, than is typically the case in rural humanitarian responses. Donors and the international community will be required to work very closely together to ensure that the additional skills required for urban programme and policy are captured.

Laura Phelps, Guest Editor, Formerly Oxfam GB, now Norwegian Refugee Council

¹UNFPA. State of world population. Unleashing the potential of urban growth, 2007. http://www.unfpa.org/swp/2007/english/introduction.html

²UNISDR, 2011

* Urban areas: There is no internationally agreed definition for urban. Urban areas range from small towns to megacities, and are typically characterised by:

• Administrative criteria such as a threshold population size (2,000 to 50,000 people)
• High population density
• Economic function: the majority of inhabitants are not dependent on agriculture
• Concentrations of infrastructure, basic services and economic assets (paved streets, lighting, transport).
• Heterogeneous and mobile populations, fragmented social networks.
• Complex governance systems with a multiplicity of actors.

**Slums: UN-Habitat defines a slum household as one that lacks one or more of the following:

• Access to improved water
• Access to improved sanitation
• Security of tenure
• Durability of housing
• Sufficient living area