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Saving lives, preserving livelihoods: Understanding risk, decision-making and child health in a food crisis

Listed author(s):
  • Hampshire, Katherine Rebecca
  • Panter-Brick, Catherine
  • Kilpatrick, Kate
  • Casiday, Rachel E.
Registered author(s):

    The purpose of this paper is to analyse household decision-making regarding resource allocation in the aftermath of a food crisis in rural Niger. International attention had resulted in humanitarian agencies launching emergency nutrition programmes to alleviate persistently high levels of acute child malnutrition. We conducted participant observation, 93 in-depth interviews, 15 focus groups, 44 feeding and illness histories for children under 5, and debriefing sessions with local humanitarian staff. The impetus for this study came from observations of marked intra-household differences in child growth and health status, despite the caregivers' ethos of treating children equally. Egalitarian input, however, does not always result in equal outcomes: vulnerable children become "victims of non-discrimination" through a form of benign neglect engendered by pervasive poverty. The ethos and practices of equal investment in children are rooted in a need to balance the perceived risks to children with the preservation of long-term livelihoods. We discuss the mismatch of views between external interventions, which focus on saving individual children's lives, and local priorities, aimed at spreading risk. This mismatch is rooted in the different ways in which humanitarian agencies and local communities weigh up risks and vulnerabilities in matters of child health.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(08)00601-1
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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 68 (2009)
    Issue (Month): 4 (February)
    Pages: 758-765

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    Handle: RePEc:eee:socmed:v:68:y:2009:i:4:p:758-765
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    1. Engle, Patrice L. & Menon, Purnima & Haddad, Lawrence, 1999. "Care and Nutrition: Concepts and Measurement," World Development, Elsevier, vol. 27(8), pages 1309-1337, August.
    2. Engle, Patrice L. & Nieves, Isabel, 1993. "Intra-household food distribution among Guatemalan families in a supplementary feeding program: Behavior patterns," Social Science & Medicine, Elsevier, vol. 36(12), pages 1605-1612, June.
    3. Howard, Mary, 1994. "Socio-economic causes and cultural explanations of childhood malnutrition among the Chagga of Tanzania," Social Science & Medicine, Elsevier, vol. 38(2), pages 239-251, January.
    4. Heaton, Tim B. & Forste, Renata & Hoffmann, John P. & Flake, Dallan, 2005. "Cross-national variation in family influences on child health," Social Science & Medicine, Elsevier, vol. 60(1), pages 97-108, January.
    5. Messer, Ellen, 1997. "Intra-household allocation of food and health care: Current findings and understandings--Introduction," Social Science & Medicine, Elsevier, vol. 44(11), pages 1675-1684, June.
    6. Engle, Patrice L. & Castle, Sarah & Menon, Purnima, 1996. "Child development: Vulnerability and resilience," Social Science & Medicine, Elsevier, vol. 43(5), pages 621-635, September.
    7. Miller, Barbara D., 1997. "Social class, gender and intrahousehold food allocations to children in South Asia," Social Science & Medicine, Elsevier, vol. 44(11), pages 1685-1695, June.
    8. Castle, Sarah E., 1995. "Child fostering and children's nutritional outcomes in rural Mali: The role of female status in directing child transfers," Social Science & Medicine, Elsevier, vol. 40(5), pages 679-693, March.
    9. Harkness, Sara & Super, Charles M., 1994. "The developmental niche: A theoretical framework for analyzing the household production of health," Social Science & Medicine, Elsevier, vol. 38(2), pages 217-226, January.
    10. Millard, Ann V., 1994. "A causal model of high rates of child mortality," Social Science & Medicine, Elsevier, vol. 38(2), pages 253-268, January.
    11. Gittelsohn, Joel & Shankar, Anita V. & West, Keith P. & Faruque, Faisal & Gnywali, Tara & Pradhan, Elizabeth K., 1998. "Child feeding and care behaviors are associated with xerophthalmia in rural Nepalese households," Social Science & Medicine, Elsevier, vol. 47(4), pages 477-486, August.
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