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Food, farming and health in Ugandan secondary cities
Umeå University, Faculty of Social Sciences, Department of Geography.ORCID iD: 0000-0001-5516-1109
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This research contributes to countering a large city research bias by focusing on the food, farming and health experiences of two secondary cities of Uganda: Mbale and Mbarara. It is not an apocalyptic story. Like anywhere in the world, for some residents things were going well; for others, less well. My research explores the varied geometries of advantage and disadvantage in diets, food security, and livelihood circumstances to shed light on why things were more secure for some than for others. I used multiple methods including a household survey, focus groups with local healthcare professionals, and in-depth interviews with varied city residents. A geographic perspective explored intersections of food, farming and health with aspects of identity (such as gender, class, tribe), and with place (the city itself, but also with rural areas, or other urban areas).

The starting point was the theorised food system, nutritional and epidemiologic transitions predicted to occur with urban development, often called nutrition transition theory. My research suggests caution with dominant models of how urban life shifts food and farming systems towards a food system and diet pattern focused around large retailer supermarkets, processed foods, fast foods, more meat, less agriculture, less movement. Nutrition transition theory postulates these changes causing a shift in epidemiology from infectious to non-infectious diseases in urban areas. Instead of the suggestion from nutrition transition theory, my work presents evidence of non-communicable disease (obesity, diabetes, hypertension) experience in Mbale and Mbarara’s residents, but without evidence of advanced change in food and farming systems. Findings revealed relatively low dietary diversities and common food insecurity. Diets remained predominantly traditional, as did the main food sources (traditional markets and neighbourhood shops), across diverse residents. The more food secure had regular salaried employment and strong relational links with rural farms and family, supporting work on multi-spatial livelihoods. This contrasts with earlier ideas of who farms the African city, or retains farming livelihoods. Most vulnerable to food insecurity and low diet diversity were those who were most dependent on purchasing all their food. In conclusion, this research suggests that food system, nutritional and epidemiologic transitions in Mbale and Mbarara may be less linked than previously thought, or linked in more complex ways. Other drivers of epidemiologic change are likely. Findings highlight the importance of local data and specific city investigations.

 

Place, publisher, year, edition, pages
Umeå: Umeå University, Department of Geography , 2019. , p. 118
Series
GERUM, ISSN 1402-5205
Keywords [en]
Uganda, Africa, urban, nutrition transition, agriculture, health, food systems, dietary diversity, food insecurity, non-communicable disease, double burden malnutrition, secondary cities, feminist geography, intersectionality, mixed methods
National Category
Social and Economic Geography Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-158306ISBN: 978-91-7855-052-4 (print)OAI: oai:DiVA.org:umu-158306DiVA, id: diva2:1306083
Public defence
2019-05-17, Hörsal S205, Samhällsvetarhuset, Umeå University, Umeå, 10:15 (English)
Opponent
Supervisors
Funder
Swedish Research Council Formas, 250-2014-1227Available from: 2019-04-26 Created: 2019-04-23 Last updated: 2019-04-25Bibliographically approved
List of papers
1. Doing things their way?: Food, farming and health in two Ugandan cities
Open this publication in new window or tab >>Doing things their way?: Food, farming and health in two Ugandan cities
2018 (English)In: Cities and Health, ISSN 2374-8834, Vol. 1, no 2Article in journal (Refereed) Published
Abstract [en]

This paper presents new data on urban households’ agriculture, food environments and non-communicable disease (obesity, diabetes, hypertension) in two intermediate-sized Ugandan cities (Mbale and Mbarara). Nutrition transition theory suggests that fast-foods, eating out and supermarket shopping, together with sedentary urban lifestyles and less agricultural activity, are drivers of growing non-communicable disease burden. We explore these claims using statistics from a 2015 socio-economic and anthropometric survey of 1995 households. Results indicate that these cities are already experiencing non-communicable diseases, despite a lack of advanced food system and nutritional transitions. Surveyed households generally had low or medium dietary diversity, and a diet pattern and an agricultural practice primarily geared towards staple foods. Food transfers (mainly staples) from rural relatives were common, particularly for agricultural households. These farming households also had better income status than non-farming households. Experience of food insecurity was relatively common. Nevertheless, high prevalence and strongly gendered patterns of obesity were identified. In contrast to some theorising of the farming practice of urban-based households, there was little evidence that such agriculture was fuelled by poverty, vulnerability or migrant status. Findings also imply that there are other drivers of epidemiologic change in these cities than those suggested by nutrition transition theory.

Place, publisher, year, edition, pages
Routledge, 2018
Keywords
urban health, urban food systems, Uganda, dietary diversity, nutrition transition, epidemiological transition
National Category
Human Geography
Identifiers
urn:nbn:se:umu:diva-144030 (URN)10.1080/23748834.2017.1414425 (DOI)881251 (Local ID)881251 (Archive number)881251 (OAI)
Projects
Agriculture and Double Burden Malnutrition in Urban Africa
Funder
Swedish Research Council Formas, 250-2014-1227
Available from: 2018-01-18 Created: 2018-01-18 Last updated: 2019-04-23Bibliographically approved
2. Farming or not farming? : Factors influencing the agricultural involvement of households in and around secondary Ugandan Cities
Open this publication in new window or tab >>Farming or not farming? : Factors influencing the agricultural involvement of households in and around secondary Ugandan Cities
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Why and where might urban residents in Africa farm? How might urban African populations be linked with rural land and peoples? This paper is situated within such debate, investigating two secondary cities of Uganda: Mbale and Mbarara. The research question asks what factors might be influencing whether, and where, urban households in these cities practice agriculture. Using multinomial logistic regression I explore which urban households had greater odds of farming, and where such farming might occur (the urban area, a rural area, or both). Results suggest that larger households, and those whose heads were not working (waged) but also not looking for such work, those with older household heads or heads who had lived longer in the cities, as well as those that had rural family connections (received food transfers), were more likely to be involved in agriculture, either in an urban or in a rural area. Findings are in contrast with some studies which have suggested that it is the urban poor, or recent rural-urban migrants who farm the city or retain farming livelihood strategies. Instead, this study suggests that, in these two secondary Ugandan cities, the more urban-rooted and the relatively better-resourced urban households have higher odds of being involved in agricultural activity. Findings contribute to better understanding of the factors influencing the agricultural practice of urban-based households, and to understanding of urban-rural linkages. Although this study focuses on Uganda, the findings may be relevant for other secondary African cities that experience similar socio-political, economic and food-related circumstances.

Keywords
agriculture, urban households, Uganda, secondary cities, multinomial regression, urban agriculture
National Category
Social and Economic Geography Environmental Sciences related to Agriculture and Land-use
Identifiers
urn:nbn:se:umu:diva-158342 (URN)
Funder
Swedish Research Council Formas, 250-2014-1227
Available from: 2019-04-24 Created: 2019-04-24 Last updated: 2019-04-24
3. A feminist geographic analysis of perceptions of food and health in Ugandan cities
Open this publication in new window or tab >>A feminist geographic analysis of perceptions of food and health in Ugandan cities
2019 (English)In: Gender, Place and Culture: A Journal of Feminist Geography, ISSN 0966-369X, E-ISSN 1360-0524, Vol. 26, no 11, p. 1519-1543Article in journal (Refereed) Published
Abstract [en]

This article contributes to a feminist geographic analysis of how urban food and health environments and non-communicable disease experience may be being constructed, and contested, by healthcare professionals (local elites) in two secondary Ugandan cities (Mbale and Mbarara). I use thematic and group interaction analysis of focus group data to explore material and discursive representations. Findings make explicit how healthcare professionals had a tendency to prescribe highly classed and gendered assumptions of bodies and behaviours in places and in daily practices. The work supports the discomfort some have felt concerning claims of an African nutrition transition, and is relevant to debates regarding double burden malnutrition. I argue that a feministic analysis, and an intersectional appreciation of people in places, is advantageous to food and health-related research and policy-making. Results uncover and deconstruct a dominant patriarchal tendency towards blaming women for obesity. Yet findings also exemplify the co-constructed and malleable nature of knowledge and understandings, and this offers encouragement.

Place, publisher, year, edition, pages
Routledge, 2019
Keywords
Feminist geography, food, non-communicable disease, nutrition transition, obesity, Uganda
National Category
Nutrition and Dietetics Public Health, Global Health, Social Medicine and Epidemiology Social and Economic Geography
Identifiers
urn:nbn:se:umu:diva-158000 (URN)10.1080/0966369X.2018.1555148 (DOI)000470408500001 ()
Funder
Swedish Research Council Formas, 250-2014-1227
Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-10-09Bibliographically approved
4. Food Sources and Access Strategies in Ugandan Secondary Cities: An Intersectional Analysis
Open this publication in new window or tab >>Food Sources and Access Strategies in Ugandan Secondary Cities: An Intersectional Analysis
2019 (English)In: Environment & Urbanization, ISSN 0956-2478, E-ISSN 1746-0301, Vol. 31, no 2, p. 375-396Article in journal (Refereed) Published
Abstract [en]

This article arises from an interest in African urbanization and in the food, farming and nutritional transitions that some scholars present as integral to urban life. The paper investigates personal urban food environments, food sources and access strategies in two secondary Ugandan cities, Mbale and Mbarara, drawing on in-depth interviews and applying an intersectional lens. Food sources were similar across dimensions of difference but food access strategies varied. My findings indicate that socioeconomic circumstance (class) was the most salient influence shaping differences in daily food access strategies. Socioeconomic status, in turn, interacted with other identity aspects, an individual’s asset base and broader structural inequalities in influencing urban food environments. Rural land and rural connections, or multispatiality, were also important for food-secure urban lives. The work illuminates geometries of advantage and disadvantage within secondary cities, and highlights similarities and differences between food environments in these cities and Uganda’s capital, Kampala.

Place, publisher, year, edition, pages
Sage Publications, 2019
Keywords
Uganda, secondary cities, food environments, non-communicable disease, nutrition transition, obesity, intersectionality, feminist geography
National Category
Social and Economic Geography Human Geography Nutrition and Dietetics Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Food and Nutrition
Identifiers
urn:nbn:se:umu:diva-158004 (URN)10.1177/0956247819847346 (DOI)000490569600002 ()
Funder
Swedish Research Council Formas, 250-2014-1227
Note

Originally included in thesis in manuscript form. 

Available from: 2019-04-09 Created: 2019-04-09 Last updated: 2019-11-08Bibliographically approved

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