Cover Image
close this bookOvercoming Global Hunger (WB)
close this folderAppendixes
View the document(introduction...)
View the documentAppendix 1 - overcoming global hunger: an issues paper
View the documentAppendix 2 - addressing hunger: a historical of international initiatives
View the documentAppendix 3 - lessons of experience: twelve case studies
View the documentAppendix 4 - ending hunger soon: concepts and priorities
View the documentAppendix 5 - hunger and the world bank: an NGO perspective

Appendix 4 - ending hunger soon: concepts and priorities

At least 700 million people do not have access to sufficient food for a healthy and productive life. This is despite the existence of sufficient global food supplies to cover their minimum deeds. The world now produces more food per capita than it did a decade ago. Of course, even if current supplies can, in theory, match current minimum needs the adequacy of future supplies is not assured. Seeking to match the food supply with the demands of a fast growing world population is a huge task. However, the problem is that hunger is not just about the food supply. Trying to guarantee a minimum diet for today's hungry even when the food is available is just as great challenge.

Hunger exists because poor people cannot gain access to available food. This occurs at all levels: food may be available at a global level, but individual countries can go short; sufficient food may be available on the market at national or regional levels, but some households go hungry because they cannot purchase it; sufficient food may be available at a household level, but some individuals go hungry because they do not have access to it. Hunger is therefore as much about access as it is about supply. Undernutrition and starvation can occur in the midst of plenty.

While hunger is thus first and foremost a humanitarian concern, it is also a development issue. Low Labor productivity and limited purchasing power impair the ability of hungry individuals to capitalize on the benefits of many development investments. This, in turn, compromises the success of such investments. If constraints to the production of and access to food are different for different groups of people, then policy and project interventions should be tailored to the location- and income-specific needs of such groups. It is therefore useful to separate out and address the issue of hunger as a major element (both a symptom and a cause) of broader problems of poverty and food insecurity.

This paper begins by presenting a conceptual framework for understanding the linkages between hunger, poverty, and food insecurity at both macro and micro levels. This is followed by a review of the characteristics and causes of hunger. Finally, the paper considers priority policies and programs for reducing hunger and for bolstering household efforts at coping with hunger and food insecurity.

Conceptual Framework

A clear distinction must be made between hunger and food security. Hunger-largely an advocacy rather than a scientific ferm is defined here as an individual's inability to eat sufficient food in terms of calories and nutrients to lead a healthy and active life. Hunger is a recurring feature of absolute poverty that has long-term (chronic), short-term (acute), and seasonal (transitory) dimensions. Food insecurity leads to, and is often characterized by, hunger, but food security is not just the absence of hunger. It is about the absence of risk relating to adequate food consumption. Food security can be defined as secure access by all people at all times to the food required for them to lead 2 healthy life. While food is the defining focus of the concept, the risk of individuals and households not being able to secure needed food is key. The risk of constrained access to food can arise from many causes, such as absolute shortages in the supply of food, which are often the result of climatic vagaries or natural disasters; inaccessibility of available food because of political (war) or economic disruptions; or massive income collapse associated with disruptions in labor or food markets.

Hunger is perhaps the most obvious manifestation of food insecurity resulting from a complex combination of these factors, compounded by institutional and policy failure. In other words, it is a combination of the degree of poverty, the degree of risk of failing to secure local food and income, and the chance of receiving external assistance that defines food insecurity.

Institutional capabilities and the capacity of policy to respond in a timely manner to crises are essential to prevent hunger from materializing on a large scale It is a failure of policy to deal appropriately with demographic, environmental, productivity, and political pressures that makes some segments of society and some regions more vulnerable to hunger than others. Wars and civil unrest may become partially endogenous to these determinants of vulnerability over time. Strategies for ending and preventing hunger must, therefore, build on a recognition that institutions and their policies (and their constraints) play a key role, and that long-term forces are as relevant as short-term forces.

The most important institution at the micro level—the household, with its complex internal organization and diverse macro-level linkage must figure prominently in the analysis of hunger, especially where state institutional capabilities remain weak. However, the failure of public action must not lead to advocacy for reliance on household "coping," the cost of which usually includes suffering". Limitations to effective market based actions against hunger in many famine prone countries and/or those undergoing policy reforms suggest a continued need for improving the role of public action.

Poverty, Policy, and Hunger

Figure 1 portrays some of the long-term relationships between causes and symptoms of hunger. Poverty, including the associated vulnerability to natural or man-made shocks, is a root cause of hunger. Yet poverty and its dynamics may be seen as an endogenous outcome of limited resources and flawed policies. Endogenous and exogenous relationships are conceptualized at different levels of analysis. The figure traces broad interactions between root causes such as policy failures (including war), resource poverty and climatic disruptions, and population growth and outcomes in the realm of macroeconomic activity and household strategies. For example, the top row of causal factors rep resents economic strategies and policy interacting with social discrimination, conflicts, and military conflict; resource endowments and their relationship to climate or disasters influencing levels of poverty and food availability; and population growth. These elements directly affect both the design and the success of policy and project interventions, such as subsidies and distributional policies, that influence input/output relationships, and thereby influence domestic food production levels and stability.

Other policies, such as wage policy, and project interventions, such as paid labor-intensive public works, interact at the level of capital, labor, and output markets. These relationships determine prices, and hence the real purchasing power and terms of trade of the poor. Severe deterioration in, or rapid fluctuations of, purchasing power and terms of trade among the poor can have a strong impact on nutrition. It is in such instances that income and consumption failure become most severe and result in extreme hunger, and that the failure of household "entitlements" becomes evident.

Analytical discussion on any one of these interactions should be pursued with a recognition of the upstream/downstream and short term / long-term linkages between individual elements. Recognition of the complicity of these relationships is crucial for effective action aimed at curbing and eliminating hunger.

Sources of Risk

Food-insecure households can be found in different socioeconomic and demographic groups depending on factors such as agroecological characteristics, access to land, diversity of income sources, and the state of development of the economy. Different types of risks affect various groups of food-insecure households and their members in different ways (table 1).

The most severe hunger problems affect particularly high risk demographic groups in rural and urban households characterized by low and variable household incomes, limited asset wealth, low human capital, and a high risk of income and consumption instability or collapse. For example, children in poor small-holder households that have limited income diversification may be severely affected if their household experiences a bad crop or loss of employment, and they are located in an area of civil unrest.

To improve household food security, location specific risks need to be identified so that effective risk reducing actions can be implemented. The risks associated with hunger have short- and long-term dimensions. Some of the more common risks are briefly discussed below.

War and oppression. The impact of civil unrest and armed conflict is not limited to the area directly affected. When wars erupt, often because of perceptions, real or otherwise, that the policies of the central authorities discriminate against peripheral groups, the poor in deficit areas away from the front line are affected through rapidly declining food supplies and rising prices. As conflicts continue crops are not sown, farmers abandon their lands, and longer-term production declines. This adds to the strain on the food supply chain in areas that may already be at risk.

Figure 1. Relationships among variables responsible for hunger in developing countries.

Unable to secure a living or feed their families, vast numbers of the poor migrate to neighboring countries or to more peaceful areas of their own country. In the early 1990s more than 5 million Africans were classified as refugees or asylum seekers, with another 35 million living outside their own countries in search of employment 7 Another 10 million or so were to be found in other parts of the developing world. Such dislocations create problems of increased food insecurity among the displaced poor, a concentration of job seekers in urban areas of already high unemployment, and resistance to the assimilation of newcomers among many host populations.

Even when peace returns to an area people continue to feel the impact of years of war. Food production in Mozambique has yet to recover from the displacement of more than 1.5 million people (about 10 percent of the population) during fifteen years of civil war The result in 1992-93 was that the total food crop area planted was far below the long-term average. What is more, 1 million refugees may soon return. The lack of productive assets owned by, and poor nutritional condition of, many resuming refugees means that production gains from a larger cultivated area and potentially higher yields will not materialize in the near future without considerable assistance. Investment will therefore be required in seed distribution and cultivation technology, as well as in defusing land mines, to return formerly cultivated lands to previous levels of productivity.

Natural resources and human resources. Estimates indicate that half of Africa's poor farmers already live in environments characterized by a natural resource base highly vulnerable to degradation, while in Latin America the figure is closer to 80 percent. The resource environment affects the nutrition and food security of hungry people mainly through impacts on crop choice and crop yields . Food insecure and poor households do not deliberately degrade their resource base without thought for the consequences. They are often confronted with a choice: short-term satisfaction of food needs with consequences for long-term environmental degradation, versus short-term hunger with fewer environmental demands. Much environmental destruction, such as deforestation and soil erosion, can therefore be ascribed to the struggle of the poor to feed themselves .

Growing family size and deepening poverty forces farmers to cultivate marginal lands and reduce fallow periods. It also forces the landless and the unemployed (as well as farmers and pastoralists) to cut trees for fuel and fodder, but environmental damage, such as tree loss through charcoal production, becomes a direct constraint on future expansion of food harvests. Failure to address hunger issues leads to productivity losses today, directly through reduced work time because of illness, and indirectly through time spent caring for the sick.

Table 1. Sources of risk of hunger and affected populations


Households and people at risk of hunger .

Politics and policy failure

· Households in war zones and areas of civil unrest

· Households in areas of low potential that are not connected le. growth centers via roads or other means of communications

Crop production risks
(pests, drought ,etc.)

· Smallholders with little income diversification and limited access to improved technology (for example, improved seeds, fertilizer irrigation, pest control

· Landless farm laborers

Agriculture trade risks
(disruption of exports or imports)

· Smallholders who are highly specialized in an expert crop

· Small-scale pastoralists

· Poor households who are highly dependent on imported food

· Urban poor

Food price risks (large sudden price rises)

· Poor, net food purchasing households

Employment risks

· Wage earning households and informal sector employees in pen urban areas and, when there is a sudden crop production failure, in rural areas

Health risks (infectious diseases, for example, resulting in labor productivity decline)

· Entire communities. but especially those households that cannot afford preventive or curative care as well as vulnerable membres of these households

Demographic risks (individual risks affecting large groups)

· Women, especially when they have no access to education

· Female-headed households, widows, abandoned women

· Children at weaning age

· The aged.

Source Adapted from von Braun and others, Improving Food Security of the Poor .

Failure to address hunger issues can also lead to further environmental degradation and depending problems in the future. Children's cognitive development and school performance are impaired by poor nutrition and health, with consequent losses in productivity during adulthood. Nutritional deficiencies play a large part in poor school enrollment, absenteeism, early dropping out, and poor classroom performance in developing countries. The education factor is particularly important for girls given its role in lowering later fertility, and thus the population growth rate.

Eradicating hunger would therefore have a beneficial impact not only on human productivity and well-being, but also on the environment. Improved adult nutrition leads to higher farm productivity, improved productivity in the Labor market, a likely reduction in population growth, and reduced depletion of natural resources for short-term gain.

Governance, participation and democracy. A key factor in eliminating persistent hunger and recurrent famines is public action. This involves not just governmental initiatives in the delivery of resources to target populations, but active participation by the public, both as individuals and through grassroots nongovernmental organizations. Public participation can have positive and powerful roles both in collaborative and in adversarial ways with regard to government policies. Collaboration is essential in public health campaigns, such as nutrition education, and in famine relief operations, which require cooperative efforts to ensure their success. However, the public's adversarial role often brings problems to the government's attention and demands resolution.

The demand for action through political activism, journalistic pressures, and informed criticism can help to identify both persistent hunger and famine risk. It is no accident that those countries most successful m famine prevention have been those with more pluralistic politics and open channels of communication and criticism. While China made great post revolutionary strides in terms of eliminating endemic hunger, the population was still vulnerable to famine in the late 1950s. By contrast India, with its open journalism and adversarial politics, was relatively less successful in reducing endemic undernutrition, but has avoided famine. Starvation deaths and extreme deprivation are newsworthy, whereas increased morbidity and mortality rates from endemic undernutrition are not.

The absence of political opposition and free speech have contributed greatly to famine vulnerability in Africa today. Many autocratic African governments have recently been challenged by mounting social anger at the increasing poverty of large segments of society. However, if fledgling, transitional democracies are to survive, they must quickly satisfy the needs and demands of those who brought them to power. This requires positive support by the international community. Democracy is vulnerable where external debt, disease, hunger, and poverty are commonplace. Opportunities for investment aimed at stabilizing fragile economies, even where democratic institutions may yet be imperfect, should be seized whenever they appear.

Setting Priorities for Ending Hunger

While the dimensions, causes, and consequences of hunger differ widely from country to country, and even within the same country, substantial numbers of hungry households and individuals inhabit practically all low-income and many middle income countries.

Incidence of Hunger

Hunger is concentrated among certain demographic and socioeconomic groups, as well as geographically. For example, hunger in most countries is concentrated among the very poor in both rural and urban areas, households headed by women, the displaced and dispossessed, the elderly and disabled, and among certain categories of infants and children. At the same time, more of the poor and hungry are located in regions of the developing world that are poor in natural, infrastructural and institutional resources. In Sub-Saharan Africa, for example, almost 40 percent of the population can be classified share that is coincided with the proportion that does not eat a minimum diet." Approximately 50 percent of Africa's poor inhabit semi-arid tropical regions that have poor physic infrastructure and services, and depend on low and variable rainfall for food production. As a result, local diets are dominated by low-yielding coarse grains (millet and sorghum) that have shown limited potential for large productivity increases.

The proportion of the total population not eating a minimum diet is 25 percent in south Asia and 16 percent in southeast Asia (ACC/SCN 1993) . In south Asia one again finds more than two-thirds of the absolute poor (who are associated closely with hunger) in the driest agroecological logical zones of warm tropics. In this instance their diet is dominated by cereals such as rice and wheat, with coarse grains and cassava an important complement. While rice and wheat were the star performers of the green revolution the chest areas of the subregion benefited relatively less from the new technologies than did the moister tropics and subtropics.

The proportion of South America's population not consuming a minimum dirt is 25 percent with the largest number of poor again located in the driest agroecological regions, as well as in urban conurbations.

Hidden Hunger

While the total number of hungry people in all regions may e. exceed 700 million, millions more people world wide are subject to chronic micronutrient deficiencies. Acute hunger may relate not only to catastrophic calorie consumption deficiencies, but also to transitory fluctuations in calorie supply, micronutrient deficiencies, diet diversity problems, and also to maldistribution of resource within household units. For example, estimates indicate that 40 million preschool children a e suffering from chronic vitamin A deficiency, and that between 200 and 300 million people worldwide are experiencing endemic iodine deficiency goite.

Addressing these forms of hidden hunger requires a multifaceted approach, including pro viding nutrition education; ensuring that food supplies have the appropriate micronutrient content, that is, that they include fruits and leafy green vegetables; supplementing people's diets through feeding programs; organizing food fortification, such as iodine modules in water supply projects or the provision of iodized salt; and disease.

It also calls for reducing the constrains disadvantaged groups within certain households face in gaining access to the benefits of development initiatives. Communitities and households are not neutral media through which development resources flow evenly. While hunger is not solely a function of adequate global food supplies, the issue of individual access to resources has implications beyond income and purchasing power Addressing hidden hunger therefore requires attention not just to health care, water supply, and education, but also to the distribution of these and other resource within the household. Hunger can exist in households that are not poor by local standards.

Hunger is therefore a problem of great complexity as well as of scale. But in a world of limited resources for development in poor countries, this raises the question of which hungry people should be taken care of first. Given wide variability in the causes and manifestation of hunger, no general blueprint for setting priorities can be sought. Each country will always address its problems according to the prevailing demands of political economy and to the perceived costs and benefits of alternative investments.

Nevertheless, the issue of setting priorities for investment initiatives has received insufficient attention Just as the sequencing of policy reforms may be crucial to the success of the overall package of reforms, the sequencing of polices and programs to address hunger can be important. Long-term initiatives independent of short-term actions may be unsustainable, while the converse is also true. Priorities need to be set for coordinated action among donors, governments, and communities to be possible.

We argue here that coordinated action should focus on the worst symptoms of hunger first, in the context of a strategy for long-term interventions aimed at removing the root causes of hunger flus suggests a primary focus on problem areas of Africa and Asia with priority attention to the acute problem of famines, which are the worst case of entitlement failure associated with all there root causes of hunger laid out in figure 1. The second focus is the much larger problem of chronic and transitory dietary deficiencies-of macronutrients and micronutrients in rural areas of Africa and Asia, particularly those areas that are resource poor and ecologically fragile. A third focus would be chronic dietary deficiencies among the urban poor, with an increasing emphasis on Latin American problems alongside those of other developing countries. .

Famine Prevention and Mitigation

Governments and donors should give the highest priority to addressing famine. The world cannot afford to let the worst cases of hunger go untreated. With high population growth the absolute number of people becoming vulnerable to famine continues to grow. In the early 1990s the number stood at roughly 30 million people in Africa. This catastrophic hunger has profound implications for economic growth in affected countries, let alone for their longer-term human capital development, as well as for demands made on more developed nations for food and other assistance. The longer the social and economic malaise associated with famine persists, the harder and more costly it becomes to eradicate.

This calls for a swift and effective response to famine set within a framework of actions to remove the underlying causes Free food aid to severely malnourished individuals will not alone solve the problem While temporary solutions to acute hunger are often achievable in a short time at relatively low cost, this does not make them sustainable in the longer run.

Famines are extreme, regionally concentrated shortfalls in food consumption that result in rising undernutrition and death rates They do not happen suddenly. Famines result from an accumulation of events that progressively erode the capacity of poor households to deal with short-term shocks to the local economy Shocks often take the form of environmental extremes, but the conditions that promote household vulnerability to extremes develop over long periods, typically in the context of inappropriate economic policies.

Famines should therefore be recognized as national and international policy failures They signal a lack of preparedness and political commitment to prepare for and implement public initiatives against acute hunger. While a reduction in long-term poverty and stimulation of private sector economic activity—two of the key aims of structural adjustment policies—serve to reduce the risk of famine, action by public agencies remains necessary, at least in the medium run, to protect vulnerable households that lack the resources to protect themselves.

Successful preparedness and mitigation depends on a public commitment to intervene effectively and on time. This has the advantage of offering high returns in reduced hunger relative to the resources invested. Also needed are the conditions that prevent hunger from recurring on the same scale and at the same intensity as before. Such conditions include building institutional capacity at regional and local levels, detecting and diagnosing indicators of distress in close collaboration with affected communities, preparing programs and projects for vulnerable regions ahead of time, and executing appropriate interventions in times of need.

The successful eradication of famine, as well as the removal of nutrient deficiencies, depends on successful economic growth. Unless growth underpins appropriate targeted interventions, short-term mitigation of acute hunger cannot be sustained. Thus, in countries with a large agricultural sector, a key contribution to famine prevention must come from an employment creating agricultural growth strategy from which hungry populations reap a direct benefit, an issue taken up in more detail below.

Agricultural Growth for Sustained Hunger Reduction

In most developing countries, there is little question that policies for enhancing economic growth' particularly in agricultural productivity, must provide the bedrock for future development, including the elimination of hunger Agricultural growth can address hunger not only by increasing production, but also by generating rural employment, and therefore income. Yet with population growth rates in excess of 3 percent per year in much of Africa, and growth in agricultural output during the 1980s rarely surpassing 2 percent per year in many countries, even outside Africa, the challenge to agriculture is daunting.

While opportunities for bringing new land under cultivation have compensated for slow yield growth in the past, continued attempts to expand agricultural land will entail ever Larger investments, accelerated deforestation and land degradation, and ultimately, falling yields. Productivity increases must be sustainable The issue is one of finding a way to meet growing food demands without compromising the ability of the total stock of resources, both natural and human, to meet even larger demands in the future .

To facilitate yield increases in developing countries higher investment in agricultural research and technology is urgently needed, particulary for those crops most important to the poor. As population and food demand continue to grow, failure to develop and implement appropriate production and marketing technologies will lead to either more food insecurity and hunger, for which the current generation of poor people will pay, or to further degradation of our natural resources, for which future generations will pay.

The tradeoff between meeting future food demands and maintaining production capacity can be avoided and sustainability in food production can be assured only if (a) investment in appropriate research and technology is accelerated; (b) relevant externalities, including those related to resource ownership and user rights and the needs of future generations, are either taken into account in production and consumption decisions or effectively dealt with by government policy; and (c) poverty is significantly reduced or alleviated .

Because of the risk of irreversible degradation of natural resources and the urgent need to assure sustainable production to meet future food demands, understanding why investment in the most promising solution, agricultural research and technology, appears to be decreasing is difficult. For example, US. assistance to agriculture in developing countries in 1990 was less than one-half (in real terms) what it had been in 1988. The World Bank showed a similar, though less dramatic, decline of 25 percent in assistance to agriculture during the same period In 1994 funding for the Consultative Group on International Agricultural Research—the driving force behind the green revolution is likely to be 27 percent below its level of funding for 1990 in real terms.

This decline is unfortunate on several counts. First investigators documented high rates of return for investments In agricultural research during the 1980s and early 1990, even in Africa. Second, there is a time lag between agricultural research and increased production. The adequacy of current food supplies is a testimony to past investments in agricultural research For the impact of new technologies or support services to be realized in the agricultural sector could take ten years or longer.

Improved crop technology need not be restricted to the production of staple food crops Growth in the staple food sector and growth in the cash crop sector are not mutually exclusive The complementarily between the production of traditional food crops and of cash crops is often overlooked Longitudinal studies in many parts of Africa show that the real income poor small-holders earn from cultivating cash crops is generally converted into food calories for consumption in a similar manner to income earned from subsistence food production . Appropriate policies for technological change, input supply, pricing, marketing, and infrastructural growth benefit both sectors and are crucial for growth in both In other words, the attainment of optimal food security should not rely on growth in the food sector alone, but on the development of the most productive agricultural resource, which may be an export crop.

Appropriate policies not directly related to agriculture are also required The use of new technology alone is not sufficient Investment in rural roads, institutional change, and appropriate policies are needed to facilitate farmers' access to modern inputs, improve farm management, develop a marketing system capable of assuring sufficient food for rapidly growing urban populations,, provide the necessary production incentives, promote economic growth in rural areas, and enhance the exchange of commodities (including labor) and services between urban and rural areas. Attention to the removal of institutional and policy barriers to dynamic factor markets continues to be needed.

Without effective markets, more food will not be within the reach of rural and urban net consumers of food, including the landless and the unemployed Agricultural production increases alone are insufficient to achieve food security if hungry individuals cannot secure that food. Thus a precondition for sustainable agricultural development is economic viability, both at microeconomic and macroeconomic levels. Increases in agricultural production must be combined with employment creation, higher incomes, and price stability if growing populations are to have access to enough food in the future.

Policy and Program Options

A range of policy instruments is available to improve access by the poor to the income and food required to alleviate hunger A combination of instruments is required so that short-term goals are achieved in tandem with long-term development The portfolio of actions taken should focus narrowly on the achievable and on the cost-efficient, both measured in terms of the effectiveness of resource transfers—be they calories, income, or technology—to target populations Key instruments to be considered include the following:

· Targeted food distribution and subsidies
· Employment creation (resulting in rural roads and resource improvements).

Institutional strengthening, such as providing credit for the poor.

· Price and trade policies for stabilizing consumption
· Human capital investments.

Targeted Distribution and Food Subsidies.

Food transfers, which are income transfers in kind, are widely used as a means of alleviating food insecurity, but they have come under attack for their potential adverse effects on markets, for their high fiscal costs, and for their perceived inconsistency with structural adjustment policies. In the current climate of structural adjustment there is additional pressure to eliminate such transfers except where justified on strong humanitarian and/or developmental grounds. This section considers three types of programs: targeted feeding programs, food stamps and other income transfers, and food price subsidies. Targeted feeding programs. Except in the context of emergency relief, feeding programs are generally aimed at those people most vulnerable to malnutrition, usually children and poor women of child bearing age. The targeting of feeding programs is achieved through various means depending on nutritional need and the programs' objectives. Geographical targeting works well when a high prevalence of hunger is identified in selected areas. School feeding programs can be used to target school-age children. Means tests and vulnerability tests are also used. General food distribution is rarely cost-effective because of leakages, but the administrative costs of targeting can overwhelm certain feeding programs.

Feeding programs rarely increase the food intake of those targeted by 100 percent of the food given because of sharing of food with household members or substitution with home produced and purchased food. The income elasticity of food expenditures tends to be less than unity, and not all the increased expenditure goes to increasing calorie intake, but also goes to improving the quality of the diet in terms of the taste and convenience of the food. However, such programs are often politically and socially acceptable as a means of transferring income.

Food stamps and other income transfers. Interest in food stamp programs as a means of providing a food-mediated income transfer to low-income households and as an alternative to food subsidies has picked up in recent years Food stamp programs are expected to display the higher consumption effects of food-based income, as well as to reduce the administrative burden and costs imposed by food handling and transport.

Yet experience with rood stamps is mixed For example, in Zambia large-scale counterfeiting compromised such programs In Sri Lanka the income verification procedure excluded wage earring workers on tea plantations even though they appeared to be a nutritionally needy group. These problems are not unique to food stamps; they are also encountered with in-kind transfers The questions which approach is more efficient in transferring its resource to a target population within the confines of accepted leakages.

Fixed, nominal value stamps do not protect consumers from price fluctuations, even when periodically adjusted for inflation. To be cost effective, the targeting of food stamp programs has to be based on narrow criteria associated with need. I his is not perfect even in the United States, which uses means testing, and is especially problematic in poor countries If food stamps programs employed the methods used for targeting feeding programs they could probably be more effective.

Food price subsidies and rationing. Consumer food price subsidies are widespread and have been introduced in most low-income countries. They can take the form of generalized price subsidies or rationed access to a commodity at a price below market value Generalized price subsidies are more costly in terms of fiscal and economic costs than limited access subsidies, and are also more regressive in the distribution of economic benefits.

Household food security is a goal of certain subsidy programs Food subsidies increase the real incomes of households with access to the subsidies. In a number of programs surveyed, food subsidies accounted for 15 to 25 percent of the real income of poor households receiving subsidies. Food price subsidies also generally increase household food consumption. Furthermore, subsidy programs have a positive and significant effect on food consumption by preschool children, although they may result in decreased consumption of other foods and leakage to other household members may occur 38.

Programs that provide rations in fixed quantities have, in general, succeeded in leaching the people to which they were directed However, experiences in Egypt the Philippines, and Sri Lanka underline the difficulty of achieving universal household food security through rationed distributions and targeted income transfer goods in a single program in a cost-effective manner 39 Self-targeting can be achieved through commodities that better off consumers consider inferior, and that are therefore used more by the poor.

Traditionally, food aid has been used to support food subsidies, an action often viewed as a mixed blessing By promoting food subsidies, food aid has been perceived as inhibiting growth in domestic food production in the short run, and as misallocating resources, both public and private, in the long run so as to create a dependency on externally subsidized food Yet the empirical evidence does not support such a generalization, at least for Asia. The so called disincentive effects of food aid on domestic agriculture have been exaggerated, and many countries that received high levels of food aid subsequently achieved above average agricultural growth For example, India, the Republic of Korea, and Taiwan (China), which used to be major ford aid recipients, no longer depend on such aid. Evidence of disincentives for agriculture at the microeconomic level in countries such as Ethiopia and Niger is also slim. In other words, the actual effects of food aid are very much a function of recipient countries' food and agricultural policies.

Employment and Income Generation Programs

Besides programs and polices oriented toward agricultural production, other programs intended to diversify employment and income can reduce risks for hungry households These other income generation programs, which can be complemented by other non-labor-based interventions, differ from programs oriented toward food production in that they stimulate or stabilize the demand for food, but may not directly expand the supply of food.

Labor intensive public works programs. Labor intensive public works programs can address four key problems facing many low-income countries today food insecurity, growing unemployment, natural resource degradation, and deficient physical infrastructure. Public works are, in general, public programs that provide employment and generate public goods, such as physical and social infrastructure Food aid can be, directly or indirectly (monetized), a component of the wage payments.

The food security effects of employment programs are a function of program design . For instance, a short-term project may result in expenditure patterns by the poor that treat project income as "windfall profits" A small food consumption benefit from the Bangladesh food-for-work program hints at that behavior. In contrast, long-term benefits from improved rural roads produce more secure income flows and substantial consumption improvements for the lowest-income households.

Good public investment through public works programs, and thus the creation of productive and sustainable assets, needs to be emphasized in policy Note, however' that income effects derived from works programs can also have favorable private savings and investment effects that improve household food security, as observed from experiences in Bangladesh and Guatemala . In countries such as Niger and Ethiopia, income from public works has contributed more than 20 percent of total income to the poorest households, who have reinvested some of this income in agriculture. Strengthening financial institutions for the poor in tandem with public works programs is suggested in order to foster these positive effects.

Public works programs can be a viable instrument for famine prevention as demonstrated by the Employment Guarantee Scheme in Maharashtra, India. The employment guarantee feature of the scheme, which generates unlimited employment to adults at a fixed wage, also triggers "relief works" automatically at local levels . This enables small crises to be addressed through local action, an important lesson for dealing with the problem of localized famines in Africa Note, however, that public works programs cannot address the immediate needs of hungry individuals who are unable to participate in the schemes. Other complementary programs are required for households that are poor in labor as well as in income terms.

Properly designed public works programs have a unique feature in favor of poverty and hunger alleviation with low administrative costs and effects: self-targeting At appropriate wage rates, the working poor identify themselves by offering their labor. However, the self-targeting feature only operates effectively with an appropriate (low) wage rate policy and a flexible absorption of applicants without rationing work places. The issue of whether to pay in cash, in kind, or a combination of the two is related to the wider problem of wage rate determination and to the risk of market failure.

Providing credit to the poor for stabilizing consumption and for self-employment through private investment is an important mechanism for improving food security in the growing and diversifying rural economies of many low-income countries Many innovations occurred in the 1980s and early 1990s. These programs are most likely to succeed in areas where agricultural growth is proceeding well and that have good roads and market activity.

The most successful programs in generating self employment for the poor and stabilizing consumption are those that combine small-scale credit with group motivation, technical advice, and other forms of assistance such as nutrition and health programs, for example, Bangladesh's.

Grameen Bank Group loans for poor households without collateral can be an effective mechanism that ensures repayment as long as the group remains small and peer pressure can operate.

Access to credit is an important food security mechanism, both in the short run and in the long run. In the short run it enables the poor to weather shocks without selling productive assets, which would render them even more vulnerable to future shocks. In the long run it enables them to adopt new technologies and farming methods that increase yields and production without causing environmental degradation and natural resource depletion.

Development practitioners increasingly understand that production fluctuations, market infrastructure, government policy, location, and sectoral diversification are important determinants of a country's demand for stabilization of food availability and prices. Stabilization must tee attuned to a country's specific production risks (for example, whether it is prone to droughts or floods and trade risks (for example, whether it is landlocked). The response of local- and farm-level storage to public policies is an important consideration, especially in circumstances where post-harvest losses are significant and where local market disruptions occur frequently.

Price stabilization has both benefits (including in terms of food security) and costs. It is expensive. Frequently, low-income countries cannot afford it financially or administratively Recent research into domestic price stabilization schemes in developing countries suggests that governments can minimize the costs of stabilization by relying on market mechanisms when possible, avoiding schemes that require physical handling of the commodity, not trying to stabilize prices too much, and attempting to mimic prices that would be established in a freely functioning market.

Food market end trade interventions are wide spread not only in low-income countries, but to an even greater extent in high-income countries The stabilization policies of high-income countries can destabilize world markets. The extent and level of intervention in low-income countries vary and the late 1980s saw considerable steps toward the liberalization of the agriculture and food sectors in these countries. This does not indicate a reduced concern for food security on their part.

Human capital investment. Longer-run enhancement of the labor productivity of the poor requires that both chronic energy deficiencies and hidden hunger be addressed directly through investments in improved health and human resources Improved investment in primary health care facilities and services could significantly reduce undernutrition and malnutrition in many regions. The improvement of potable water supplies also remains a long-term priority.

At the same time, improved education is needed The upgrading of human capital, with a positive emphasis on female education, has strong multiplier effects in income growth, technology adoption, and the control of population expansion All are crucial to the enhancement of long-term food security.

Combining the Options: Targeting Risks of Food Insecurity

The policies and programs briefly reviewed above address the risk of a household becoming food insecure, and therefore hungry. These risks can originate from different sources and the effectiveness of policies and programs can vary For example, a program that raises crop yields may not have an impact on household food security in the short run, whereas a short-term feeding scheme on its own may not have a measurable impact in the long run Table 2 links the risks of hunger with the policies and programs discussed above The following points from the table deserve highlighting:

· Crop production risks are best addressed directly through technological change and improved commercialization of agriculture in the long run. In countries with high risks of food unavailability and price fluctuations, join/promotion of technological change in staple foods and an appropriate incentive environment for agricultural commercialization is called for. Hunger is often best addressed not by self-sufficiency goals (be it at household or at national levels), but by food security goals that seek an efficient balance between higher domestic production and trade

· Short-term food availability and related food price risks can be addressed by means of a large array of options, including policies at the macroeconomic level; stockholding; trade and aid policies; and programs such as public works, provision of consumption credit, food subsidies, feeding programs, and income transfers that strengthen the entitlements of food-insecure households. Agricultural production policies address these risks in the long run

· Employment and income risks can be tackled in the long run through agricultural production policies, and in the short run through entitlement strengthening as indicated Labor-intensive public works would have both short- and long-run risk reduction effects, the latter by cre.

· Food security policies alone—with the exception of those feeding programs that have strong ties to health care—have only a limited impact on the mitigation or prevention of health risks, which together with food security risks establish nutritional risks Other policies and programs are needed in conjunction with food security policies. Promoting behavioral change through nutrition education can have favorable effects for dealing with most of the risks. Long-run benefits result from the human capital enhancement effects of short-term subsidies and transfer policies.

Table 2. Hunger risks and policy choices.

The typical problem of combined chronic and transitory food security problems of poor house holds requires a well-designed portfolio of food security policy actions. Such a portfolio builds on assessments of the nature of risks and of the instruments available, which are influenced by institutional capacities. Throughout this review, a number of complementary actions that need to be undertaken in conjunction with food security policies and programs have been identified. These complementary actions include the development of an adequate market infrastructure and policies that do not impair trade The rapid development of rural financial markets open to all individuals, which permits the smoothing of consumption, is another complementary action.

From Hunger Response to Social Security

A long-term view of hunger alleviation needs to be established and institutionalized Polices aimed at household food security must be seen as basic to social security policy, achievable by an appropriate division of labor between the private and public sectors Such a division of labor depends on country and community-specific capabilities It also depends on more than ensuring an adequate supply of food to countries with a severe hunger problem.

A key component in the pressure on the world to feed itself is that many regions still exhibit high and rising population growth rates. Large families are a means of social security for the poor. In the next two decades 2 billion people will be added to the world's population the largest population increase ever in a twenty year period. Efforts that provide social security will contribute to lowering fertility rates by (a) reducing mortality rates, (b) reducing the number of births required in a family to ensure a given number of surviving children, and (c) reducing the demand for surviving children. This will reduce the pressure on the food supply chain. Many of these goals, however, can only be achieved in the long run.

Given the close relationship between agricultural production and the livelihood of the poor in rural-based economies partly mediated via price, wage, and employment effects—it is in the agricultural policy area that a number of countries can most rapidly contribute to social security with growth. Improved agricultural technology and roads, combined with an effective foreign trade policy, contribute to basic social security by reducing the impacts of production fluctuations.


The absolute number of hungry people is likely to continue to grow well into the twenty-first century. Successes in reducing hunger in parts of Asia, and even in parts of Africa, should not be overlooked; they are signals that certain policies, projects, and practices can work However, the donor community and the governments of poor countries have finite resources for investment against hunger, and the problem has no easy or inexpensive solution.

This requires developing country policymakers and international donors to focus on key policies and programs that will not only raise the food supply, but will also improve food access by the poor This calls for three major priorities with back ward and forward linkages as illustrated in the conceptual framework presented at the outset, namely.

· First, the focus must be on tackling the worst hunger where it exists today. This requires effective famine mitigation and preparedness activities in Africa's most vulnerable countries.

· Second, well-targeted investments are required in rural areas to tackle chronic and hidden hunger. Potential actions include employment creation programs aimed at raising and stabilizing the incomes of the poor, improved institutional credit programs, targeted food distributions, and effective price and trade policies, coupled with appropriate education, nutrition and health investments.

· Third, the first two priorities should be under written by longer-term investment in agricultural growth, which benefits the poor directly, supported by agricultural research, trade, and well-functioning factor markets.

Success in the third priority should, over time, reduce the need for investments of the first and second kinds. Investment in agriculture over and above investment in emergency interventions yields three important gains: (a) a net increase in the aggregate food supply, (b) a net saving in the Volume of relief activities required, and (c) a net saving in relief costs because of improved efficiency of delivery. Quantifying these savings in absolute terms is a complex task, but one that would better guide the process of setting investment priorities. The longer decisions are made on an uninformed ad hoc basis, the longer hunger will persist.

For success in the fight against hunger, international cooperation toward food security for ale must be institutionalized by means of appropriate incentives. Given the nature of political and administrative processes, the recognized need for cooperation and coordination among agencies and ministries, for example, those concerned with agriculture and health, must be continuously reinforced. The related United Nations' agencies, such as the Food and Agriculture Organization of the United Nations, the World Health Organization, the United Nations Children's Fund, the World Food Programme, the International Fund for Agricultural Development, and other development agencies, as well as the Consultative Group on International Agricultural Research, the World Bank, and the International Monetary Fund, have a key role to play in setting good examples and in fostering such cooperation at country and international levels.

There is no excuse for the continued occurrence of hunger in today's world Public policy actions based on partnerships between communities and public agencies can tackle hunger effectively This calls for an improved understanding of local constraints and needs. With its complex origins, hunger requires appropriate multisectoral solutions that focus on a narrow set of achievable priorities. Local conditions will dictate these priorities, which must be welt coordinated, not just among international players, but also among local communities and their governments.


1. Per Pinstrup-Andersen. "World Food Trends and How They May Be Modified" (Paper presented at the Consultative Group on International Agricultural Research (CGIAR) International Centers Week, Washington, D.C. October 25 29,1993).

2 Food and Agriculture Organization of the United Nations (FAO), Food Outlook 8/9 (Rome: FAO, 1993).

3. J. von Braun and others, Improving Food Security of the Poor: Concept Policy, and Programs (Washington, D.C.: International Food Policy Research institute, 1992).

4. Patrick Webb, "Coping with Drought and Food Insecurity in Ethiopia," Disasters 17 (1) (1993): 33-47.

5. Jean Dr and Amartya Sen, Hunger and Public Action (Oxford: Clarendon Press, 1989); J. von Braun, T. Teklu, and Patrick Webb, "Famine as the Outcome of Political, Production, and Market Failures," IDS Bulletin 24 (4) (1993): 73-78.

6. Patrick Webb, J. von Braun, and Y. Yohannes, Famine in Ethiopia’s Policy implications of Coping Failure at National and Household Levels, Research Report 92 (Washington, D.C: International Food Policy Research Institute, 1992).

7. R S. Chen, "Hunger among Refugees and Other People Displaced across Borders," Hunger 1993: Uprooted People, ed. Bread for the World Institute on Hunger and Development (Washington, D.C.: Bread for the World Institute on Hunger and Development, 1992); S. S. Russell, K. Jacobsen, and W. D. Stanley, International Migration and Development in sub-Saharan Africa, vol. 2, Country Analyses, World Bank Discussion Paper 102 (Washington, D.C.: World Bank, 1990).

8. Bread for the World Institute on Hunger and Development, ea., Hunger 1993: Uprooted People (Washington, D.C.: Bread for the World Institute on Hunger and Development, 1992).

9. H. J. Leonard and contributors, Environment and the Poor: Development Strategies for a Common Agenda U.S. Third World Policy Perspectives 11 (New Brunswick, N.J.: Transaction Books, 1989).

10. T. Reardon and S. A. Vosti, "Issues in the Analysis of the Effects of Policy on Conservation and Productivity at the Household Level in Developing Countries," Quarterly Journal of International Agriculture 31 (4) (1992): 33-34.

11. S. A. Vosti, "Reprise of Rio: Survival's Sharp Edge," Diversity 8 (4) (1992): 380-96.

12. Dr and Sen, Hunger and Public Action.

13. Von Braun, Teklu, and Webb, "Famine as the Outcome of Political, Production, and Market Failures," 73 78.

14. United Nations Administrative Committee on Coordination /Subcommittee on Nutrition (ACC /SCN), Second Report on the World Nutrition Situation (Geneva: ACC/SCN, 1993); S. Broca and P. Oram, "Study on the Location of the Poor," Report prepared for the Technical Advisory Committee of the Consultative Group on International Agricultural Research (Washington, D.C.: International Food Policy Research Institute, 1991).

15. J. S. Davis, P. A. Oram, and J. C;. Ryan, Assessment of Agricultural Research An International Perspective (Canberra: Australian Centre for International Agricultural Research in collaboration with the International Food Policy Research Institute, 1987).

16. ACC/SCN, Second Report on the World Nutrition Situation.

17. Broca and Oram, "Study on the Location of the Poor".

18. Broca and Oram, "Study on the Location of the Poor.”

19. ACC/SCN, Second Report on the World Nutrition Situation; Per Pinstrup Andersen, "Global Perspectives for Food Production and Consumption," Tidsskrift for Landakanimi 4 (December 1992): 145 69.

20. World Health Organization (WHO), Notional Strategies for Overcoming Micronutrient Malnutrition, Document A45/17, forty-fifth World Health Assembly (Geneva: WHO, 1992).

21. J. von Braun and others, Urban Food insecurity and Malnutrition in Developing Countries: Trends Policies, and Research Implications (Washington, D.C: International Food Policy Research Institute, 1993).

22. "Slow Famine Relief Imperils Millions" Africa Recovery, June 3. 1993.

23. Patrick Webb and J. von Braun, Food Security and Famine in Ethiopia: Lessons for for (London: (London: John Wiley and Sons, 1994).

24 T. Teklu, J von Braun, and E Zaki, Drought and Famine Relationship in Sudan: Policy Implications, Research Report 88 (Washington, D C: International Food Policy Research Institute, 1991); Webb, von Braun, and Yohannes, Famine in Ethiopia: Policy Implications of Coping Failure at National and Household Levels.

25 Per Pinstrup-Andersen, "Socio-economic and Policy Considerations for Sustainable Agricultural Development" (Paper presented at the Thirteenth World Bank Agricultural Symposium on Agriculture and Environmental Challenges, Washington, D C, January 6-7, 1993.

26. Pinstrup-Andersen "World Food Trends and How They May Be Modified."

27. Pinstrup-Andersen. "World Food Trends and How They May Be Modified ".

28. Von Braun and others, Urban Food Insecurity and Malnutrition in Developing Countries.

29. This decline relates to the thirteen international research centers that existed prior to the expansion in 1992. The CGIAR currency comprises eighteen centers.

30. Pinstrup-Andersen, "World Food Trends and How They May Be Modified ".

31. J. von Braun and E Kennedy, eds., Agricultural Commercialization, Economic Development, and Nutrition (Baltimore, Maryland; The Johns Hopkins University Press for the International Food Policy Research institute, forthcoming).

32 Per Pinstrup-Andersen, "The Social and Economic Effects of Consumer-Oriented Food Subsidies: A Summary of Current Evidence," Food Subsidies in Developing Countries. Costs, Benefits, and Policy Options, ed P. Pinstrup-Andersen (Baltimore and London: The Johns Hopkins University Press for the International Food Policy Research Institute, 1988).

33. E. T. Kennedy and H. H. Alderman, Comparative Analyses of Nutritional Effectiveness of Food Subsidies and Other Food-Related Interventions (Washington, D.C.: International Food Policy Research Institute, 1987).

34. Kennedy and Alderman, Comparative Analyses of Nutritional Effectiveness of Food Subsidies and Other Food-Related Interventions.

35. Kennedy and Alderman, Comparative Analyses of Nutritional Effectiveness of Food Subsidies and Other Food-Related Interventions.

36. H. Alderman, M. G. Chaudhry, and M. Garcia, Household Food Security in Pakistan: The Ration Shop System, Working Papers on Food Subsidies 4 (Washington, D.C: International Food Policy Research Institute, 1988).

37. Per Pinstrup-Andersen and H. Alderman, "The Effectiveness of Consumer-Oriented Food Subsidies in Reaching Rationing and Income Transfer Goals," Food Subsidies in Developing Countries.

38 M. Garcia and Per Pinstrup-Andersen, The Pilot Food Price Subsidy Scheme in the Philippines: Its Impact on Income, Food Consumption, and Nutritional Status, Research Report 61 (Washington, D C: International Food Policy Research Institute, 1987); N. Lustig, "Fiscal Cost and Welfare Effects of the Maize Subsidy in Mexico," Food Subsidies in Developing Countries.

39 H. Alderman and J. von Braun, The Effects of the Egyptian Food Ration and Subsidy System on Income Distribution and Consumption, Research Report 45 (Washington, D.C.: International Food Policy Research Institute, 1984); N. Edirisinghe, "Food Subsidy Changes in Sri Lanka: The Short-Run Effect on the Poor," and M Garcia, "Food Subsidies in the Philippines: Preliminary Results," Food Subsidies in Developing Countries.

40. H. Singer and S. Maxwell, "Food Aid to the Developing Countries A Survey," World Development 7 (3) (1979) : 225 46; J. von Braun and B. Huddles ton, "Implications of Food Aid for Price Policy in Recipient Countries," Agricultural Price Policy for Developing Countries, eds. J W. Mellor and R Ahmed (Baltimore and London The Johns Hopkins University Press for the International Food Policy Research Institute, 1988).

41. Patrick Webb, "Food Security through Employment Creation in the Sahel: Labor-Intensive Programs in Niger," Report to the Deutsche Gesellschaft fur Technische Zusammenarbeit (Washington, D C: International Food Policy Research Institute, 1993); Webb, von Braun, and Yohannes, Famine in Ethiopia.

42. International Food Policy Research Institute! Bangladesh Institute of Development Studies (IFPRI/ BIDS), "Development Impact of the Food-for-Work Program in Bangladesh," Final report submitted to the World Food Programme (Washington, D.C.: International Food Policy Research Institute, 1989); l- von Braun, T. Teklu, and P. Webb, Labor Intensive Public Works for Food Security: Experience in Africa, Working Papers on Food Subsidies 6 (Washington, D.C: International Food Policy Research Institute, 1991).

43. M. Hossain and M. Mokaddem Akkash, Public Rural Works for Relief and Development A Review of the Bangladesh Experience, Working Papers on Food Subsidies 7 (Washington, D.C.: International Food Policy Research Institute, 1993).

44. S. K. Kumar and O. H. Chowdhury, '´The Effects on Nutritional Status, Development Impact of the Food for-Work Program in Bangladesh," eds. International Food Policy Research Institute
(IFPRI)/Bangladesh Institute of Development Studies, final report submitted to the World Food Programme (Washington, D.C.: IFPRI, 1989); S. R. Osmani and O. H. Chowdhury, "Short-Run Impacts of Food-for-Work Programs in Bangladesh," Bangladesh Development Studies 11 (1 and 2) (1983):135-90.

45. S. Kurnar, S. 1988. "Rural Infrastructure in Bangladesh: Effects on Food Consumption and Nutrition of the Population" (Washington, D.C.: International Food Policy Research Institute, 1988); K L. Bell, R W. Hay, and T. Martinez, "Consumers and Savers: Can Food-for-Work Stimulate Economic Growth at the Household Level?" (Oxford. University of Oxford, International Development Centre, Food Studies Group, 1989).

46. Webb, "Food Security through Employment Creation in the Sahel: Labor-Intensive Programs in Niger"; P. Webb and S. Kumar, "Ethiopia's Food/Cash for Work Programs: Experiences under Joint Stress from Famine, Drought, and Economic Policy Reform" (Paper presented at the International Policy Workshop on Employment for Poverty Alleviation and Food Security, Virginia, October 11-14,1993).

47 H. Ezekiel and J. C. Stuyt, "The Maharashtra Employment Guarantee Scheme Its Response to Differences in Employment Patterns between Districts," The Economic Times (Bombay), May 31-June 2,1989.

48. M. Ravallion, G. Datt, and S. Chaudhuri, "Higher Wages for Relief Work Can Make Many of the Poor Worse Off: Recent Evidence from Maharashtra's Employment Guarantee Scheme" (Washington, D.C.: World Bank, 1990).

49. Osmani and Chowdhury, "Short-Run Impacts of Food-for-Work Programs in Bangladesh"; Webb and Kumar, "Ethiopia's Food/Cash for Work Programs.”

50. M. Zeller, G. Schreider, J. von Braun, and F. Heidhues, "Credit for the Rural Poor in Sub-Saharan Africa," Report to the Deutsche Gesellschaft fur Technische Zusammenarbeit (Washington, D.C: International Food Policy Research Institute, 1993).

51. M. Hossain, Credit for Alleviation of Rural Poverty The Grammeen Bank in Bangladesh, Research Report 65 (Washington, D C: International Food Policy Research Institute, 1988).

52. A. H Sarris, "Degree of Reliance on National Food Stocks and Imports," World Food Security: Selected Themes and Issues, Economic and Social Development Paper 53 (Rome: Food and Agriculture Organization of the United Nations, 1985).

53. Von Braun and others, Improving Food Security of the Poor.

54. O. Knudsen and J Nash, "Domestic Price Stabilization Schemes in Developing Countries," Economic Development and Cultural Change 38 (3) (1990): 539-58.

55. J. Mellor, C. Delgado, and M. Blackie, Accelerating Food Production in Sub-Saharan Africa (Baltimore: The Johns Hopkins University Press, 1987).