The connections between malaria and food security are recognized in various international health and development frameworks. Below is a look at one side of the equation, how malaria in the household affects food security and agricultural production.
Lewnard and colleagues reported that severe food insecurity was associated with increased risk for positive malaria tests among the Batwa pygmies in Uganda. Also malaria control interventions were associated with decreases in child mortality, accounting for the effect of rainfall and food security in central Tanzania. The authors concluded that achieving targets like the MDGs, “requires the contribution of many health interventions, as well as more general improvements in socio-environmental and nutritional conditions,” i.e. an integrated development approach.
A study in Niger hypothesized that Unconditional Cash Transfers (UCT) would have a positive impact on food security. Two different UTC regimens were tested along with a supplemental food package, but ironically the study found no difference in endline food security between arms. The group felt that the results were possibly driven by increased fever/malaria in children, and thus nonfood related drivers of malnutrition, such as disease, may limit the effectiveness of UCTs.
Tusting and co-researchers recognize that agricultural development interventions reduce poverty. They also documented that relative agricultural success was associated with higher socio-economic position, which in turn, was associated with lower human biting rate of malaria-infected mosquitoes. They conclude that “Further interdisplinary research is needed to understand fully the complex pathways between poverty and malaria and to develop strategies for sustainable malaria control.” One possible pathway would be malaria prevention interventions. A study in Ghana reported that, “Children who slept under a bednet were also more likely than those who did not to live in a food secure household.”
Malaria interventions can also affect agricultural productivity. In a Zambian experiment, access to subsidized bed nets was randomly assigned at the community level, and 516 farmers were followed over a one-year farming period. The researchers found “large positive effects of preventative health investment on productivity: among farmers provided with access to free nets, harvest value increased by US$ 76, corresponding to about 14.7% of the average output value.”
Studying the effects of malaria on employees of an oil palm plantation in Papua New Guinea, Pluess and team found that, “on average, an employee sick with malaria was absent for 1.8 days, resulting in a total of 9,313 workdays lost.” This is an indirect influence on a family’s food security.
Seeking malaria care can have untoward effects when fees are attached to health services. Johnson and co-researchers report that, “The qualitative data reveal multi-faceted health and socioeconomic effects of user fees, and illustrate that user fees for health care may impact quality of care, health outcomes, food insecurity, and gender inequality, in addition to impacting health care utilization and household finances.”
Malaria can deprive the household of funds needed for food. It can also reduce the ability of the family to work and produce or buy food. Such economic, social and nutritional impacts need to be taken into account in developing intersectoral malaria policies.