This report examines the nature of urban poverty and how it relates to food in-security and malnutrition in Accra, Ghana. By exploring the major determinants of food security and nutritional status, it develops indicators that are appropriate in an urban context, identifies vulnerable groups within the city, and suggests policies and programs to improve the lives of the urban poor. (Adapté du résumé).

The urban population in Africa south of the Sahara (SSA) is expected to expand rapidly from 376 million people in 2015 to more than 1.25 billion people by 2050. Measuring and ensuring food security among urban households will become an increasingly pertinent task for development researchers and practitioners. In this paper we characterize food security among a sample of low- and middle-income residents of Accra, Ghana, using 2017 survey data. We find that households tend to purchase food from traditional markets, local stalls and kiosks, and street hawkers, and rarely from modern supermarkets. We characterize food security using three established metrics: the Household Food Insecurity Access Scale (HFIAS); the Household Food Insecurity Access Prevalence (HFIAP); and the Food Consumption Score (FCS). We then estimate the determinants of food security using general linear models. The food security metrics are not strongly correlated. For example, according to HFIAP, as many as 70 percent of households sampled are food insecure, but only 2 percent fall below acceptable thresholds measured by FCS. Model results show that household education, assets, and dwelling characteristics are significantly associated with food security according to HFIAS and HFIAP, but not with FCS. The poor correlation and weak model agreement between the dietary recall metric, FCS, and the experience-based metrics, HFIAS and HFIAP, call for closer attention to measurement of urban food security. Given Africa’s urban future, our findings highlight the need for an urban-oriented comprehensive approach to the food security of urban households.

In recent decades, Ghana has experienced high economic growth and transformation, which contributed to the nation achieving the Millennium Development Goal targets on reducing extreme poverty and hunger. Against this background and in view of achieving the food and nutrition security targets of the Sustainable Development Goals, Ghana started a process of reviewing its food security and nutrition strategies and policies, including the overarching Zero Hunger Strategy. This discussion paper aims to contribute to this process by providing an update on the state of Ghana’s food and nutrition security. In addition to providing an overview of long-term historical trends at the national level, this analysis provides an overview of regional patterns of food and nutrition insecurity and recent changes across Ghana’s 10 administrative regions. Finally, the analysis identifies regional “hot spots” of food and nutrition insecurity. This paper confirms that Ghana has achieved substantial improvements in food and nutrition security overall, especially over the past decade. Nationwide, progress has been made in improving households’ economic access to food by reducing poverty and extreme poverty and in reducing chronic and acute child undernutrition. However, progress in reducing micronutrient malnutrition—particularly anemia and especially among young children—has been more modest. Across Ghana, large rural-urban gaps and regional differences—mainly between the north and the south—remain for most dimensions of food and nutrition security. In addition, Ghana is increasingly facing new nutrition-related public health problems that result from overnutrition and diets too rich in calories. Overweight and obesity among adults are rising rapidly in both urban and rural areas, leading to an increase in the risk of noncommunicable diseases. The rising double burden of malnutrition—that is, the coexistence of overnutrition and undernutrition, including micronutrient deficiencies—constitutes a challenge to public health and social protection policy. These new nutritional realities may make some existing food and nutrition security policies obsolete or even detrimental to nutrition security.

"In recent years an extensive body of literature has emerged on the definition, measurement, and analysis of poverty. Much of this literature focuses on analyzing poverty at the national level, or spatial disaggregation by general categories of urban or rural areas, with adjustments made for regional price differentials. Yet for an individual city attempting to tackle the problems of urban poverty, this level of aggregation is not sufficient for answering specific questions such as where the poor are located in the city, whether there are differences between poor areas, if access to services varies by subgroup, whether specific programs are reaching the poorest, and how to design effective poverty reduction programs and policies. Answering these questions is critical, particularly for large, sprawling cities with highly diverse populations and growing problems of urban poverty. Understanding urban poverty presents a set of issues distinct from general poverty analysis and thus may require additional tools and techniques. Baker and Schuler summarize the main issues in conducting urban poverty analysis, with a focus on presenting a sample of case studies from urban areas that were implemented by a number of different agencies using a range of analytical approaches for studying urban poverty. Specific conclusions regarding design and analysis, data, timing, cost, and implementation issues are discussed. This paper-a product of the Urban Unit, Transport and Urban Development Department-is part of a larger effort in the department to promote strategies for reducing urban poverty"--World Bank web site.