Food Security

, Volume 6, Issue 1, pp 101–112 | Cite as

Urbanization, nutrition and development in Southern African cities

  • Bruce FrayneEmail author
  • Jonathan Crush
  • Milla McLachlan
Original Paper


This paper draws on exisiting studies and survey data collected from 11 cities in nine Southern African countries by the African Food Security Urban Network in order to explore the relationship between urban poverty and food and nutrition insecurity in Southern Africa. The paper demonstrates that poverty underpins the high levels of food insecurity and malnutrition evident amongst the urban poor in Southern Africa; therefore, access to food, and not availability, is at the heart of the urbanisation-nutrition-development nexus. The paper reviews the state of knowledge about food insecurity and the double burden of nutritional diseases in the urban areas of Southern Africa and lays out an agenda for future research to fill significant knowledge gaps.


Nutrition Food security Urbanisation Poverty Cities Southern Africa 



The publication of this paper was made possible by funding from the Canadian Government through the Canadian International Development Agency (CIDA) under its University Partners in Cooperation and Development (UPCD) Tier One Program. We wish to thank our colleagues in AFSUN for their assistance. Appreciation is extended to the referees of this article.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. Aguëro, J., Carter, V., & Woolard, I. (2006). The impact of unconditional transfers on nutrition: the South African child support grant. Pretoria: Report for DFID and USAID.Google Scholar
  2. Akubakari, A., Lauder, W., Agyemang, C., Jones, M., Kirk, A., & Bhopal, R. (2008). Prevalence and time trends in obesity among adult West African populations: a meta-analysis. Obesity Review, 9, 297–311.CrossRefGoogle Scholar
  3. Amis, P. (1995). Making sense of urban poverty. Environment and Urbanization, 7, 145–157.CrossRefGoogle Scholar
  4. Anyamele, O. (2009). Urban and rural differences across countries in child mortality in Sub-Saharan Africa. Journal of Health Care for the Poor and Underserved, 20, 90–98.PubMedCrossRefGoogle Scholar
  5. Ardington, C. & Gasealahwe, B. (2012). Health: Analysis of the NIDS Wave 1 and 2 Datasets. NIDS Discussion Paper/Working Paper Series, 80.Google Scholar
  6. Benson, T. (2008). Improving nutrition as a development priority: Addressing undernutrition in national policy processes in sub-Saharan Africa. Research Report, 156. IFPRI, Washington, DC.Google Scholar
  7. Bilinsky, P., & Swindale, A. (2007). Months of adequate household food provisioning (MAHFP) for measurement of household food access: indicator guide. Washington, DC: Food and Nutrition Technical Assistance Project (FANTA), Academy for Educational Development.Google Scholar
  8. Bourne, L. (1996). Dietary intake in an urban African population in South Africa–with special reference to the nutrition transition. Doctoral Thesis. University of Cape TownGoogle Scholar
  9. Bourne, L., Lambert, E., & Steyn, K. (2002). Where does the black population of South Africa stand on the nutrition transition? Public Health Nutrition, 5(1A), 157–162.PubMedCrossRefGoogle Scholar
  10. Brinkman, H. J., de Pee, S., Sanogo, I., Subran, V., & Bloem, M. (2010). High food prices and the global financial crisis have reduced access to nutritious food and worsened nutritional status and health. Journal of Nutrition, 140, 153S–161S.PubMedCrossRefGoogle Scholar
  11. Case, A., & Menendez, A. (2009). Sex differences in obesity rates in poor countries: evidence from South Africa. Economics and Human Biology, 7(3), 271–282.PubMedCentralPubMedCrossRefGoogle Scholar
  12. Chopra, M., Drimie, S., Witten, C. (2009). Combating malnutrition in South Africa. GAIN Working Paper Series, 1.Google Scholar
  13. Coates, J., Swindale, A., & Bilinsky, P. (2007). Household food insecurity access scale (HFIAS) for measurement of food access: Indicator guide, version 3. Washington, DC: Food and Nutrition Technical Assistance Project (FANTA).Google Scholar
  14. Crush, J., & Frayne, B. (2010). The invisible crisis: urban food insecurity in Southern Africa. AFSUN Series, 1Google Scholar
  15. Crush, J., Frayne, B., Drimie, S., Caesar, M. (2011a). The urban food security and HIV nexus in Africa. Food Security.Google Scholar
  16. Crush, J., Hovorka, A., & Tevera, D. (2011b). Food security in Southern African cities: the place of urban agriculture. Progress in Development Studies, 11(4), 285–305.CrossRefGoogle Scholar
  17. Delany, A., Ismail, Z., Graham, L., Ramkissoon, Y. (2008). Review of the child support grant: Uses, implementation and obstacles. Johannesburg: Department of Social Development, the South African Social Security Agency (SASSA) and UNICEF.Google Scholar
  18. Deleuze, G., Bouzitou, N., Fayomi, B., & Delisle, H. (2005). Child malnutrition and maternal overweight in same households in poor urban areas of Benin. Cahiers d’études et de recherches francophones/Santé, 15, 263–270.Google Scholar
  19. Department of Health. (2001). South Africa demographic and health survey 1998. Full report. Pretoria: Government of South Africa, Department of Health.Google Scholar
  20. Department of Health and Medical Research Council. (2003). The South African demographic and health survey (SADHS). Pretoria: Department of Health and Medical Research Council.Google Scholar
  21. Devereux, S. (2001). Social pensions in Namibia and South Africa. IDS Discussion Paper, 379. Brighton: University of Sussex, IDS.Google Scholar
  22. Doak, C., Adair, L., Bentley, M., Monteiro, C., & Popkin, B. (2005). The dual burden household and the nutrition transition paradox. International Journal of Obesity, 29, 129–136.PubMedCrossRefGoogle Scholar
  23. Drimie, S., & Garrett, J. (2009). Aligning and transforming institutions to safeguard food security in South Africa: concepts and critique. Washington, DC.: IFPRI.Google Scholar
  24. Ecker, O., & Qaim, M. (2011). Analyzing nutritional impacts of policies: an empirical study for Malawi. World Development, 39(3), 412–428.CrossRefGoogle Scholar
  25. Evans, A. (2009). The feeding of the nine billion: global food security for the 21st century. London: Royal Institute of International Affairs.Google Scholar
  26. Faber, M., Schwabe, C., & Drimie, S. (2009). Dietary diversity in relation to other household food security indicators. International Journal of Food Safety, Nutrition and Public Health, 2(1), 1–15.CrossRefGoogle Scholar
  27. FAO/WHO. (2005). Proceedings from regional conference on food safety for Africa: National food safety systems in Africa–a situation analysis. Harare: FAO/WHO.Google Scholar
  28. Fotso, J. (2006). Child health inequities in developing countries: Differences across urban and rural areas. International Journal for Equity in Health, 5.Google Scholar
  29. Fotso, J. (2007). Urban-rural differentials in child malnutrition: trends and socioeconomic correlates in Sub-saharan Africa. Health and Place, 13(1), 205–223.PubMedCrossRefGoogle Scholar
  30. Frayne, B., Pendleton, W., Crush, J., Acquah, B., Battersby-Lennard, J., Bras, E. et al. (2010). The state of urban food insecurity in southern Africa. Urban Food Security Series, 2. Queen’s University and AFSUN: Kingston and Cape Town.Google Scholar
  31. Garrett, J., & Ruel, M. (2003). Stunted child-overweight mother pairs: An emerging policy concern? Washington, DC: IFPRI.Google Scholar
  32. Glanz, K., Sallis, J., Saelens, B., & Frank, L. (2005). Healthy nutrition environments: concepts and measures. American Journal of Health Promotion, 19(5), 330–333. Resource Document. doi: 10.4278/0890-1171-19.5.330. Accessed November 2011.PubMedCrossRefGoogle Scholar
  33. Glanz, K., Sallis, J., Saelens, B., & Frank, L. (2007). Nutrition environment measures survey in stores (NEMS-S): development and evaluation. American Journal of Preventive Medicine, 32, 282–289.PubMedCrossRefGoogle Scholar
  34. Gleason, G. (2010). Tackling undernutrition the right way. Nutrition Today, 45(5), 202–206.CrossRefGoogle Scholar
  35. Goedecke, J., Jennings, C. L., & Lambert, E. V. (2006). Obesity in South Africa. In K. Steyn, J. Fourie, & N. Temple (Eds.), Chronic diseases of lifestyle in South Africa: 1995–2005 (pp. 33–47). Cape Town: South African Medical Research Council.Google Scholar
  36. Guthrie, T. (2002). Assessing the impact of the child support grant on the well-being of children in South Africa: A summary of available evidence. Report for Children’s Institute, University of Cape TownGoogle Scholar
  37. Honeycutt, S., Davis, E., Clawson, E., & Glanz, K. (2010). Training for and dissemination of the nutrition environment measures surveys (NEMS). Prevention of Chronic Disease, 7(6).Google Scholar
  38. Kruger, H., Venter, C., Vorster, H., & Margetts, B. (2002). Physical inactivity is the major determinant of obesity in black women in the North West Province, South Africa: The THUSA Study. Transition and health during urbanisation of South Africa. Nutrition, 18, 422–427.PubMedCrossRefGoogle Scholar
  39. Kruger, H., Puoane, T., Senekal, M., & van der Merwe, M. T. (2005). Obesity in South Africa: Challenges for government and health professionals. Public Health Nutrition, 8, 491–500.PubMedCrossRefGoogle Scholar
  40. Labadarios, D. (Ed.). (2007). The national food consumption survey – fortification baseline (NFCS-FB). Stellenbosch: Directorate Nutrition, Department of Health.Google Scholar
  41. Li, X., Stanton, B., Chen, X., Hong, Y., Fang, X., Lin, D., et al. (2006). Health indicators and geographic mobility among young rural-to-urban migrants in China. World Health and Population, 8(2), 5–21.PubMedCentralPubMedCrossRefGoogle Scholar
  42. Lytle, L. (2009). Measuring the food environment: state of the science. American Journal of Preventive Medicine, 36(4), S134–S144.PubMedCentralPubMedCrossRefGoogle Scholar
  43. Malhotra, R., Hoyo, C., Østbye, T., Hughes, G., Schwartz, D., Tsolekile, L., et al. (2008). Determinants of obesity in an urban township of South Africa. South African Journal of Clinical Nutrition, 21, 315–320.Google Scholar
  44. McLachlan, M. (2006). Tackling the child malnutrition problem: from what and why to how much and how. Journal of Pediatric Gastroenterology and Nutrition, 43, S38–S46.PubMedCrossRefGoogle Scholar
  45. McLachlan, M., & Garrett, J. (2008). Nutrition change strategies: the new frontier. Public Health Nutrition, 11, 1063–1075.PubMedCrossRefGoogle Scholar
  46. McLachlan, M., & Koch, J. (2011). The food security policy context in South Africa. Country study, 21. Brasilia: International Policy Centre for Inclusive Growth.Google Scholar
  47. McLachlan, M., & Thorne, J. (2009). Seeding change: a proposal for renewal in the south African food system. Development planning division working paper, 16. Midrand: Development Bank of South Africa.Google Scholar
  48. Mehta, D. (2000). Urbanisation of poverty. Habitat debate, 6. Nairobi: UN-HABITAT.Google Scholar
  49. Monteiro, C., Conde, W., & Popkin, B. (2004). The burden of disease from undernutrition and overnutrition in countries undergoing rapid nutrition transition: a view from Brazil. American Journal of Public Health, 94(3), 433–434.PubMedCrossRefGoogle Scholar
  50. Oldewage-Theron, W., Salami, L., Zotor, F., Venter, C. (2008). Health status of an elderly population in Sharpeville, South Africa. Health SA Gesonheid. Google Scholar
  51. Pingali, P. (2004). Westernization of African diets and the transformation of food systems: Implications for research and policy (p. 64). Rome: FAO. ESA Working Paper, 64–17.Google Scholar
  52. Popkin, B. (2004). The nutrition transition and its relationship to demographic change. In D. Semba and M. Bloem, Nutrition and Health in Developing Countries (pp. 601–616).Google Scholar
  53. Popkin, B., & Gordon-Larsen, P. (2004). The nutrition transition: worldwide obesity dynamics and their determinants. International Journal of Obesity, 28, S2–S9.PubMedCrossRefGoogle Scholar
  54. Popkin, B., & Ng, S. (2007). The nutrition transition in high- and low-income countries: what are the policy lessons. Agricultural Economics, 37, 199–211.CrossRefGoogle Scholar
  55. Puoane, T., Steyn, K., Bradshaw, D., Laubscher, R., Fourie, J., Lambert, V., et al. (2002). Obesity in South Africa: the south African demographic and health survey. Obesity Research, 10, 1038–1048.PubMedCrossRefGoogle Scholar
  56. Ravallion, M. (2007). Urban poverty. Finance and Development., 44(3), 15–17.Google Scholar
  57. Reardon, T., Henson, S., & Gulati, A. (2010). Links between supermarkets and food prices, diet diversity and food safety in developing countries. In C. Hawkes, C. Blouin, S. Henson, V. Drager, & L. Dubé (Eds.), Trade, food, diet and health: perspectives and policy options (pp. 111–130). New York: Wiley-Blackwell.Google Scholar
  58. Reddy, S., Resnicow, K., James, S., Kambaran, N., Omardien, R., & Bewu, A. (2009). Underweight, overweight and obesity among south African adolescents: results of the 2002 national youth risk behaviour survey. Public Health Nutrition, 12(2), 203–207.PubMedCrossRefGoogle Scholar
  59. Ruel, M. (2008). Addressing the underlying determinants of undernutrition: examples of successful integration of nutrition in poverty-reduction and agriculture strategies. SCN News, 36, 21–29.Google Scholar
  60. Saelens, B., Glanz, K., Sallis, J., & Frank, L. (2007). Nutrition environment measures study in restaurants (NEMS-R): development and evaluation. American Journal of Preventive Medicine, 32(4), 273–281.PubMedCrossRefGoogle Scholar
  61. Schönfeldt, H., Gibson, V., & Vermeulen, H. (2010). The possible impact of inflation on nutritionally vulnerable households in a developing country using South Africa as a case study. Nutrition Bulletin, 35, 254–267.CrossRefGoogle Scholar
  62. Siervo, M., Grey, P., Nyan, O., & Prentice, A. (2006). Urbanization and obesity in the Gambia: a country in the early stages of the demographic transition. European Journal of Clinical Nutrition, 60, 455–463.PubMedCrossRefGoogle Scholar
  63. Smith, L., & Haddad, L. (2001). How important is improving food availability for reducing child malnutrition in developing countries? Agricultural Economics, 26(3), 191–204.CrossRefGoogle Scholar
  64. Smith, L., Ruel, M., & Ndiaye, A. (2005). Why is child malnutrition lower in urban than in rural areas? Evidence from 36 developing countries. World Development, 33(8), 1285–1305.CrossRefGoogle Scholar
  65. Sodjinou, R., Agueh, V., Fayomi, B., & Delisle, H. (2008). Obesity and cardio-metabolic risk factors in urban adults of Benin: relationship with socio-economic status, urbanisation, and lifestyle patterns. BMC Public Health, 8, 84.PubMedCentralPubMedCrossRefGoogle Scholar
  66. Solomon, N. (2009). Malnutrition in developing countries: a changing face. Annales Nestlé, 67, 73–84.CrossRefGoogle Scholar
  67. Steyn, N. (2006). Nutrition and chronic diseases of lifestyle in South Africa. In K. Steyn, J. Fourie, & N. Temple (Eds.), Chronic diseases of lifestyle in South Africa: 1995–2005 (pp. 33–47). Cape Town: South African Medical Research Council.Google Scholar
  68. Steyn, N., Labadarios, D., Nel, J., Kruger, H., Maunder. E. (2011). What is the nutritional status of children of obese mothers in South Africa? Nutrition. Resource Document. Accessed November 2011.
  69. Swindale, A., & Bilinsky, P. (2006). Household dietary diversity score (HDDS) for measurement of household food access, indicator guid, version 2. Washington, DC: Food and Nutrition Technical Assistance Project (FANTA).Google Scholar
  70. Temple, N., & Steyn, N. (2011). The cost of a healthy diet: a South African perspective. Nutrition, 27(5), 505–508.PubMedCrossRefGoogle Scholar
  71. Temple, N., Steyn, N., Fourie, J., & De Villiers, A. (2011). Price and availability of healthy food: a study in rural South Africa. Nutrition, 27, 55–58.PubMedCrossRefGoogle Scholar
  72. Tibaijuka, A. K. (2009). There is no sustainable development without sustainable urbanisation. 17th Session of the commission on sustainable development (CSD-17) high-level segment. New York: UN-HABITAT.Google Scholar
  73. UNDP. (2012). Africa human development report 2012: towards a food secure future. New York: United Nations Development Programme Regional Bureau for Africa (RBA).Google Scholar
  74. UNICEF. (2006). Progress for children. a report card on nutrition, 4. Resource Document. UNICEF. Accessed November 2011.
  75. UNICEF/W. H. O. (2009). Diarrhoea: why children are still dying and what can be done. New York: United Nations Children’s Fund.Google Scholar
  76. United Nations (UN). (2008). Health and MDG. Resource Document. 2008. Accessed November 2011.
  77. United Nations Department of Economic and Social Affairs (UNESA): Population Division. (2011). World urban prospects: The 2011 revision. Resource Document. Accessed November 2012.
  78. United Nations Development Program (UNDP). (2012). Africa human development report 2012: Towards a food secure future. New York: UNDP.Google Scholar
  79. UNSCN. (2010). 6 th Report on the world nutrition situation. Resource Document. UNSCN. Accessed November 2011.
  80. Van Der Merwe, M. T., & Pepper, M. (2006). Obesity in South Africa. Obesity Reviews, 7, 315–322.PubMedCrossRefGoogle Scholar
  81. Villamor, E., Urassa, W., Petraro, P., Spiegelman, D., Hunter, D., & Fawzi, W. (2006). Trends in obesity, underweight, and wasting among women attending prenatal clinics in urban Tanzania, 1995–2004. American Journal of Clinical Nutrition, 83, 1387–1394.PubMedGoogle Scholar
  82. Von Braun, J., McComb, J., Fred-Mensah, R., & Pandya-Lorch, R. (2003). Urban food insecurity and malnutrition in developing countries: trends, policies, and research implications. Washington, DC: International Food Policy Research Institute.Google Scholar
  83. Vorster, H., Kruger, A., & Margetts, B. (2011). The nutrition transition in Africa. Can it be steered into a more positive direction? Nutrients, 3(4), 429–441.Google Scholar
  84. Wojcicki, J. (2005). Malnutrition and the role of the soft drink industry in improving child health in Sub-Saharan Africa. International Journal of Obesity, 29, 129–136.CrossRefGoogle Scholar
  85. World Bank. World Bank Open Data. (2012). Accessed 2012.
  86. World Food Program and Food and Agriculture Organisation (WHO/FAO). (2010). The state of food insecurity in the world: Addressing food insecurity in protracted crises. Rome: WFP/FAO.Google Scholar
  87. World Health Organisation(WHO)/UN Habitat. (2010). Hidden cities: Unmasking and overcoming health inequities in urban settings. Geneva: WHO/UN Habitat.Google Scholar
  88. Ziraba, A., Fotso, J., & Ochako, R. (2009). Overweight and obesity in urban Africa: a problem of the rich or the poor? BMC Public Health, 9, 465.PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht and International Society for Plant Pathology 2014

Authors and Affiliations

  1. 1.School of Environment, Enterprise and Development (SEED), Faculty of EnvironmentUniversity of WaterlooWaterlooCanada
  2. 2.Balsillie School of International AffairsWilfrid Laurier UniversityWaterlooCanada
  3. 3.Division of Human Nutrition, Faculty of Health SciencesUniversity of StellenboschTygerbergSouth Africa

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