ARTICLES

 

Welfare Implications of Home Gardens Among Rural Households: Evidence from Ingquza Hill Local Municipality, South Africa

 

 

Nontu Y.^I; Taruvinga A.^II

^IMaster's Student at the University of Fort Hare : Agricultural Economics and Extension, University of Fort Hare, P/Bag x 1314, Alice, 5700. .Email: nontuyanga@gmail.com, Orcid. 0000-0003-4843-9437
^IISenior Lecturer: Agricultural Economics and Extension, University of Fort Hare, P/Bag x 1314, Alice, 5700. Email: ataruvinga@ufh.ac.za, Orcid: 0000-0001-8829-2826

Correspondence

 

 

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ABSTRACT

Food insecurity is widely recognised as a global issue that requires immediate attention using multifaceted approaches. There is a generalised consensus about the positive role of home gardens in improving household income and food security. However, there is limited empirical evidence to support the above nexus worth exploring to enhance evidence of based programming. Therefore, this study used cross-sectional survey data from Ingquza Hill local municipality in the Eastern Cape Province of South Africa (n = 200) to estimate the correlation between participation in home gardening, household food security, and household income. Results revealed that income from home garden sales was the least source of income for most households in the study area, contributing an average of 10.4% to total household income. An insignificant negative correlation was confirmed between home gardens and household food insecurity access score, suggesting that home gardens fall short of addressing household food security. A positive linear significant correlation was also confirmed between home garden participation and household income. The study concludes that home gardens designed for cash crop production may have a better food security premise than those intended for home food consumption and the sale of surplus.

Keywords: Food security, Spearman's rho correlation, Household Food Insecurity Score, Income

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1. INTRODUCTION

Today the world faces the fundamental challenge of ensuring that millions of households living in poverty have enough food to sustain a better life. South Africa is food secure at the national level; however, the case is different at the household level, where households experience inadequate food access (Hendriks, 2014). According to the FAO (2015), South Africa has achieved the Millennium Development Goal (MDG) 1c of halving hunger by 2015 . Nonetheless, South Africa is far from food security at the household level (Hendriks, 2014). Slightly over a quarter of households experienced hunger in 2012, while 28.3% were at "risk of hunger" (Hendriks, 2014). Approximately 26.5% of children aged 0-3 years were stunted in the same year. Evidence exists that micronutrient deficiencies (i.e., hidden hunger) are high among samples of South African children and adults. These deficiencies coexist with high levels of overweight and obesity (Steyn et al., 2005).

Statistics South Africa (Stats SA) (2014) reports that about 17% of South African households have inadequate access to food, and about 34.4% of households are experiencing hunger. This means that measures addressing poverty and food insecurity need significant consideration at the household level, especially in rural areas where high unemployment, low literacy rate, and high dependency ratio are prevalent (Mahlangu & Garutsa, 2014). Hendricks (2014) also argues that hunger and unemployment are still significant challenges in South Africa. Galhena et al. (2012) state that household food insecurity among South African citizens is worsened by increased prices of services and goods such as electricity and oil, which has led to increased food prices. The items that constitute a staple diet of poor South Africans, mainly maize and wheat, have been the worst hit.

Food insecurity affects both rural and urban settlements. However, it is more pronounced in rural settlements, whereby the current statistics show a 4.5% increase in poverty over the past five years (Stats SA, 2017). In the Eastern Cape Province of South Africa, household poverty increased from 13.6% to 15.5% in the past five years (Stats SA, 2017). Mahlangu and Garutsa (2014) noted that the high poverty levels in the Eastern Cape could be attributed to unemployed households. Thus, it may be inferred that there are often large numbers of job seekers than available jobs, particularly for those considered unskilled. Such high levels of poverty and unemployment require interventions to help mitigate the high levels of food insecurity within the province. The Eastern Cape is the second poorest province in South Africa (StatsSA, 2011). Currently, the Eastern Cape Province poverty gap is 16.5% (Stats SA, 2017). This suggests a need for the province to focus on poverty alleviation strategies through interventions by government and private organisations.

Over the years, Africa has sought ways to solve food insecurity (Schaetzel et al., 2013). In developing countries, the agriculture industry has been considered a fundamental backbone in rural areas (Fanzo, Remans & Termote, 2016). However, numerous attempts in South Africa to implement home garden programs often fail to improve the food security of the poor (Adekunle, 2013; Reddiar, 2016). Home gardens are considered a community's most adaptable and accessible land-based activity and are essential in reducing vulnerability and ensuring food security (Adekunle, 2013). Also, home gardens form an integral part of urban and rural livelihoods. They are sites where people grow staple foods and cultivate plants for income and medicine (Reddiar, 2016). Home gardening also plays a significant role in household food production, improved household status, income generation, and nutrition (Gebremedhin et al., 2017, Malahlela, 2015.).

Home gardens are vital in providing income and sustenance throughout the year from diverse crops contained within them, harvested at different times of the year (Galhena et al., 2013). Reddiar and Reddiar (2016) assert that the cultural value attached to home gardens has been reinforced by their essential contribution to household food security over the past 50 years. However, income is the principal determinant of household food security (Puett et al., 2014). Walsh and Van Rooyen (2015) argue that home gardening remains the most important method of food production for most people in the developing world. Moreover, household members' daily nutrition and healthy food can be obtained from home garden production (Puett et al., 2014). Thus far, home garden ownership is vital to urban and rural households since both locations encounter food insecurity and poverty (Schreinemachers et al., 2016). Against this background, the study questions the claimed nexus between home gardens and household food security and the income premise, given the high food insecurity and low participation in home gardens among rural communities. Therefore, this paper focused on the contribution of home gardens to a household's food security and income.

 

2. PROBLEM STATEMENT

Household food insecurity remains a significant concern in developing countries (von Grebmer et al., 2012). Hunger is not widespread in South Africa as in other Southern African countries (du Toit et al., 2011), but household food and nutrition insecurity persist among the majority of the Black South African population (Maliwichi et al., 2010). Multiple strategies are required to address the issue of food production and food security (Bhandari et al. 2016). It is evident from the literature that home gardens are a part of the agriculture and food production systems in many developing countries and are widely used as a remedy to alleviate hunger and malnutrition in the face of a global food crisis (FAO, 2015; Uzokwe et al., 2016; van Lier, 2017). Furthermore, several studies have documented home gardens as an essential supplemental source of food and nutritional security, livelihoods, and income generation in rural areas (Reddiar & Reddiar, 2016; Walsh & Van Rooyen, 2015). On the contrary, several studies by Masset et al., 2012; Webb, 2013, also question home gardens' food and nutritional security contributions at the household level in rural areas. Therefore, the actual contribution of home gardens to household food and nutritional security remains a highly debated issue worth probing in different geopolitical environments.

From a policy perspective, the South African government developed the National Policy on Food and Nutrition Security in August 2013, intending to increase and better target public spending in social programmes. These programs play an imperative role in food security to increase food production and distribution, including increased access to production inputs for the emerging agricultural sector (DAFF, 2014). Through the National Food and Nutrition Security Policy, the state has set out several programs to support the food and nutrition-insecure population and promote food security across the country (DAFF, 2014; FAO, 2015). Literature, however, highlights that little is documented on the outcomes of the investment towards achieving food and nutrition security at the household level (Aryal et al., 2022). Unfortunately, the blurring between income-based and subsistence rationales within programme and policy provisions frustrates the overall success of community gardening, with implementation processes failing to achieve its objectives (DAFF, 2014). Home gardens, therefore, fail to find a niche within broader production systems, marketing and availability, or as safety nets and social protection (Webb, 2013).

 

3. METHODOLOGY

3.1. Study Area

Ingquza Hill local municipality is one of the five local municipalities within the OR Tambo District Municipality of the Eastern Cape Province. Ingquza Hill is located to the northwest of the OR Tambo District with the coordinates 32°10'S 28°35'E. The Municipality seat is in Flagstaff, and the municipal area is divided into 31 wards (Stats SA, 2017). It covers 2,477 square kilometres (956-metre square) of the municipality's total area (Stats SA, 2008). Inggquza Hill local municipality has approximately 278 481 people (Stats SA, 2008). Flagstaff town is part of Ingquza Hill local municipality of OR Tambo District. Flagstaff is located in the northeast of Umtata, in the former Pondoland.

3.2. Empirical Model Used

The study used a cross-sectional field survey whereby data was gathered from 200 households using the availability sampling method from four randomly selected villages of Ingquza Hill Local Municipality. A correlation analysis was used to estimate the association between participating in home gardens and household income and food security. Daniel (1990) notes that outliers, unequal variances, non-normality, and nonlinearity influence Pearson correlation. Spearman's rank correlation coefficient can be used (Daniel, 1990). Pearson correlation measures the strength of the linear relationship between X and Y. In the case of nonlinear but monotonic relationships, a useful measure is Spearman's rank correlation coefficient, Rho, which is a Pearson's type correlation coefficient computed on the ranks of X and Y values as detailed in equation one below (Daniel, 1990).

Where;

di is the difference between the ranks of Xi and Yi.

n = the number of (X, Y) observation (ranks).

rs = +1, if there is a perfect agreement between the two sets of ranks.

rs = - 1, if there is a complete disagreement between the two sets of ranks.

 

4. RESULTS AND DISCUSSION

4.1. Basic sample statistics

This section presents the basic sample statistics of home gardeners and non-home gardeners. Table 1 below summarises the sample statistics from the study area. A sample of 200 participants was selected from the study area, with a mean household head age of 59 years. The mean education level was 2, meaning that participants were educated on average to the primary level.

The results also revealed that there were more females than males in the study area, with an average monthly income of R3151.63. Primary sample results show an average household size of six family members, with a minimum of 0 and a maximum of 12 family members. Most respondents did not have access to markets, membership to CBOs and credits. The distribution asymmetry was positively and negatively skewed, as shown in Table 1 above. Most of the characteristics had skewness values below and close to one (except household income and access to land); this suggests that the distribution did not differ significantly from a normal symmetric distribution.

4.2. Contribution of Home Gardens on Total Household Income

This section presents results for home gardens' contribution to total household income, as illustrated in Figure 2 below. The primary income sources emerging from the study results were old-age pensions, home garden sales, salaries and wages, welfare grants and remittances.

The results presented in Figure 2 above indicate that although being a minor contributor to total household income (10.4%), home garden sales positively represent household income. Similar findings are also shared by several studies that mentioned that surplus produce from home gardens can be sold for additional income and used for other essential household needs (Chauhan, 2015; Uzokwe, Giweze & Ofuoku, 2016). However, Muzawazi et al. (2017) caution against the income premise of home gardens since the bulk of home garden crops is used for household consumption.

4.3. The Contribution of Home Gardens to Household Food Security and Income

The emerging results indicate that HFIAS for the home gardeners was 13, while that of nonhome gardeners was 12. These results suggest that although both groups were classified as moderately food insecure, non-home gardeners are relatively more minor food insecure than home gardeners. However, by broad classification, results suggest that there may be no difference in the food insecurity status of home gardeners and non-home gardeners from the study area. The study also tested the significance of the "no difference hypothesis," as suggested above. The results of this are presented in the next section.

 

Table 2

 

4.4. Bivariate Correlation Analysis

This section presents the association between participation in home gardening, household food insecurity status and household income, as highlighted in Table 3 below. A non-parametric correlation model (Spearman's rho) was used to assess the association between participation in home gardening, household food insecurity status, and household income.

4.5. Household Food Security

Results indicate a statistically insignificant (p-value = 0.403) weak negative correlation (coefficient = -0.018) between home gardening participation and household food insecurity access score. These findings suggest that as participation in home gardening increases, there is a slight decrease in households' food insecurity access score. However, this association is statistically insignificant, implying that the observed negative association may result from chance. As such, results suggest that the observed association is not statistically significant, meaning that, based on the results from the study area, home gardening does not influence household food security. Previous descriptive statistics also confirm a "no difference hypothesis" for home gardeners (HFIAS =13) and non-home gardeners (HFIAS = 12). This may be explained by the low-income contribution of home garden sales to total household income (10.4%), which is spread across several households' cash demands. Also, the diversity of crops grown from the study area typically under 1ha; [cereals (maize); vegetables and tubers (cabbage, spinach, and potatoes, pumpkin) and fruits (oranges, peaches and plums)] falls short of a balanced food basket to address food requirements for average family size. The dominant home garden crop (yellow maize - 40%) was mainly used for stock feed. In line with these findings, previous studies also cautioned about the home gardens and food security nexus in the absence of an adequate amount of food produced to meet food security requirements at the household level (Caskie, 2000; Vavra et al., 2018).

4.6. Household Income

Results reveal a weak positive significant correlation between home gardening and household income. These results suggest that household income is slightly increased as home gardening participation increases. Although participation in home gardening and household income highlighted a significant positive linear association with the Spearman's rho p-value (0.030), the coefficient's (0.133) absolute value was not large enough to give a convincing clue of the observed relationship. These results confirm the slightly higher contribution of home garden sales (10.4%) to total household income. Comparable previous studies note a positive contribution of home gardens to household income (Joel et al., 2018; Neelamegam et al., 2017), arguing that income revenue generated through home gardening sales boosts household purchasing power additional expenditures such as education, savings and other services.

The results also reveal a strong negative correlation (coefficient = -0.617; p = 0.00) between household income and household food insecurity access score. These findings suggest that as household income increases, there is a considerable decrease in households' food insecurity access score. Therefore, this means household income addresses food security through purchasing household foods and indirectly financing other income-generating activities. Consequently, it can be argued that promoting home gardens for cash crops has a better food security premise than promoting home gardens for household food availability from the study area. These findings support Puett et al. (2014), who argue that income is the principal determinant of household food security in contemporary South Africa. Several conclusions can be drawn from the above results, as summarised below:

(a) Home gardens generate income for rural households (estimated to be 10.4% of total household income) but fall short of addressing household food security. Therefore, home gardening participation may be better promoted to address household food security through the income effect, not food availability.

(b) The observed weak association between home gardening participation and household income suggest home gardens are designed for subsistence purposes (stock feed, home consumption and sale of surplus), of which, unfortunately, the diversity and quantities of food groups grown fall short of addressing household food security as suggested by empirical evidence from the study area.

(c) Interestingly, the observed significant negative association of household income and household food insecurity access score, as read with the observed significant positive association of participation in home gardens and household income, suggests a new dimension of home gardens. It can be argued that promoting home gardens for cash crops may address household food security through the income effect much better than promoting home gardens for household food availability.

 

5. CONCLUSION AND RECOMMENDATIONS

The study concludes that participation in home gardening is more likely to improve household income. However, the results also highlight that the association is weak, suggesting that participating in home gardening to household income, though positive, might not be as high as popularly believed. The study revealed that income from home garden sales might be insufficient to address household food insecurity. Therefore, the study concludes that participation in home gardening may be better promoted to manage household food security through the income effect than food availability. The weak association between home gardening participation and household income suggests that home gardens are designed for subsistence purposes (home consumption and sale of surplus). Unfortunately, the diversity and quantities of food groups grown fall short of addressing household food security. In addition, the observed significant negative association of household income and household food insecurity access score, as read with the observed significant positive association of participation in home gardens and household income, suggests that promoting home gardens for cash crops may address household food security through the income effect much better that promoting home gardens for household food availability.

Thus far, the message for rural households and policymakers is that: Home gardens in their current designs (<1ha and dominated by the production of yellow maize and vegetables) may be promoted to address household food security through the income effect as opposed to food availability. Therefore, rural households should grow more cash crops in their small gardens that can be traded locally to boost their household income, which has a better promise to address household food security.

The following home garden designs are suggested to promote household food security and income: Empirical findings revealed that home gardens have a more positive impact on household income than household food security. In contrast, household income has a strong positive association with food security. Against this background, home gardens designed to produce cash crops may have a better impact on household food security (through the income effect) than home gardens designed to produce household food crops for consumption and sale of surplus (the current status quo).

 

6. ACKNOWLEDGEMENTS

The authors wish to acknowledge the additional funds for financial support from Ada and Bertie Levenstein Bursary and National Research Foundation (NRF).

 

REFERENCES

ADEKUNLE, O., MONDE, N., AGHOLOR, I. & ODEYEMI, A.S., 2013. The role of home gardens in household food security in Eastern Cape: A case study of three villages in Nkonkobe Municipality. J. Agric. Sci., 6(1): 67-76.         [ Links ]

ARYAL, J.P., MANCHANDA, N. & SONOBE, T., 2022. Expectations for household food security in the coming decades: A global scenario. In R. Bhat (ed.), Future foods: Global trends, opportunities, and sustainability challenges. USA: Elsevier, 107-131.         [ Links ]

BHANDARI, S., SAYAMI, J.T., THAPA, P., SAYAMI, M., KANDEL, B.P. & BANJARA, M.R., 2016. Dietary intake patterns and nutritional status of women of reproductive age in Nepal: Findings from a health survey. Arch. Public. Health., 74(1): 1 -11.         [ Links ]

CASKIE, P., 2000. Back to basics: Household food production in Russia. J. Agric. Econ., 51: 196-209.         [ Links ]

CHAUHAN, R., 2015. An investigation of the relationships among home gardens, dietary diversity, and the nutritional status of children aged 0 to 5 in Indian households. Unpublished Masters Thesis, University of Illinois at Urbana-Champaign, United States of America.         [ Links ]

DANIEL, W.W., 1990. Procedures that utilise data from two independent samples. Applied Nonparametric Statistic. 2^nd ed. Boston, Massachusetts: PWS-Kent Publishing.         [ Links ]

DEPARTMENT OF AGRICULTURE, FORESTRY AND FISHERIES (DAFF)., 2014. Directorate: Food Security, Strategic outlook, 1-10.         [ Links ]

DU TOIT, D.C., RAMONYAI, M.D., LUBBE, P.A. & NTUSHELO, V., 2011. Food Security. Pretoria: South African Department of Agriculture, Forestry and Fisheries.         [ Links ]

FANZO, J., REMANS, R. & TERMOTE, C., 2016. Smallholders, agro-biodiversity and mixed cropping and livestock systems. In B. Pritchard, R. Ortiz & M. Shekar (Eds.), the Handbook of Food and Nutrition Security. London: Routledge, 299-318.         [ Links ]

FOOD AND AGRICULTURE ORGANIZATION (FAO)., 2015. Guidelines for measuring household and individual dietary diversity. Rome: FAO.         [ Links ]

GALHENA, D.H., FREED, R. & MAREDIA, K.M., 2013. Home gardens: A promising approach to enhance household food security and well-being. Agric. Food. Secur., 2(1): 1-8.         [ Links ]

GALHENA, D.H., MIKUNTHAN, G. & MAREDIA, K.M., 2012. Home gardens for enhancing food security in Sri Lanka. Farming Matters., 28(2): 12.         [ Links ]

GEBREMEDHIN, S., BAYE, K., BEKELE, T., THARANEY, M., ASRAT, Y., ABEBE, Y. & RETA, N., 2017. Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia. Nutrition., 33: 163-168.         [ Links ]

HENDRIKS, S., 2014. Food security in South Africa: Status quo and policy imperative. Agrekon., 53(2): 1-24.         [ Links ]

JOEL, T., MARY, K.B.T., JOSEPH, J.M. & ONIKIA, N.B., 2018. Factors that influence food security in Nicaragua and the role of home gardening in reducing food insecurity and improving income. Int. J. Food. Sci. Nutr., 6(5): 555697. doi: 10.19080/NFSIJ.2018.06.555697.         [ Links ]

LOWE, W.A.M., SINNIAH, J., JEYAVANAN, K., SILVA, G.L.L.P. & PUSHPAKUMARA, D.K.N.G., 2021. Can homegardens assist in enhancing the domestic food security?: A study in Jaffna Peninsula, Sri lanka. Agrofor. Syst., 95(6): 1205-1216.         [ Links ]

MAHLANGU, M. & GARUTSA, T. C., 2014. Application of indigenous knowledge systems in water conservation and management: The case of Khambashe, Eastern Cape South Africa. Acad. J. Interdiscip. Stud., 3(4): 151.         [ Links ]

MALAHLELA, N.D., 2015. Socio-economic contribution of community food gardens to the livelihoods of rural households in Lepelle-Nkumpi Local Municipality of Limpopo Province, Unpublished Masters thesis, University of Fort Hare, Eastern Cape, South Africa.         [ Links ]

MALIWICHI, L.L., ONI, S.A. & SIFUMBA, L., 2010. An evaluation of small-scale agribusinesses and household income generating activities in Vhembe District of Limpopo Province, South Africa. African. J. Food. Agric. Nutr. Dev., 10(9): 3080-99.         [ Links ]

MUZAWAZI, H.D., TERBLANCHÉ, S.E. & MADAKADZE, C., 2017. Community gardens as a strategy for coping with climate shocks in Bikita District, Masvingo, Zimbabwe. S Afr. Jnl. Agric. Ext., 45(1): 102-117.         [ Links ]

NEELAMEGAM, R., SINDHU, PRATHIBA, N., THANGASUTHA, MUTHU, B., ANCY, E. S., RAMANI, M., THANGASUTHA, G., MOHAMMED, & IRSATH, J. 2017. Household economy and homegarden plants composition, diversity and utilisation in rural villages of Kanyakumari District, Tamil Nadu, India, 12-24.         [ Links ]

PRITCHARD, B., VICOL, M., RAMMOHAN, A. & WELCH, E., 2019. Studying home gardens as if people mattered: Why don't food-insecure households in rural Myanmar cultivate home gardens? J. Peasant. Stud., 46(5): 1047-1067.         [ Links ]

PUETT, C., SALPÉTEUR, C., LACROIX, E., ZIMUNYA, S.D., ISRAËL, A.D. & AÏT-AÏSSA, M., 2014. Cost-effectiveness of community vegetable gardens for people living with HIV in Zimbabwe. Cost Eff. Resour. Alloc., 12(1): 11.         [ Links ]

REDDIAR, K.L. & REDDIAR, S.K., 2016. Family agriculture for bottom-up rural development: a case study of the indigenous Mayan population in the Mexican Peninsula. Future of Food. J. Food. Agric. Soc., 4(1): 29-39.         [ Links ]

SCHAETZEL, T., ANTAL, M. & GUYON, A., 2013. Factors motivating home garden choices affecting dietary diversity in Bangladesh. Paper presented at IUNS 20^th International Congress of Nutrition, 15-20 September, Granada, Spain.         [ Links ]

SCHREINEMACHERS, P., PATALAGSA, M.A. & UDDIN, N., 2016. Impact and cost-effectiveness of women's training in home gardening and nutrition in Bangladesh. J. Dev. Eff., 8(4): 473-488.         [ Links ]

Statistics South Africa (Stats SA)., 2014. General Household Survey. Pretoria.         [ Links ]

Statistics South Africa (Stats SA)., (2017). Poverty report. [Viewed 20 November 2017]. Available from http://www.statssa.gov.za/?p=1033        [ Links ]

Statistics South Africa (Stats SA)., 2008. Population estimates 2009. [Viewed 27 December 2017]. Available from www.statssa.gov.za/publications/P0302/P03022009.pdf.         [ Links ]

STEYN, N., NEL, J., NANTEL, G., KENNEDY, G. & LABARADORIOS, D., 2005. Food variety and dietary diversity scores in children: are they good indicators of dietary adequacy? Public. Health. Nutr., 9(5): 644-650.         [ Links ]

UZOKWE, U.N., GIWEZE, E.A. & OFUOKU, A.U., 2016. Contribution of home gardening to family food security in Delta North Agricultural Zone, Delta State, Nigeria. J. Agric. Ext. Rural Dev., 3(2): 26-33.         [ Links ]

VAN LIER, L.E., 2017. Home Gardening and the Health and Well-Being of Adolescents. Health Promot. Pract., 18(1): 34-43.         [ Links ]

VÁVRA, J., DANEK, P. & JEHLICKA, P., 2018. What is the contribution of food self-provisioning towards environmental sustainability? A case study of active gardeners. J. Clean. Prod., 185: 1015-1023.         [ Links ]

VON GREBMER, K., RINGLER, C., ROSEGRANT, M.W., OLOFINBIYI, T., WIESMANN, D., FRITSCHEL, H., BADIANE, O., TORERO, M. & YOHANNES, Y., 2012. Global Hunger Index: The challenge of hunger: Ensuring sustainable food security under land, water, and energy stresses. Deutsche Welthungerhilfe, International Food Policy Research Institute, and Concern Worldwide: Bonn, Washington, DC, and Dublin.         [ Links ]

WALSH, C.M. & VAN ROOYEN, F.C., 2015. Household food security and hunger in rural and urban communities in the Free State Province, South Africa. Ecol. Food. Nutr., 54(2): 118-137.         [ Links ]

WEBB, P., 2013. Impact pathways from agricultural research to improved nutrition and health: Literature analysis and research priorities. Rome: Food and Agriculture Organization and Geneva: World Health Organization.         [ Links ]

 

 

Correspondence:
Y. Nontu
Correspondence Email: nontuyanga@gmail.com