Browsing by Author "Crush, Jonathan"

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    Food deserts and household food insecurity in the informal settlements of Windhoek, Namibia
    (2014) Nickanor, Ndeyapo Martha; Crush, Jonathan; Parnell, Sue; Battersby, Jane
    Rapid urbanization and rising urban poverty characterize much of Sub-Saharan Africa in the 21st Century. Africa's urban transition provides the context within which this thesis examines the causes and consequences of poverty and food insecurity in the growing informal settlements of Windhoek, Namibia. Rapid urbanization in Windhoek has been accompanied by limited industrialization with few job opportunities in the formal employment sector. Moreover, the informal sector has not been able to absorb the ever rising volume of migrants from the rural areas, increasing urban poverty and food insecurity among the most vulnerable group in the urban environment: female -centred households in informal settlements. The informal settlements in Windhoek are an ideal site in which to examine the struggle for food security and other basic needs by poor women. Despite the accumulated literature on the food security of female-centred households, much of this work has focused on the rural sector and has paid little attention to the contribution of women to food security in the urban areas, and the strategies they adopt to eke out a living. This study combines qualitative and quantitative research methods in order to understand the factors that determine the food security status of female-centred households and to explore their strategies to access food and build resilience to food insecurity. Firstly, the thesis demonstrates that female-centred households in the informal settlements are poorer and more food insecure than all other types of household. Secondly, these households source food from a variety of sources including supermarkets, the informal food economy and rural-urban food transfers. Urban agriculture is completely unimportant as a food source. Thirdly, formal food sources such as supermarkets may offer cheaper quality food but they are located too far from the informal settlements for regular use. Fourthly, female-centred households rely heavily on the informal food sources, both as consumers and as a source of income for their own households. The informal food economy is dominated by women who find it extremely difficult to access formal sector jobs. Fifthly, food borrowing, sharing of food with neighbours and consumption of food provided by neighbours are increasingly important food sources in coping with food shortages. This thesis also addresses the broader question of whether the informal settlements of this African city qualify as "food deserts" and whether this concept (developed to describe inner-city neighbourhoods in Europe and North America) helps to shed light on the food security situation in Namibia. The thesis concludes that the concept needs to be redefined to be appropriate to African realities. The fundamental problem in the African city is not lack of spatial access to formal sector outlets such as supermarkets. Supermarkets are distant but the informal economy ensures that sufficient and diverse food is available in the informal settlements. In Windhoek's food deserts, as one respondent noted, the problem is not food but income.
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    Health worker migration from South Africa: causes, consequences and policy responses
    (2015) Labonté, Ronald; Sanders, David; Mathole, Thubelihle; Crush, Jonathan; Chikanda, Abel; Dambisya, Yoswa; Runnels, Vivien; Packer, Corinne; MacKenzie, Adrian; Murphy, Gail Tomblin; Bourgeault, Ivy Lynn
    BackgroundThis paper arises from a four-country study that sought to better understand the drivers of skilled health worker migration, its consequences, and the strategies countries have employed to mitigate negative impacts. The four countries—Jamaica, India, the Philippines, and South Africa—have historically been “sources” of skilled health workers (SHWs) migrating to other countries. This paper presents the findings from South Africa.MethodsThe study began with a scoping review of the literature on health worker migration from South Africa, followed by empirical data collected from skilled health workers and stakeholders. Surveys were conducted with physicians, nurses, pharmacists, and dentists. Interviews were conducted with key informants representing educators, regulators, national and local governments, private and public sector health facilities, recruitment agencies, and professional associations and councils. Survey data were analyzed using descriptive statistics and regression models. Interview data were analyzed thematically.ResultsThere has been an overall decrease in out-migration of skilled health workers from South Africa since the early 2000s largely attributed to a reduced need for foreign-trained skilled health workers in destination countries, limitations on recruitment, and tighter migration rules. Low levels of worker satisfaction persist, although the Occupation Specific Dispensation (OSD) policy (2007), which increased wages for health workers, has been described as critical in retaining South African nurses. Return migration was reportedly a common occurrence. The consequences attributed to SHW migration are mixed, but shortages appear to have declined. Most promising initiatives are those designed to reinforce the South African health system and undertaken within South Africa itself.ConclusionsIn the near past, South Africa’s health worker shortages as a result of emigration were viewed as significant and harmful. Currently, domestic policies to improve health care and the health workforce including innovations such as new skilled health worker cadres and OSD policies appear to have served to decrease SHW shortages to some extent. Decreased global demand for health workers and indications that South African SHWs primarily use migratory routes for professional development suggest that health worker shortages as a result of permanent migration no longer pertains to South Africa.