Fishing for food? Analyzing links between fishing livelihoods and food security around Lake Victoria, Kenya

Fiorella, Kathryn J.; Hickey, Matthew D.; Salmen, Charles R.; Nagata, Jason M.; Mattah, Brian; Magerenge, Richard; Cohen, Craig R.; Bukusi, Elizabeth A.; Brashares, Justin S.; Fernald, Lia C. H.

doi:10.1007/s12571-014-0393-x

Cited by 45 publications

(46 citation statements)

References 18 publications

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“…In reality, many patients are engaged in livelihoods that require mobility. In communities surrounding Lake Victoria, one third of households are engaged in fishing,(Fiorella et al, 2014) requiring frequent travel to keep up with the migratory patterns of fish. (Camlin, Kwena, & Dworkin, 2013), Such mobility is not always predictable.…”

Section: Discussionmentioning

confidence: 99%

Movement between facilities for HIV care among a mobile population in Kenya: transfer, loss to follow-up, and reengagement

Hickey

Omollo²,

Salmen

et al. 2016

AIDS Care

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HIV treatment is life-long, yet many patients travel or migrate for their livelihoods, risking treatment interruption. We examine timely reengagement in care among patients who transferred-out or were lost-to-follow-up (LTFU) from a rural HIV facility. We conducted a cohort study among 369 adult patients on antiretroviral therapy between November 2011 and November 2013 on Mfangano Island, Kenya. Patients who transferred or were LTFU (i.e. missed a scheduled appointment by ≥90 days) were traced to determine if they re-engaged or accessed care at another clinic. We report cumulative incidence and time to reengagement using Cox proportional hazards models adjusted for patient demographic and clinical characteristics. Among 369 patients at the clinic, 23(6%) requested an official transfer and 78(21%) were LTFU. Among official transfers, cumulative incidence of linkage to their destination facility was 91% at three months (95%CI 69–98%). Among LTFU, cumulative incidence of reengagement in care at the original or a new clinic was 14% at three months (95%CI 7–23%) and 60% at six months (95%CI 48–69%). In the adjusted Cox model, patients who left with an official transfer reengaged in care six times faster than those who did not (aHR 6.2, 95%CI 3.4–11.0). Patients who left an island-based HIV clinic in Kenya with an official transfer letter reengaged in care faster than those who were LTFU, although many in both groups had treatment gaps long enough to risk viral rebound. Better coordination of transfers between clinics, such as assisting patients with navigating the process or improving inter-clinic communication surrounding transfers, may reduce delays in treatment during transfer and improve overall clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Movement between facilities for HIV care among a mobile population in Kenya: transfer, loss to follow-up, and reengagement

Hickey

Omollo²,

Salmen

et al. 2016

AIDS Care

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“…Lying within Lake Victoria, Mfangano Island has a population of 21,000 (Mbita Division, ). Broadly representative of much of the Lake Victoria region, the island's inhabitants are vulnerable to changes in the lake as fishery involvement for trade and subsistence is widespread (Fiorella et al, ). Mfangano Island is rural with no running water or paved roads, and limited electricity and health services.…”

Section: Methodsmentioning

confidence: 99%

“…Since the 1990s, the quantity of fish caught from Lake Victoria has been declining (Abila, ; Pauly, Watson, & Alder, ). Food insecurity in the Lake Victoria basin is intertwined with an export‐oriented fishery, household dependence on fluctuating fish catch (Abila, ; Abila, ; Fiorella et al, ; Nagata et al, ), and complex gender dynamics within the fishery (Fiorella et al, ; Geheb et al, ).…”

Section: Introductionmentioning

confidence: 99%

Timing, intensity, and duration of household food insecurity are associated with early childhood development in Kenya

Milner

Fiorella

Mattah³

et al. 2017

Maternal & Child Nutrition

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This study examines the association between 3 dimensions of food insecurity (timing, intensity, and duration) and 3 domains of child development (gross motor, communication, and personal social). Longitudinal data from 303 households (n = 309 children) visited 9 times over 2 years were collected. Children in households experiencing severe food insecurity 3 months prior (timing) had significantly lower gross motor (β -0.14; 95% CI [0.27, -0.0033]; p = .045), communication (β -0.16; 95% CI [-0.30, -0.023]; p = .023), and personal social (β -0.20; 95% CI [-0.33, -0.073]; p = .002) Z-scores, using lagged longitudinal linear models controlling for current food insecurity; these results were attenuated in full models, which included maternal education, household asset index, and child anthropometry. Children in households that experienced greater aggregate food insecurity over the past 2 years (intensity) had significantly lower gross motor (β -0.047; 95% CI [-0.077, -0.018]; p = .002), communication (β -0.042; 95% CI [-0.076, -0.0073]; p = .018), and personal social (β -0.042; 95% CI [-0.074, -0.010]; p = .010) Z-scores; these results were also attenuated in full models. Children with more time exposed to food insecurity (duration) had significantly lower gross motor (β -0.050; 95% CI [-0.087, -0.012]; p = .010), communication (β -0.042; 95% CI [-0.086, 0.0013]; p = .057), and personal social (β -0.037; 95% CI [-0.077, 0.0039]; p = .076) Z-scores; these results were no longer significant in full models. Our findings suggest that acute and chronic food insecurity and child development are related, but that many associations are attenuated with the inclusion of relevant covariates.

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“…Mfangano is situated in Homa Bay County where 27.1% of adult residents are living with HIV (Ministry of Health, Republic of Kenya, 2013), most residents practice subsistence farming and fishing (Nagata et al 2011; Fiorella et al 2014), and food insecurity is common (Nagata et al 2013; Nagata et al 2011; Nagata et al 2014). …”

Section: Methodsmentioning

confidence: 99%

Around the Table: Food Insecurity, Socioeconomic Status, and Instrumental Social Support among Women Living in a Rural Kenyan Island Community

Nagata

Fiorella

Salmen

et al. 2015

Ecology of Food and Nutrition

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Food insecurity is a leading cause of morbidity and mortality in sub-Saharan Africa. Because food procurement is a social process embedded in complex social structures, social support may serve a critical role in sustaining food security in resource-limited settings. The objective of this study was to investigate the relationship among socio-economic status, social support, and food insecurity in a rural Kenyan island community. A cross-sectional random sample of 111 female heads of households representing 583 household members were surveyed in Mfangano Island, Kenya from August to October 2010 using adaptations of the Household Food Insecurity Access Scale and the Medical Outcomes Study Social Support Survey. In multiple linear regression models, less instrumental social support, defined as concrete direct ways people help others (B = −0.81; 95% confidence interval [CI] −1.45 to −0.17), and decreased ownership scale based on owning material assets (B = −2.93; 95% CI −4.99 to −0.86) were significantly associated with increased food insecurity, controlling for age, education, marital status, and household size. In addition to economic interventions, social support interventions geared at group capacity and resilience may be crucial adjuncts to improve and maintain the long term food security and health of persons living in low-resource regions.

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Fishing for food? Analyzing links between fishing livelihoods and food security around Lake Victoria, Kenya

Cited by 45 publications

References 18 publications

Movement between facilities for HIV care among a mobile population in Kenya: transfer, loss to follow-up, and reengagement

Movement between facilities for HIV care among a mobile population in Kenya: transfer, loss to follow-up, and reengagement

Timing, intensity, and duration of household food insecurity are associated with early childhood development in Kenya

Around the Table: Food Insecurity, Socioeconomic Status, and Instrumental Social Support among Women Living in a Rural Kenyan Island Community

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