Terms of Reference
Rural – Urban linkages:
Implications for action on undernutrition
May 2011
Morwenna Sullivan
Introduction
There has been unprecedented growth of cities and towns in recent history. In 2008, the world
reached a tipping point, for the first time in history more than half the world’s population was
classified as living in urban centres as opposed to rural areas. Urbanisation rates in developing
countries are particularly high. According to UN HABITAT (2008) cities of the developing world will
absorb 95% of urban growth in the next two decades, and by 2030, will be home to almost 4 billion
people, equivalent to 80% of the world’s urban population. Sub-Saharan Africa has both the highest
annual urban growth rate and the highest slum growth rate in the world, 4.58% and 4.53%,
respectively, more than twice the world average. Contrary to popular belief, much of this growth
will not happen in the mega cities, rather growth is expected to be concentrated in secondary urban
centres which are closer to rural contexts. As urban centres expand, and as more people will migrate
from rural to urban areas, the number of urban poor will rise. Indeed, some commentators go as far
as to highlight demographic expansion, (including migration and urbanisation) as the number one
factor that will condition West Africa’s vulnerability to humanitarian crisis over the next generation.1
As populations become increasingly mobile, so it is becoming increasingly important for ACF to
understand the interactions between rural and urban components of households and transform this
understanding into concrete, action oriented programme and policy recommendations.
It is well known that households, whether urban or rural, are reliant, in varying degrees, on the
market to cover their food needs. They are therefore vulnerable to price fluctuations. Analysis of the
food price crisis and price volatility is not new. Much macro level analysis exists on the causes and
consequences of the recent crisis of 2008 on undernutrition. What is less well known is the extent to
which the geography of individual households determines the severity of impact of price volatility or
the degree to which the existence of strong links across the geographical divide mitigates impact of
high prices. In other words, to what extent are urban households able to draw on assets and
resources of their rural counterparts in times of stress? This piece of work will provide an insight into
how households have coped with volatile markets, highlighting the differences and similarities
between urban households and their rural counterparts through comparative analysis. By
incorporating both urban and rural components of the household, it aims to build up a more
complete gender sensitive picture of the household economy.
Traditionally ACF and other humanitarian/development agencies has targeted rural populations,
paying little attention to the fact that migration to urban centres (previously perceived as a coping
mechanism in times of crisis) has now become an integral part of livelihoods. The numbers speak for
themselves; there is demonstrable need to shift our attention to the needs of a rapidly expanding
urban population.
Rationale & Main Objectives
Population growth rates and urbanisation levels are likely to remain high in the coming decades.
Added to this is the declining importance in absolute terms of the agricultural sector in the economic
base of many regions. Furthermore, in many places, there is no longer a clear cut distinction
between rural and urban livelihoods. Rather, they are interconnected on many levels. Recognising
that this rural urban gap no longer exists, and that households often have one foot in the rural
economy and another in the urban economy, implies that ACF needs to understand the system as a
whole rather than focussing exclusively on the rural sector. It is clear that rural urban linkages and
1
See http://www.humanitarianfutures.org/sites/default/files/Beyond%202020%20Crisis%20Drivers.pdf
interactions play an increasingly significant role in local economies and in the livelihoods of a large
number of people. Understanding these rural urban linkages and their impact on (the causes of)
undernutrition will be key. This research will provide a critical analysis of rural urban linkages; it will
seek to ascertain what these linkages mean for undernutrition and how they can contribute to
addressing the underlying causes of undernutrition.
Existing field based research demonstrates the complexity of livelihoods in both rural and urban
environments. However, lessons have rarely crossed over into the mainstream thinking of nutrition
and livelihood analysis. Households will engage in a wide variety of activities in order to generate
income and provide food for their families. The geography of livelihoods is changing; in many cases,
this will involve the migration of one or more family members to an urban centre in the search for
work. Understanding the increasing spatial and occupational complexity of livelihoods is key if we
want to ensure that activities intended to tackle the underlying causes of undernutrition are relevant
to today’s household. ACF has already moved beyond the assumption that households are spatially
homogenous. Indeed it is well recognised that engaging in diverse activities across wide geographical
areas is a means of spreading risk for many households. In many contexts of chronic and seasonal
malnutrition circular migration is no longer a “coping mechanism” for bad years but part of every
day life. For example in large parts of the Sahel, seasonal migration in search for income
opportunities leaves whole villages and regions virtually empty of the male population. Women,
children and elderly are left to their own devices to endure the dry hunger season. Understanding
the impact of migration (Is movement always seasonal and circular? Or does it become more
permanent? What determines this?) on household economies will enable ACF to identify
appropriate entry points for interventions. Analysis of the causes of migration will also be
important.
By their nature, urban populations are more reliant on the market to access food. As such it is
assumed that they are more vulnerable to vagaries of the world market and to sudden price
fluctuations. A critical analysis of the ways in which urban households and their rural counterparts
respond to food price rises will enable ACF to determine the extent to which this is the case. To what
extent are urban households able to draw on assets and resources of their rural cousins in times of
difficulty? How do urban households change their expenditure patterns when faced with price rises?
How is this different to their rural counterparts? And how do these changes potentially impact upon
undernutrition (in terms of healthcare, dietary diversity)?
This piece of work aims to go beyond existing reactive analysis. It will identify the main issues
relating to urban rural linkages that both policy makers and programmers will need to take on board.
It aims to point out opportunities for ACF and other NGOs to incorporate lessons learned in their
programme interventions (for example strengthen links between rural producers and urban food
markets). It will enable us to build up a detailed understanding of the household economy including
both rural and urban elements of livelihoods and most importantly, how the two interact. ACF will
then be in a position to put forward concrete action oriented recommendations for both policy and
programming.
Scope & Coverage
Research will provide a critical analysis of rural urban linkages. Rural urban migration will be an
integral element of this; research will also analyse the extent to which understanding rural urban
linkages could mitigate the impact of food crises/price crises on urban populations. Both urban and
rural economies react in very different ways to seasonal and externally determined food price
volatilities. Rural food markets are dominated by large variation of prices between post harvest and
dry season. Urbanisation in itself is a response strategy against seasonality. Urban dwellers face a
new set of access constraints to food commodities such as high prices, dependency on cash income,
low skill set and generally higher cost of living. This research will strive to assess the full circle of
urban-rural livelihoods and analyse the impact on mother & child health, child feeding and
undernutrition.
Key question #1: Are households with strong linkages less likely to have children suffering from
undernutrition?

To what extent do linkages exist between rural and urban households in ‘non crisis’ years,
and how well can these be used in times of a crisis? In what way are links maintained?

Are goods/people/capital flowing mainly from rural to urban areas? To what extent do
goods/people/capital flow in the opposite direction? Seasonality.

Are remittances sent home? Is a child’s nutritional status an incentive to remit? How are
links maintained? Does the dietary diversity and nutritional density of HH and >5year old
change due to rural -urban migration? In what way?

Are supplies of staple foods and e.g. vegetables sent with the migrant for use or sale in
urban areas? What role does access to land for agriculture (within the urban perimeter)
have on the nutritional outcome of the >5year old child for urban households?

Connections between producers and consumers: Do rural communities with higher seasonal
migration have better market access for their products? Can rural households take
advantage of urban markets by having one member of the household living in the town?
Key question #2: Is migration an effective strategy to prevent undernutrition in children under
5?What, if any, effect does migration have on dietary diversity?
Key question #3: Is tackling undernutrition in an urban area a question of health/care practises
rather than food security?



Understanding the urban economy – are urban households likely to have a more diverse
diet?
Female income generation activities – impact on nutrition
Are urban households likely to have better understanding of care and feeding practises?
Key question #4: Food price crises: How have urban/rural households been affected by recent
price rises?
 How can strengthening our understanding of rural urban linkages mitigate impact of future
price crises?
 What are the main differences in which urban and rural households respond to recent price
rises?
 Do rural households support urban households who are more reliant on the market? In what
way?

Significant differences in impact of food price rises between urban and rural areas?
This project will be managed by ACF Policy Advisor. An external consultant will be contracted to co
ordinate field work and write the final report. The consultant will also be responsible for carrying
out fieldwork in at least one case study area, and for writing the final report. The consultant will
develop the methodology (including identification of appropriate indicators of undernutrition), in
consultation with the Policy Advisor. The Policy Team will conduct fieldwork for the two remaining
case studies. The consultant will actively contribute to the finalisation of the scope of research, on
the basis of the findings of desk research conducted in preliminary stages.
ACF missions will provide secondary information where necessary and will facilitate research needs
during fieldwork. They will be instrumental in providing leads for possible field work locations, and
key informants to interview. Their knowledge will be essential in identifying ‘typical’ households to
profile.
METHODOLOGY
The suggested conceptual framework merges the UNICEF nutrition causal analysis (UNICEF, 1990),
the sustainable livelihoods framework (Chambers, 1991) and the Lancet maternal and child nutrition
framework (Black et al., 2008).2 Methodology will include three steps: desk research, field work and
analysis:
Desk research
 Mapping ACF urban programmes
 Literature review – NGO, UN, academic journals, media
Field work
 To include at least three locations – to be determined but likely to be drawn from Central
African Republic, Liberia, Zimbabwe, Sierra Leone, Chad.
 Profiling households with urban – rural dimension
 Using PRA techniques, such as key informant interviews and focus group discussions, and
oral testimonies, combined with household economy profiling, the consultant will build up a
picture of the extent to which households with strong R-U linkages are more resilient to
undernutrition. Understanding dietary diversity through 7 day recall at the household level
will be integral to this.
Analysis
This will incorporate analysis of desk research, field work and of the wider political landscape (e.g.
G20 in order to set research within context)
Report writing
One briefing paper (8 pp) per case study.
One report (12-24 pp) bringing together evidence from case studies with analysis of desk research
and wider political economy. See below for more detail.
2
See ACF (2010) ‘The threats of climate change on undernutrition: A neglected issue that requires further analysis and
urgent actions’, in SCN, 2010. Newsletter #38 – Climate Change: Food and Nutrition Security Implications. See also
exchanges with the ACF/TUFTS-FIC team leaders who developed a standard Nutrition Causal Analysis methodology.
Suggested timetable/work plan
Recruitment
Desk review
Mission mapping
Field work
Report writing
Publication
Dissemination
May June July August Sept Oct Nov Dec
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EXPECTED OUTCOMES
REPORTS
Briefings
Three briefing papers (one per case study) will be produced in English. They will present evidence
from each context. The emphasis will be on household profiling. These briefings will provide the
content for the main report. These will be approx 8-12 pp in length.
Report
The main report will be submitted in English, and will be approximately 20- 30 pages only. It will
combine analysis of the desk research, with evidence from the field set within the wider political
economy. The main report will have the following format:
 Cover Page
 Table of Contents
 Executive Summary
 Main Body: The suggested structure for the main body of the report is as follows:
o Background Information – set research within context
o Methodology – outline methodology used
o Findings & Discussion – based on analysis of desk research, case study material and
analysis of wider political economy
o Conclusions
o Recommendations – these must be practical and action-oriented with the aim of
achieving policy change and programming
o Bibliography (rigorous and complete - Harvard reference logic)
o Annexes
The report will contribute to policy discourse on undernutrition highlighting the need to recognise
the complex nature of household economies. It will also contribute to raising the profile of ACF as a
reference organisation on undernutrition. Internally, case study reports will be used to inform
messages for ACF advocacy strategy, providing the essential link between field evidence and policy
makers. Outcomes of the research are intended to inform programme design and to provide
concrete recommendations for policy and programming.
DISSEMINATION
Briefings and reports will be distributed both internally and externally. The following provides an
idea of target audience.
Internally, three briefings and one report will be disseminated to ACF HQs and to the field. It will be
diffused through the AMAI and the West African advocacy strategy.
Externally, they will be disseminated to policy makers such as EC and DFID, think tanks/research
institutions and NGOs through forums such as the Hunger Alliance. Reports will also be disseminated
to UNSCN, the High Level Task Force and any other relevant institutions.
Dissemination will be via email and distribution of hard copies and via email.
Key stakeholders will be invited to an event to launch the report, which will be in the form of a
roundtable or interactive panel discussion.
Key dates
Expected Start Date:
Project End Date:
Submission of Draft Report
Submission of Final Report
July 2011
December 2011
September 2011
October 2011
ANNEX 1: DEFINITIONS
Food security
Food security exists when all people, at all times, have physical, social and economic access to
sufficient, safe and nutritious food that meets their dietary needs and food preferences for an active
and healthy life (FAO, 2002).
Nutrition security
Nutrition security exists when food security is combined with a sanitary environment, adequate
health services, and proper care and feeding practices to ensure a healthy life for all household
members (UNSCN, 2010).
Figure 1. Distinction between food security and nutrition security, considering the conceptual
framework of the nutritional status at household level
Source: Gross et al., 2000
Vulnerability
Vulnerability within social systems is, at its simplest, concerned with the degree to which systems
have the ability to cope with, resist and recover from the impact of a shock or a stress (Jones et al.,
2010). Definitions of vulnerability vary, but all incorporate ‘lack of means to cope’. Vulnerability is a
state as well as a process, and only gives meaning when described in relation to something: for
example hazards or changes in climate and environments. Vulnerability is a function of the
character, magnitude, and rate of a shock or stress to which a system is exposed, its sensitivity, and
its capacities to cope and adapt. Causes of vulnerability relate both to the assets people own and to
the accountability and effectiveness of institutions and, for many population groups, long-term
processes of social, economic and political marginalisation.
Coping and adaptive capacity
Coping and adaptive capacity is defined as the ability of a system to cope with and adjust to shocks
and stresses, to moderate potential damages, to take advantage of opportunities, or to deal with the
consequences. One of the most important factors shaping the coping and adaptive capacity of
individuals, households and communities is their access to and control over natural, human, social,
physical, and financial resources. Access to and control over the resources necessary for adaptation
varies within countries, communities and even households. It is influenced by external factors such
as policies, institutions and power structures. Coping and adaptive capacity can vary over time based
on changing conditions, and may differ in relation to particular shocks and stresses. In general, the
world’s poorest people are also the most vulnerable to shocks and stresses. This is often because
they have limited access to those resources that would facilitate coping and adaptation strategies.
For instance, women are often particularly vulnerable to the impacts of climate change due to their
responsibilities in the home and their limited access to information, resources and services. Coping
and adaptation strategies are the behavioural strategies and choices adopted by people to cope with
and adjust to shocks and stresses; in others terms, they refer to the ways in which households utilize
and combine their assets to cope and adapt. The strategies adopted by households are a response to
a variety of triggers (IDS et al., 2009). Outcomes of these strategies can be both positive and
negative over different lengths of time (IDS et al., 2009). Some responses lock households into
patterns of depleting assets and lead to greater pressure on natural resources, with knock-on effects
for peoples’ options to cope adapt over the long term (IDS et al., 2009). Still, other responses open
up new opportunities, make households more resilient to shocks and stresses (IDS et al., 2009). The
terms “adaptation” and “coping” are sometimes used interchangeably, leading to confusion about
the similarities and differences between these two important concepts. The following table suggests
some of their characteristics.
Characteristics of coping and adaptation strategies
Source: CARE, 2009
Further reading
ACF 2010 The threats of climate change on undernutrition – a neglected issue that requires further
analysis and urgent action
ACF and TUFTS-FIC, 2010. NCA Protocol – (draft 10 31 10)
ACF 2006 La Faim dans les Villes