London School of Hygiene & Tropical Medicine

In the first in-depth study of its kind of the Maasai people of Tanzania, research led by the London School of Hygiene & Tropical Medicine has revealed that the health of Maasai children is very poor compared to neighbouring ethnic groups.

The new research, published in PLOS ONE, shows that four out of five Maasai households face severe food insecurity and nearly 60% of Maasai children are physically stunted, indicating chronic malnourishment. In contrast, less than 50% of households experienced severe food insecurity and only around 20-40% of children were stunted in all other ethnic groups surveyed. Maasai children were also more frequently reported to have illnesses such as pneumonia and diarrhoea, and to have inadequate diets.

Owing to their distinctive customs and dress, and their proximity to the popular East African wildlife parks of Tanzania and Kenya, which attract hundreds of thousands of tourists annually, the Maasai are the most globally recognisable ethnic group in sub-Saharan Africa. However, this study of over 3,500 households across 56 villages highlights that this 'fame' is not met with good fortune with respect to child health.

Dr David Lawson, Research Fellow in Population Health at the London School of Hygiene & Tropical Medicine and the lead author on the study said: "The Maasai face a number of challenges, including vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts in the region. This is the first study to quantify differences in child health between the Maasai and neighbouring ethnic groups that rely more on farming. Our findings are alarming."

The Maasai are traditionally semi-nomadic pastoralists, relying predominantly on livestock herding as a way of life. Dr Lawson notes: "Maasai households most reliant on livestock herding had the highest food insecurity and worst child health outcomes. However, this does not necessarily imply that herding is an inherently more vulnerable livelihood than farming. We also found that the Maasai lived in considerably drier areas, where successful farming may not even be possible."

"Living in drier areas may also have some unexpected advantages. Maasai children had fewer reported cases of malaria. This was unexpected, but is most likely because Maasai villages are drier, and with less standing water they attract fewer mosquitos carrying the malaria parasite. Overall, however, our study confirmed our expectations that Maasai and non-Maasai children living in the driest villages would have the worst child health outcomes."

Data for the study were collected by the non-governmental organisation (NGO) Savannas Forever Tanzania, as part of the Whole Village Project, a novel initiative providing data on over 50 villages across an ethnically diverse region of Northern Tanzania.

Susan James, Executive Director of Savannas Forever Tanzania and co-author of the study, said: "There is growing recognition that research on child health and agricultural systems needs to be integrated if we are to increase the number of children achieving adequate nutrition in countries like Tanzania. Our data provide a unique opportunity to consider how alternative rural livelihoods influence child health".

The researchers conclude that the evidence could be used to reinforce support for targeted initiatives that address the health needs of the marginalised Maasai. The extent to which Maasai children are disadvantaged has previously been "invisible" to both policy makers and health researchers due to a lack of ethnicity data in national heath surveys. Many NGOs working with the Maasai, and other pastoralist groups in Tanzania and Kenya are represented by PINGOS - the Pastoralist and Indigenous NGOS Forum.

The study was made possible by funding from UK Medical Research Council and the Department of International Development, and is part of an on-going collaboration between Savannas Forever Tanzania and researchers at the London School of Hygiene & Tropical Medicine.

Publication:

• David W. Lawson, Monique Borgerhoff Mulder, Margherita E. Ghiselli, Esther Ngadaya,Bernard Ngowi, Sayoki G. M. Mfinanga, Kari Hartwig, Susan James, Ethnicity and Child Health in Northern Tanzania: Maasai Pastoralists Are Disadvantaged Compared to Neighbouring Ethnic Groups. PLOS ONE. DOI: 10.1371/journal.pone.0110447