Abstract:
The last mile may constrain socioeconomic development and the achievement of household food security and nutrition as households are remote and distant from public facilities such as roads, health facilities and markets. Households distant from such facilities may find it challenging to buy food, sell agricultural produce and earn incomes. Moreover, food aid organisations may experience difficulties in reaching these communities. For these reasons, remote households may be trapped in food insecurity. Improving the proximity of rural households to public facilities such as all-season roads would ease rural accessibility and foster socioeconomic development and food security.
This study set out to determine how household food security and child nutrition were affected by last-mile factors, i.e., the distance of a household from public facilities. The study employed multivariate regressions and the Tobit model to analyse household food security. In addition, multilevel models were used to regress the last mile variables on child nutrition outcomes.
The study observed a statistically significant and negative influence of the distance from local food and input markets on household food security indicators. However, the coefficients were small, suggesting that proximity to local markets did not significantly affect food security. The lack of a large relationship between the distance to a local market and household food security could be because local markets did not satisfy the market needs of the surrounding households for farm input supplies or markets for crop products. However, the prevalence of underweight among children under five years of age reduced with the proximity to food markets. The results suggested that children living in households close to food markets had greater access to diverse foods.
The food security and nutrition status of households did not depend on the distance from transport facilities and health centres. Distances to transport facilities such as roads did not significantly influence food security because roads were impassable in certain seasons. The lack of a significant effect of the proximity of households to health centres on food security could be because health centres focus on their primary roles, namely disease treatment and prevention. Additionally, the nutrition information from the health centres reached both households near and farther from health centres through the community nutrition volunteers. Therefore, the hypothesis claiming that the last mile affected food security was rejected. In contrast, the hypothesis that the last mile affected child nutrition outcomes was partially accepted.
In conclusion, the last mile did not significantly affect household food security but partially affected the nutrition of children under five years of age. While proximity to health centres and transport facilities did not affect child nutrition, the proximity of a household to a food market reduced the prevalence of underweight. Therefore, nutrition policies should support the establishment of food markets in the last mile to reduce the distances covered to purchase food or sell surplus agricultural products.