1 Climate Change, Gender, Youth and Nutrition Situation Analysis - Ghana CONTENTS Climate Change ............................................................................................................................................. 2 CLIMATE SCENARIOS ................................................................................................................................. 2 EFFECTS ON THE AGRICULTURAL SECTOR ................................................................................................ 4 Gender .......................................................................................................................................................... 5 WOMEN AND AGRICULTURE .................................................................................................................... 5 WOMEN’S ROLE IN NUTRITION AND FOOD SECURITY ............................................................................. 6 Nutrition ........................................................................................................................................................ 7 THE NUTRITION SITUATION ...................................................................................................................... 7 URBANIZATION AND THE NUTRITION TRANSITION ................................................................. 10 FOOD SUPPLY AND DIETS........................................................................................................................ 11 HOUSEHOLD NUTRIENT AVAILABILITY ...................................................................................... 12 Youth ........................................................................................................................................................... 13 THE ROLE OF YOUTH AND AGRICULTURE ............................................................................................... 13 Reference List .............................................................................................................................................. 15 2 CLIMATE CHANGE Ghana is one of Africa’s fastest growing economies and has made significant strides in poverty reduction. Economic growth since 2010 has been fueled by high commodity prices and newfound wealth in offshore oil. But climate variability and change pose a threat to future growth and development. Rising sea levels, drought, higher temperatures and erratic rainfall negatively impact infrastructure, food security and coastal and agricultural livelihoods. Despite the country’s recent transition to an industry and services-oriented economy, 45 percent of the workforce still depends on rainfed agriculture. The vulnerability of Ghana’s agriculture to climate change is largely due to its dependence on rainfall (Yaro, 2010), particularly in the country’s semi-arid north. Climate change can also exacerbate underlying problems that affect the agriculture sector. Such problems include: 1. the north-south social divide and water allocation disputes between the two regions; 2. cross-boundary water issues; and 3. tensions arising from economic dependence on crops susceptible to changes in climatic conditions, such as cocoa (Brown and Crawford, 2008). Ghana’s agriculture is not only vulnerable to climate change; it also contributes to the problem: Agriculture is estimated to be the second largest contributor to Ghana’s greenhouse gas (GHG) emissions after the energy sector. Important sources of growth in emissions— especially of nitrous oxide (NO2) and methane (CH4)— are livestock, chemical fertilizers, rice farming, and biomass burning (Brown and Crawford, 2008). NO2 and CH4 emissions in Sub-Saharan Africa are driven primarily by agriculture and are projected to steadily increase (Smith et al. 2007). As domestic and international demand for agricultural products continues to increase, emissions from Ghana’s agricultural sector will likely increase as well. CLIMATE SCENARIOS Ghana has already experienced an increase in mean annual temperature of 1°C per decade since 1960. Monthly rainfall decreased about 2.4 percent per decade during the same period, though in the 1960s, the rainfall over Ghana was particularly high (Government of Ghana, 2015; McSweeney et al, 2010). Another study found that the decline in annual mean rainfall is the most severe in the southwestern regions divided by the Kwahu Plateau (Owusu and Waylen, 2009). In the remaining part of the country, the Volta Basin, prolonged dry seasons have replaced shorter dry spells (Owusu, Walen, and Qiu, 2008). Other climate trends since the 1960s include an increase in the average number of “hot” nights per year, with the rate of increase most pronounced from September to November and a rise in sea level of 63 mm over the past 30 years and average coastal erosion of 1.13 m per year. Future climate scenarios, and the predicted effects that climate change might have on the country, vary considerably according to which Global Circulation Model is used. However, models generally agree on the general trend for temperature changes, which are predicted to increase more in the northern region than in the rest of the country. Based on a review of 15 different models, the mean annual temperature is expected to increase by 1.0°C - 3.0°C by 2060, and by 1.5°C - 5.2°C by 2090 with changes expected to be more pronounced severe in the north (McSweeney et al 2010). Model results for changes in rainfall precipitation are more uncertain than those for temperatures. However, more erratic and intense rainfall during the wet season and lower precipitation levels during the dry season are likely with larger decreases in the south. Variations in climate projections significantly affect estimates for future crop yield. 3 Figure 1 . Projected changes in mean daily maximum temperature of the warmest month from four climate models, from 1960- 1990 to 2050 GFDL-ESM2M HADGEM2-ES IPSL-CM5A-LR MIROC-ESM Source: CMIP5 data (Taylor, Stouffer, and Meehl 2012), downscaled for Müller and Robertson (2014). Figure 2 Projected changes in annual rainfall from four climate models, from 1960-1990 to 2050 GFDL-ESM2M HADGEM2-ES IPSL-CM5A-LR MIROC-ESM Source: CMIP5 data (Taylor, Stouffer, and Meehl 2012), downscaled for Müller and Robertson (2014). Notes: Values are in millimeters and are from IPCC AR5 and are for RCP8.5. 4 EFFECTS ON THE AGRICULTURAL SECTOR Most agricultural production in Ghana relies on small, rainfed plots potentially highly vulnerable to the impacts of climate change. Changes in precipitation patterns particularly if precipitations become more erratic can have severe consequences on production since only some two percent of the total cultivatable area in Ghana is irrigated. The Northern region of Ghana in particular, it is one of the most vulnerable and exposed regions to climate change and variability in Ghana (Etwire et al., 2013, Stanturf et al., 2011). Particularly exposed to the impacts of climate change are the millions of poor smallholder farmers with minimal livelihood alternatives who are already marginalized, poor and largely rely on nature for food and income (Frank and Penrose Buckley, 2012, Morton, 2007). Their rain-fed agriculture, forming the dominant economic activity in the region (Antwi-Agyei et al., 2012), relies heavily on a single and already modified rainy season. Climate change is likely to intensify seasonal and inter-annual rainfall variation (for example, drought in one year and floods the next), as long-term changes and trends take place (for example, rising annual mean temperatures) (Challinnor et al, 2007). Climate change may create water and heat stress, the outbreak of pests and diseases, the loss of productive lands through the deterioration of ecosystems, and additional burdens to supply chains such as increased postharvest losses during storage and distribution. The likely consequences of such stresses include yield reductions, decreased livestock values, post-harvest losses, and reduced food accessibility and consumption (Vermeulen et al, 2010). Rising temperatures are projected to lower yields in major staple crops (maize cassava, sorghum, yams, plantains, and rice). Cassava yields, for example, are projected to fall by 12 percent and maize yields by 7 percent by 2050. Total crop failure is expected to occur approximately once every five years in Ghana’s northern region due to delayed or diminished rains. Cocoa, a major cash crop and a leading foreign exchange earner, is sensitive to rising temperatures and drought. Areas suitable for cocoa production, which lie primarily along the coast, are contracting as temperatures rise, floods increase, and soil salinization and coastal erosion continue. In addition, natural disasters, migrations, and threats to human health can degrade human and social capital and devalue assets and infrastructure in agricultural communities. Rural populations in the Upper East, Upper West and Northern regions are more vulnerable to climate change than the people in other regions. This is attributed to the region’s stagnated development and the dryland agriculture’s vulnerability to climatic stresses (Stanturf et al., 2011). 5 Figure 3 Climate Impact on Ghana's Leading Rainfed Crops, 2000-2050, percent change Source: Author’s analysis based on Rosenzweig et al. (2014) using weights from MapSPAM harvested area (You et al. 2014). Notes: GFDL = Geophysical Fluid Dynamics Laboratory; HadGEM = Hadley Centre Global Environmental Model; IPSL = L’Institut Pierre-Simon Laplace; and MIROC = Model for Interdisciplinary Research on Climate. GENDER WOMEN AND AGRICULTURE Women are central to agriculture in Ghana. Understanding their distinct roles and priorities in agricultural households is critical for continuing to tackle poverty, food insecurity, and malnutrition. Literature on gender and agriculture points to the importance of women’s decision-making power in the household because women are more likely than men to invest in the nutrition, food security, and overall wellbeing of children and other members of the household. However, traditional gender norms often limit women’s access to farm inputs, agricultural trainings, and land and other natural resources. While access to land holdings varies according to inheritance norms and other differences, men tend to have stronger rights over land and revenues (Lambrecht, Schuster, Asare Samwini, & Pelleriaux, 2018). In addition, women are less likely to apply modern agricultural inputs than men, which may decrease their productivity. However, some commonly held beliefs about gender relations in agriculture may not hold true, or may be more nuanced than previously thought, in Ghana. A common conceptualization of gendered domains of control depicts women as responsible for domestic activities, while men are responsible for productive activities. Similarly, literature often refers to “women’s crops” and “men’s crops”, wherein women are 6 responsible for food crops produced for own-consumption and men are responsible for cash crops produced for sale (Ezumah & Di Domenico, 1995; Gladwin, 2002). This suggests, for instance, that promoting commercial exchange of these crops may take them out of the hands of women, decreasing their potential access to the income from sales and their household bargaining power (Carney & Watts, 1990; Hagenimana et al., 1999). However, these dichotomous characterizations of gendered domains have been heavily critiqued in Ghana. For instance, Lambrecht et al. (Lambrecht et al., 2018) find that female households heads are just as likely as men to engage in marketing of agricultural products. Doss (2002) finds gendered cropping patterns, but not specific crops grown by men or women. Finally, Carr (2008) argues that there are a number of different household types and livelihood approaches that interact with gender roles; these interactions must be considered to fully understand gendered domains. He concludes that gendered roles and power/vulnerability in domestic and productive spheres are different for each livelihoods approach. WOMEN’S ROLE IN NUTRITION AND FOOD SECURITY Women’s nutrition knowledge and beliefs, income, and decision-making power in the household can all play an important role in food security and nutrition outcomes. Women’s nutrition knowledge and beliefs have implications for how infants and children are fed. For instance, mothers of well-nourished infants in Kumasi, Ghana considered porridge the main complementary food and believed that giving infants a wide variety of foods was unhealthy (Davis, Tagoe-Darko, & Mukuria, 2003). However, if children rejected the porridge or had poor appetite due to illness, mothers would offer different foods to induce the child to eat. Thus, unexpectedly, malnourished (underweight) children were fed a wider variety of food than well- nourished children. In addition, living with the maternal grandmother was more important for children’s diets than the presence of or financial contributions from the father (Davis et al., 2003). Women also play an important role in food security, and yet are more vulnerable to food insecurity themselves. This is likely due to their lower empowerment status, unequal intrahousehold food distribution. For instance, in some ethnic groups it is common practice for women eat only after men are served and for nutrient-rich animal source foods to largely be served to male household members (Laar & Aryeetey, 2015). In addition, women’s power in decisions related to household food production and consumption may play a role in diet choices. Doss (2002) finds that men typically have more control over crops that will be sold compared to those used for households consumption. Similarly, Carr (2008) finds that women in farm households are usually expected to prioritize their produce for household use. Both of these outcomes point to lower access to income and less autonomy over produce. Looking at the associations between women’s empowerment and nutrition outcomes, Malapit and Quisumbing (2015) find that higher overall empowerment and participation in credit decisions are positively correlated with diet quality and a woman’s participation in production decisions is significantly associated with nutritional status, suggesting that individuals who have greater decision-making power in the household receive a larger share of the benefits from household resources, including nutritious food. Amugsi et al (2016) finds that women in Ghana who have a say in household purchases are more likely to 7 achieve higher dietary diversity compared to those who do not. Furthermore, women in monogamous households are also more likely to have higher household dietary diversity than those in polygamous households. This may indicate that competition for resources in polygamous households decreases dietary diversity, or that there is a relationship between monogamy and household decision-making power. Finally, a review of studies on women’s time use and nutrition indicates that women are indeed time- constrained due to their significant role in domestic and productive realms, and that agriculture interventions tend to further constrain time (Johnston, Hull, Malapit, Stevano, & Kadiyala, 2015). The authors also note that the impacts of agricultural practices on nutrition are not clear cut but are mediated by a number of household characteristics such as socioeconomic status, ability to purchase food, and the presence of household members who can take up additional work when needed. NUTRITION THE NUTRITION SITUATION Between 1988 and 2008, the national prevalence of child stunting declined by an annual average rate of 0.3 percentage points, or 0.9 percent, as shown in Figure 2. The national prevalence of child wasting declined by an annual average rate of 0.2 percentage points, or 0.2 percent (Ecker & van Asselt, 2017). The decline in stunting was even more rapid between 2008 and 2014, dropping from 28.1 percent to 18.4 percent nationwide. And the prevalence of both chronic and acute child undernutrition declined much more quickly urban areas than in rural areas. In spite of these improvements, some diet and nutrition challenges remain. Furthermore, there are important geographic disparities between rural and urban areas and across regions. And an ongoing nutrition transition has created a number of new challenges and opportunities. There are still major challenges with child feeding practices; only 13 percent of children age 6-23 months met the criteria for a minimum acceptable diet in 2014 (Ghana Statistical Service, Ghana Health Service, & ICF International, 2015). In 2014, 42.4 percent of all Ghanaian women of reproductive age were anemic, and a primary cause of anemia is diet-related iron deficiency, though this is a decrease from 59 percent 2008 (Ghana Statistical Service et al., 2015). Anemia rates were even higher among young children—two out of three Ghanaian children under five years were anemic in 2014, which is a decrease from 2008 when it was 78 percent. The national-level improvements in nutrition outcomes, mask persistent undernutrition and food insecurity concentrated in rural areas and some regions. Calculations from Ecker and Van Asselt (2017) based on national nutrition statistics from the Ghana Statistical Service et al. (2014) indicate regional variations in nutrition outcomes. The Northern and Central regions both show child stunting and child wasting above the national averages in 2008 and 2014. In 2014, the prevalence rate of child stunting was highest in the Northern region, followed by the Central and the Upper West regions. Anemia is highly prevalent across Ghana, as described above. Anemia among children in 2014 was highest in the Northern region, followed by the Upper East, Upper West, and Central regions, all with similar prevalence rates. 8 Rural areas in the Northern Region lagged further behind rural areas in all other regions in 2013/2014, especially for chronic child undernutrition and micronutrient malnutrition. The number of affected rural individuals in the Northern region exceeds by far the number of affected rural individuals in each of the other regions. The Northern region also had 27.8 percent of all rural stunted children, 18.7 percent of all rural wasted children, 20.0 percent of all rural anemic children, and 16.1 percent of all rural anemic women. In 2014, the prevalence of anemia and its moderate or severe form among women was roughly similar in rural and urban areas, whereas any anemia and moderate or severe anemia among children was more prevalent in rural areas than in urban areas. 9 Source: Ecker and van Asselt, 2017; Note: Prevalence rate (%) | Annual percent change (pc.) | Number of poor/malnourished individuals (tsd.) Figure 4: Deviation from national prevalence rates (pp.) a. Rural poverty b. Extreme rural poverty c. Rural child stunting d. Rural child wasting e. Rural child anemia f. Rural women anemia Annual Percent Change ↓↓↓ <-10 ↓↓ <-5 & >-10 ↓ <-1 & >-5 ↘ <0 & >-1 ↗ <1 & >0 ↑ <5 & >1 ↑↑ <10 & >5 ↑↑↑ >=10 <-10 <-5 & >-10 <0 & >-5 <5 & >0 <10 & >5 <15 & >10 >=15 Deviation for National Average Prevalence Rate a. b. e. d. f. c. 10 Figure 5: Trends in calorie availability and share of animal protein Source: (Ecker & van Asselt, 2017) URBANIZATION AND THE NUTRITION TRANSITION Rapid urbanization and economic transformation have presented both challenges and opportunities to improving food security and nutrition across the country. With an average annual urbanization rate of 4.2 percent between 1985 and 2015, today more than 50 percent of the Ghanaian population lives in cities (World Bank, 2018). This demographic shift has prompted changes across the food system. In particular, Ghana is undergoing a diet transition, in part because people can now purchase more calories for the same price compared to a few decades ago. Increased purchasing power offers the potential for greater dietary diversity but can also result in overconsumption of calories, and commonly leads to overconsumption of fat, sugar, and salt. Increasing incomes among urban populations represent potential markets for producers. Cities are a draw for the rural poor in search of employment. This may provide new livelihood opportunities and benefit the family members remaining in rural villages through remittances, but may also subject poor urban dwellers to new food security challenges (Warren, Hawkesworth, & Knai, 2015). Along with decreases in food insecurity, hunger, and undernutrition, overweight and obesity are rising in Ghana. Thus, creating a double burden of malnutrition: that is, the coexistence of overnutrition and undernutrition across the population, within households, and/or in individuals. The prevalence of overweight and obesity among women of reproductive age increased from 25 percent in 2003 to 40 percent in 2014. This is predominantly an urban phenomenon; 45 percent of women in urban areas are 0 10 20 30 40 50 60 0 500 1,000 1,500 2,000 2,500 3,000 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 2015 Total calories from food Calories from staple foods Share of animal protein Calories per capita (kcal/day) Share of animal protein on total protein (%) 11 overweight or obese versus on 28 percent of women in rural areas. The prevalence of overweight and obesity among children has remained low at only 2.6 percent but is expected to rise if trends continue (Ghana Statistical Service et al., 2015). However, the analysis of food availability by Ecker & Fang (2015) does not indicate widespread increases of consumption of animal-source food, a risk factor for non- communicable diet-related diseases if consumed in excess (see Figure 5). FOOD SUPPLY AND DIETS The food supply system determines the food that is available for consumption, and thus influences diets. Estimates of nationally available food provide insights into the type and diversity of foods available in the country over time. According to FAO Food Balance Sheet data, between 90 and 93 percent of Ghana’s food supply was produced domestically from 2003 to 2013. A study by Hartley and Arndt (2018) reports that Agriculture generates almost 20 percent of Ghana’s national GDP. Furthermore, crop production dominates the agricultural sector, accounting for almost 16 percent of total GDP (approximately 80 percent of the total value of agricultural productivity). Vegetables, fruits and nuts, and cocoa make up the largest share of crops produced in Ghana collectively, accounting for 36 percent of total agricultural GDP. Maize is also a relatively important crop, accounting for 10 percent of total agricultural GDP. Own-production is an important source of food for many in Ghana. A study in northern Ghana by Signorelli, Haile and Kotu (2017) finds that higher productivity and production diversity both increase household dietary diversity (HHDD), which is associated with higher calorie consumption. Production diversity is more important when households are further from markets, and the more a household depends on food from their own production the lower the dietary diversity. As shown in Figure 5, per capita availability of calories from food has continuously improved since the early 1980s, apart from a drop in 1990 (related to a devaluation of Ghanaian currency). In fact, per capita calorie availability has doubled between 1982 and 2010. Calorie availability has plateaued at around 3,000 kcal per capita per day, which is well above the dietary energy requirement of an average person. This increase in total per capita calorie availability has been driven by an increase in the availability of calories from staple foods. In the context of a nutrition transition, we would expect the consumption of animal source protein to increase. However, counter to expectations, the share of available protein from animal- source foods on total protein has been slightly decreasing since 1975. There are important differences in food availability across regions and between rural and urban areas. For instance, the share of calories consumed that come from staple foods is lowest in the urban areas of the south and highest in the rural areas of the south, indicating that different parts of Ghana are at different stages of a nutrition transition. 12 HOUSEHOLD NUTRIENT AVAILABILITY Household food consumption patterns are useful for estimating individual diets. Detailed household food consumption data was collected as a part of a nationally representative household panel survey conducted in 2013 and 2016. The endline (2016) data was anlayzed to provide a breakdown of per capita food and nutrient consumption shares in Figures 6. Nutrient availability depends on both the intrinsic nutritional content and the amount consumed of a specific food. The nutritional content of individual foods was estimated by using the West African Food Composition Table (FCT) (Stadlmayr et al., 2012). Food quantities consumed were multiplied by conversion factors from the FCT to allow the estimation of nutrient availability, a rough proxy indicator for nutrient intake. The analysis presented here focusses on two macronutrients (energy and protein) and three micronutrients (iron, vitamin A and zinc). The analysis of food consumption and nutrient availability/access patterns at household level can also provide some insights on the potential nutrient gaps from dietary intake. For this purpose we employed the recommended daily nutrient requirements for both macro- and micronutrients as published in WHO guidelines. We first estimated household requirements by nutrient, using household demographics and nutrient requirements by age and gender. We then estimated the nutrient availability adequacy of household food consumption by dividing the household level nutrient availability from food consumed, by the household level requirements. Figure 9 estimates the adequacy of nutrient consumption, derived from per capita household food consumption. Source: Aberman et al (2019) 0.77 0.86 0.86 0.61 0.90 0.73 0.84 0.85 0.53 0.88 0.80 0.88 0.86 0.66 0.92 0.00 0.10 0.20 0.30 0.40 0.50 0.60 0.70 0.80 0.90 1.00 Energy Protein Iron Vit. A Zinc All Q1 Q5 Figure 6: Estimated adequacy of nutrients available to the household, by income quintile 13 The figure illustrates the share consumed of required energy, protein, iron, zinc and vitamin A. This is further broken down to show consumption of poorest and wealthiest quintiles. These estimates show zinc and iron consumption as close to adequate, however we know that it comes primarily from grain consumption which is a much less bioavailable form of these nutrients. Vitamin A consumption is well below adequate for all income levels but has the greatest difference according to income quintile. Energy consumption is also lowest for the poorest quintile. YOUTH THE ROLE OF YOUTH AND AGRICULTURE Ghana has a very young population, with approximately 57% of the population under the age of 25. Despite Ghana’s economic growth, unemployment rates remain relatively high especially among youth who have been affected by joblessness and low-wage employment. National Youth Policy (2010) in Ghana defines youth as those between 15-35 years. The total unemployment rate in Ghana was estimated as 2.4% while the youth unemployment remained higher as 4.9% by the ILO in 2017. Youth unemployment is recognized as a growing concern in Ghana and even more so in the Northern Ghana. While employment opportunities in Ghana are becoming more numerous due to the country’s economic growth, the job market remains unable to absorb the rapidly expanding young labor force. The levels of unemployment among Ghanaian youth vary across sexes as well as living areas. In urban areas, unemployment rates are significantly higher than in rural areas because young people are often attracted to the cities in search of jobs. In terms of gender, young women face higher unemployment rates than their male counterparts, which seriously undermines efforts towards economic empowerment of women. The lack of employable skills, mismatch of education and industry, an inability of the economy to create new jobs and limited access to start-up capital for the youth are some of the contributing factors identified by the government. The agricultural sector can offer large employment opportunities to young people and spur economic growth, especially given the growing demand for food. However, efforts to create jobs opportunities for youth in the agricultural sector are often separated from efforts to accelerate agricultural growth and improve food security. The Ghana Statistical Service reports that about 14.3% of young people in agriculture have abandoned their farms and remain idle in their communities or migrated to cities in 2015. The phenomenon has a causal link with crime as many of the rural youth in the cities are observed to be engaged in criminal activities. Agriculture and farming in particular is perceived as an occupation 14 for aged, illiterate and rural people. It is not seen as a venture that could provide job security and a stable income. This situation poses a great challenge to future employment of youth in agriculture and therefore to the food security of Ghana in general. Overall lack of opportunities and occurrence of seasonal drought and flooding in rural area is causing an increasing exodus from rural to urban areas of the country; especially from the five Northern Regions to the South. As with every migration, this trend is highly selective, with mainly young and dynamic men and fewer women leaving their villages, resulting in an aging and generally less dynamic population in rural areas, high rates of youth unemployment and social inequality. This implies that a special focus is needed on the creation of employment and business opportunities for young women and men living in rural areas in activities complementary to or outside of farming. 15 REFERENCE LIST Amugsi, D. A., Lartey, A., Kimani, E., & Mberu, B. U. (2016). Women’s participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana. Journal of Health, Population, and Nutrition, 35(1). https://doi.org/10.1186/s41043-016-0053-1 Brown, O. and Crawford, A. (2008). Assessing the security implications of climate change for West Africa-Country case stud-ies of Ghana and Burkina Faso. Winnipeg: International Institute for Sustainable Development. Carney, J., & Watts, M. (1990). Manufacturing dissent: Work, gender and the politics of meaning in a peasant society. Africa. https://doi.org/10.2307/1160333 Carr, E. R. (2008). Men’s Crops and Women’s Crops: The Importance of Gender to the Understanding of Agricultural and Development Outcomes in Ghana’s Central Region. World Development, 36(5), 900–915. https://doi.org/10.1016/j.worlddev.2007.05.009 Challinor, A., Wheeler, T., Garforth, C., Craufurd, P., and Kas-sam, A. (2007). Assessing the vulnerability of food crop systems in Africa to climate change. Climatic Change, 83(3) 381-399. doi:10.1007/s10584-007-9249-0 Davis, P., Tagoe-Darko, E., & Mukuria, A. (2003). Water, koko, and appetite: Complementary feeding practices in Kumasi, Ghana. DHS Qualitative Research Studies No. 6. Retrieved from http://dhsprogram.com/pubs/pdf/QRS6/QRS6.pdf Dixon, J., Omwega, A. M., Friel, S., Burns, C., Donati, K., & Carlisle, R. (2007). The Health Equity Dimensions of Urban Food Systems, 84(1), 118–129. https://doi.org/10.1007/s11524-007-9176-4 Doss, C. R. R. (2002). Men’s crop? Women’s crop? The gender patterns of cropping in Ghana. World Development, 30(11), 1987–2000. Ecker, O., & van Asselt, J. (2017). Food and Nutrition Security in Transforming Ghana A Descriptive Analysis of National Trends and Regional Patterns (IFPRI Discussion Paper Series No. 01650). Washington D.C. Ezumah, N. N., & Di Domenico, C. M. (1995). Enhancing the role of women in crop production: A case study of Igbo women in Nigeria. World Development, 23(10), 1731–1744. https://doi.org/10.1016/0305-750X(95)00075-N FAO. (2009). Ghana Nutrition Profile-Nutrition and Consumer Protection Division. Rome. FAO. (2012). Gender Inequalities in Rural Employment in Ghana: An Overview. Rome. https://doi.org/10.1080/10670564.2014.898893 FAO. (2014). Socio-economic context and role of agriculture. Ghana country fact sheet on food and agriculture policy trends. Rome. https://doi.org/I5890E/1/07.16 Ghana Ministry of Food and Agriculture. (2015). Agriculture in Ghana: Facts and Figures. Accra, Ghana. Retrieved from http://www.agrofood-westafrica.com/fileadmin/user_upload/messen/agrofood- Westafrica/Brochure/AGRICULTURE-IN-GHANA-Facts-and-Figures-2015.pdf%0Ahttp://cairngorms.co.uk/discover- explore/facts-figures/ Ghana Statistical Service, Ghana Health Service, & ICF International. (2015). Ghana Demographic Health Survey 2014. Rockville, Maryland: GSS, GHS, and IFC International. https://doi.org/10.15171/ijhpm.2016.42 Ghana Statistical Service, Ghana Health Service, & IFC International. (2014). Ghana Demographic and Health Survey. Accra, Ghana. https://doi.org/10.1007/s13398-014-0173-7.2 Government of Ghana. (2015). Ghana’s Third National Communication to the UNFCCC, 2015. Retrieved from https://unfccc.int/resource/docs/natc/ghanc3.pdf. Accessed in February 3, 2019. 16 Gladwin, C. (2002). Gender and soil fertility in Africa: an introduction. African Studies Quarterly, 6(1&2), 219–236. https://doi.org/10.2136/sssaspecpub51.c9 Hagenimana, V., Oyunga, M. A., Njoroge, S. M., Bay, H., Gichuki, S. T., & Kabira, J. (1999). The Effects of Women Farmers’ Adoption of Orange-Fleshed Sweet Potatoes: Raising Vitamin A Intake in Kenya. Research Program International Center for Research on Women Vital Hagenimana International Potato Center (CIP), (June). Hartley, F., & Arndt, C. (2018). Identifying Priority Value Chains in Ghana. Washington DC: IFPRI. Johnston, D., Hull, E., Malapit, H., Stevano, S., & Kadiyala, S. (2015). Agriculture, Gendered Time Use and Nutritional Outcomes: A Systematic Review. London, UK. Laar, A., & Aryeetey, R. (2015). Nutrition of women and children: focus on Ghana and HIV/AIDS. In N. Stein (Ed.), Public Health Nutrition: Principles and Practice in Community and Global Health. Burlington, MA: Jones and Bartlett Learning, LLC. Lambrecht, I., Schuster, M., Asare Samwini, S., & Pelleriaux, L. (2018). Changing gender roles in agriculture? Evidence from 20 years of data in Ghana. Agricultural Economics, 49(6), 691–710. https://doi.org/10.1111/agec.12453 McSweeney, C., New, M., Lizcano, G., and Lu, X. (2010). The UNDP climate change country profiles. American Meteorologi-cal Society, 91, 157-166. Owusu, K. and Waylen, P. (2009). Trends in spatio-temporal variability in annual rainfall in Ghana (1951-2000). Weather, 64(5), 115-120 Ragasa, C., Andam, K. S., Kufoalor, D. S., & Amewu, S. (2018). A blue revolution in sub-Saharan Africa? Evidence from Ghana’s tilapia value chain (GSSP Working Paper No. 49). Washignton DC. Retrieved from http://ebrary.ifpri.org/cdm/ref/collection/p15738coll2/id/132732 Signorelli, S., Haile, B., & Kotu, B. (2017). Exploring the agriculture-nutrition linkage in northern Ghana, (December). Retrieved from http://ebrary.ifpri.org/cdm/singleitem/collection/p15738coll2/id/132235 Smith, P., D. Martino, Z. Cai, D. Gwary, H. Janzen, P. Kumar, B. McCarl, S. Ogle, F. O’Mara, C. Rice, B. and Scholes, O. S. (2007). Agriculture. In Climate Change 2007: Mitigation. In L. A. M. B. Metz, O.R. Davidson, P.R. Bosch, R. Dave (Ed.). Cam-bridge and New York: Cambridge University Press. Stadlmayr, B., Charrondiere, U., Enujiugha, V., Bayili, R., G Fagbohoun, E., Samb, B., … Burlingame, B. (2012). West African Food Composition Table / Table de composition des aliments d´Afrique de l´Ouest. Rome: FAO. Stanturf, J. A., Warren, M. L., Charnley, Jr., S., Polasky, S. C., Goodrick, S. L., Armah, F., and Nyako, Y. A. (2011). Ghana Cli-mate Change Vulnerability and Adaptation Assessment. Wash-ngton: US Agency for International Development Vermeulen, S. J., Aggarwal, P. K., Ainslie, A., Angelone, C., Campbell, B. M., Challinor, A. J., and Hansen, J. W. (2010). Ag-riculture, Food Security and Climate Change : Outlook for Knowledge, Tools and Action. CCAFS Report No. 3. Agriculture (pp. 1-16). Copenhagen: CGIAR-ESSP Program on Climate Change, Agriculture and Food Security. Warren, E., Hawkesworth, S., & Knai, C. (2015). Investigating the association between urban agriculture and food security, dietary diversity, and nutritional status: A systematic literature review. Food Policy, 53, 54–66. https://doi.org/10.1016/j.foodpol.2015.03.004 World Bank. (2018). World Development Indicators Database. Retrieved July 20, 2018, from http://data.worldbank.org/data-catalog/world- development-indicators Yaro, J. A. (2010). The Social Dimensions of Adaptation to Climate Change in Ghana. The World Bank Discussion paper no.15. Washington: The World Bank. 17