Building the evidence-base for healthy food systems in East Africa

Food systems are undergoing a rapid transition in Africa, and this has come with significant changes to people’s diets and environments. Left unaddressed, these changes in food production and consumption will negatively impact the health of the population, for example through rising rates of malnutrition and non-communicable diseases (NCDs) and by degrading natural ecosystems. In East Africa, 40% of all deaths are currently attributed to NCDs. By 2030, it is projected that deaths from diet-related NCDs will surpass deaths from communicable diseases, a scenario that requires significant changes to intersecting domains that include health, nutrition, agriculture and more.

Following its inception in 2020, IDRC’s Catalyzing change for healthy and sustainable food systems (CCHeFS) initiative launched a competitive call for proposals for robust research projects to enhance the understanding of policies and interventions that could contribute to healthier and more sustainable food systems in East Africa. Out of more than 300 proposals, four teams were selected in Ethiopia, Kenya and Tanzania. They kick-started their projects in 2021.

After their first year of implementation, each research team is already contributing to building the evidence base to transform the food environment of their respective country. These contributions include nuanced studies that are revealing the socio-economic and gendered differences in food consumption and production across different locales, and that act as either barriers or enablers to healthy and sustainable food systems.

Find out more about the projects, meet the research teams and learn about their innovative areas of study, including how their projects could contribute to transformational change.

What role do microbusinesses play in transforming the Kenyan food system? This is what the Kenya SME4Nutrition project, led by Wasafiri Consulting Kenya in collaboration with Village Enterprise and Shack Dwellers International, aims to find out.

While the food environment in Kenya is rapidly evolving with the expansion of formal retailing such as supermarkets, microbusinesses are the main channel through which most households in both urban and rural communities access their food. The research aims to show how microbusiness owners can be agents for catalyzing agri-food systems towards healthy and sustainable foods, with a particular focus on extremely poor women in both rural and urban areas. This project seeks to identify the conditions that can influence microbusinesses in informal and rural contexts to contribute to equitable food system transformation. The research team is examining incentives for businesses to change, the factors that influence demand and how they are shaped by gender.

A cross-scale research approach with case studies in rural areas (agricultural and agro-pastoral) and in an informal urban settlement is showing some early research results. The food consumption patterns of households have been mapped, with clear trends of widespread yet inadequate and vulnerable consumption of healthy foods, and differences among gender and age groups. Affordability and accessibility of healthy foods have been identified as barriers to greater consumption. Detailed surveys and discussion panels with microbusiness owners have shown gendered differences in business types while also revealing an unfavourable business environment for healthy and sustainable foods. Businesses follow consumer demand, and the health and nutritional content of food is only considered by a small minority (about 20%) of customers, with the local food environment promoting unhealthy eating habits in both urban and rural areas and providing only limited support to food businesses.

With these preliminary results, the research is already expanding the knowledge base on both household food consumption patterns and the enablers and barriers faced by microbusiness owners. Ultimately, the intention for this research is to provide further insights into how the formulation of policies and programs at the county and national levels in Kenya can be improved to encourage commercial production, market interaction and demand for healthy and sustainable foods.

Meet the team:

Dr. Hezekiah Agwara

Hezekiah is a Policy Economist and currently the Executive Director of OGIVES Limited. His fields of interest and research are development socioeconomics, policy and institutions, and innovation and entrepreneurship. He specializes in quantitative and qualitative development research and has led several analyses of agro-industrial development, agro-industrial value chains and market systems, and trade during a period spanning more than 20 years. Hezekiah received a PhD in Public Policy from George Mason University (USA) and an MPA/ID from Harvard University. He is the team lead and co-Principal Investigator (PI) in this project.

Catherine Kilelu

Catherine is a Kenyan qualitative research and monitoring & evaluation expert with 20 years of experience in livelihoods and agriculture. Her research interest and areas of expertise are in agri-food systems innovation and transitions linked to sustainability, gender equity and social inclusion, nutrition, agriculture advisory and knowledge systems, digitalization, markets, and resilient livelihoods. Catherine received a PhD in Social Sciences (Knowledge, Technology and Innovation) from Wageningen University. She is a co-PI on this project.

Alex Rees

Alex is passionate about making positive change happen and at a large scale. He has over twenty years of leadership in the international development field inspiring and influencing transformative systems change within organisations. He’s ever more curious and determined to find better ways to collaborate to reduce conflict and poverty, combat climate change and improve nature and food systems. Alex joined Wasafiri in 2017 to lead the food systems portfolio and assumed the role of Managing Director in 2022. He acts as the project leader for the Kenya SME4Nutrition project.

Prof. Judith Kimiywe

Judith is a Certified Nutrition Specialist and currently a Professor at Kenyatta University Department of Food, Nutrition and Dietetics. Her main interest is to transform livelihoods by translating nutritional science into sustainable action. Her research centers on the use of locally-available resources and systems to enhance food and nutrition security of individuals and communities. She is the Director of the Center for Research Ethics and Chairperson of the Institutional Science Research Ethics Committee at Kenyatta University, and is the Nutrition Advisor for this project.

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This project, led by the Economic and Social Research Foundation, has been studying the food environment in Dar es Salaam, the commercial capital of Tanzania. Currently, food security in Tanzania is high, but dietary diversity and food affordability remains a challenge when looking at basic caloric intake. The country is also experiencing the double burden of malnutrition, whereby undernutrition now co-exists with overnutrition, leading to increased associated non-communicable diseases. The Economic and Social Research Foundation team is determining what types of unhealthy products are being consumed in Dar es Salaam, identifying substitutes and studying how consumer choices are affected by characteristics such as price. The aim is to use the study results to improve understanding of the gendered differences in food purchasing and how to strengthen the drivers of healthy food purchasing habits in low-income and vulnerable populations. Ultimately, the goal is to test interventions for improving how urban Tanzanians can access, afford and choose healthy foods, and to use these insights to inform policy for improving the demand for, and affordability of, healthy diets while supporting gender-sensitive approaches.

Several early results are emerging now that the first food environment study is complete. Field data shows that study respondents have a basic knowledge of food and nutrition. This is an informative finding because it clears the widespread perception that the people of Tanzania, including urban residents, lack this basic knowledge. Instead, results reveal that it is the affordability of healthy foods that is a key constraint, with 64% of households in the study area reporting an inability to afford and therefore eat healthy foods. The research identified the following four drivers responsible for influencing food consumption and choices in the study area: affordability, desirability, convenience and awareness. Gendered differences in patterns of food consumption were also identified, which will be further explored by the research team in the coming months. The opportunities for translating policy into action to address the double burden of malnutrition and increase the affordability of healthy diets will also be explored in the next stages of the research.

Meet the team:

Constantine Manda

Constantine is a political scientist with interests in impact evaluation and the study of African politics and economy. Along with others at the Economic & Social Research Foundation (ESRF) he co-founded the Impact Evaluation Lab whose mission is to expand impact evaluation through greater capacity building, research, and policy engagement. Constantine has undergraduate and graduate degrees from Yale University, the University of Chicago, and Xavier University in political science, public policy, and economics, respectively. He is the PI on this project.

Mr. Danford Sango

Mr. Danford Sango is an Agricultural Economist with a background in Human Nutrition. He received master’s degree in Agricultural Economics and bachelor’s degree in Human Nutrition from Sokoine University of Agriculture in Tanzania. He works as the Head of Department of Governance and Capacity Development at ESRF. His main areas of interest are on planning and monitoring of national development processes. He contributes to the project at the capacity of Research Fellow and Program Manager

Magreth Henjewele

Magreth Henjewele is a social scientist with 15 years of experience undertaking policy research, capacity building and policy advocacy in agriculture, food security, nutrition and integration of gender issues in policy and budget processes. Henjewele holds a master’s degree in political science and public administration from the University of Dar es Salaam. In this project, she serves as a gender expert.

Vivian Hoffman

Vivian Hoffman is a senior research fellow at the International Food Policy Research Institute (IFPRI) and an adjunct research professor of economics at Carleton University in Canada. Her research addresses the economics of food systems, with a focus on food safety in low- and middle-income countries. Hoffman served as an associate editor of the American Journal of Agricultural Economics and she has published extensively in the fields of development and agricultural economics. For this project, she is advising the team on study design.

Alan de Brauw

Alan de Brauw is a senior research fellow at IFPRI. He has a PhD in agricultural and resource economics from the University of California at Davis. Prior to joining IFPRI, he was an assistant professor of economics at Williams College. His research includes understanding the impacts of agricultural interventions and migration on source households, and ways to improve consumption patterns in low- and middle-income countries.

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This project explores the barriers and enablers to healthy and sustainable food systems in Ethiopia, including policy-level blockades. It also examines urban agriculture as a component for sustainable poverty reduction and environmental sustainability in Ethiopia.

Led by the School of Public Health at Addis Ababa University, in collaboration with Hawassa University and the Ministries of Agriculture and Health in Ethiopia, the project team is seeking to identify how small-scale agricultural production in metropolitan areas can increase access to fresh and nutritious foods for the urban poor, reduce food miles (the distance food is transported from production to consumer) and stabilize the market. Further, the team will explore how the newly launched urban agriculture program in Addis Ababa contributes to healthy food systems in the city, including how the benefits can be maximized for the urban poor. Through partial reclamation of agricultural land lost to urban encroachment, the program provides an opportunity to examine the environmental impact of intensified urban food production. 

To date, the research team has conducted a food-systems policy analysis, a barrier-enabler study of the Ethiopian food system, and a comparative study on the drivers of food choice comparing urban and rural areas, all of which present interesting preliminary results. The policy review found that while Ethiopia has a strengthened policy environment with ambitious multisectoral development plans, key trade policies and health and nutrition policies suffer from short-termism, without sufficient attention given to the domestic food market, non-communicable diseases and socially disadvantaged populations. The barrier-enabler study identified recommendations for transforming the agricultural system, including building the capacity of agricultural cooperatives and broadening food market production.

Increasing producer and consumer awareness of food safety and health has also been identified as a need, which requires working together with the food industry and the horticulture, health and trade sectors. Lastly, the food choice study has shown variances between rural and urban settings and socio-demographic factors, including age and sex. For example, intake of fruits and vegetables is estimated as low for 99% of the population in Addis Ababa, compared to 65% in the rural area Butajira. The nutritional literacy of the general population, accessibility, religious norms and social influence are all identified as key areas that can improve diet in both rural and urban settings. The research team aims to conduct feasibility studies to explore mechanisms for integrating urban agricultural initiatives with social-protection programs. They will also pilot and evaluate a strategy to integrate urban agriculture with social-protection programs in Addis Ababa. 

Meet the team:

Samson Gebremedhin Gebreselassie

Samson Gebremedhin Gebreselassie holds a PhD from Addis Ababa University (AAU) and is currently serving as associate professor of public health at the School of Public Health, AAU. He researches maternal and child nutrition and has published extensively in that area. Gebreselassie has led several large-scale research projects in Ethiopia and he has also served as an editorial board member for multiple journals including PLOS ONE, BMC Public Health, BMC Pediatrics and Ethiopian Journal of Health Development. He is the lead for this project.

Kaleab Baye Yiman

Kaleab Baye Yiman is associate professor of human nutrition at the Center for Food Science and Nutrition, AAU. He earned a PhD in nutrition and health from the University of Montpellier, France and a master’s degree in food science and nutrition from AAU. His research interest is food systems, with a particular focus on maternal and child nutrition, micronutrients and interventions to improve diet quality. Yimam is deputy editor of the journal Public Health Nutrition and a member of the editorial boards of Global Food Security and Biomed Research International. He is the project’s co-principal investigator.

Seifu Hagos Gebreyesus

Seifu Hagos Gebreyesus is a faculty member at the School of Public Health, AAU, and holds an associate professor position. He has a PhD in public health nutrition from University Bergen, Norway. He also holds MSc degrees in human nutrition (Ghent University) and public health (AAU). He is the president of the Public Health Officers Association of Ethiopia. Gebreyesus has led many international and national implementation research projects related to public health and nutrition. He is co-principal investigator on this project.

Fikadu Reta Alemayehu

Fikadu Reta Alemayehu is an assistant professor at the Academic Center of Excellence for Human Nutrition, Hawassa University. He holds a MSc degree in agricultural development from the University of Copenhagen, Denmark. His major research and development priorities are agriculture, food and nutrition security and livelihoods of smallholder farmers. Alemayehu also engages in voluntary capacities, such as moderating the Ag2nut-Ethiopia online Community. He is a founder of YesEthiopia, a non-profit organization focusing on career development for Ethiopian youth. He is co-principal investigator on this project.

Alemtsehay Sergawi Hailegiorg

Alemtsehay Sergawi Hailegiorg is has served as head of the Food and Nutrition Coordination Office at the Federal Ministry of Agriculture since January 2018 and has held different leadership positions at the ministry, including senior food and nutrition expert. She holds a MSc in rural livelihood development from AAU and a BSc degree in rural development from Haromaya University. She was highly engaged in the establishment of the Food and Nutrition Coordination Office of the Ministry of Agriculture and contributed to the design and implementation of the National Nutrition Program of Ethiopia. Hailegiorgis is co-principal investigator on this project.

Dr. Meseret Zelalem Tadesse

Dr. Meseret Zelalem Tadesse has served as director of the Maternal and Child Health Directorate of Ethiopia’s Federal Ministry of Health since August 2017. She also holds the chief of staff position for the office of the Minister of Health. Dr. Tadesse holds a MD and specialty certificate in pediatrics and child health from Gondar University. She is the secretary for the National Nutrition Coordination Body and chair of the National Nutrition Technical Committee. In this project, she is co-principal investigator.

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This project employs a systems approach to map out the structure and dynamics of the food system in Ethiopia, which influences the availability and affordability of protective and healthy foods. The research, led by the Ethiopian Policy Studies Institute (PSI), in collaboration with the Ethiopian Public Health Institute, McGill University and Wageningen University, focuses on the actors involved in food production, transportation and marketing. It also explores the underlying factors that drive their influence on food availability, affordability and acceptability. Existing policies and interventions, along with linkages among actors and stakeholders, are being reviewed, mapped and characterized. Knowledge gained from these studies will be foundational for developing and promoting policy interventions that encourage greater access to and affordability of healthy and protective foods, especially for low-income groups and other vulnerable populations. 

Through comprehensive policy and data analysis, the PSI-led research team has conducted national-level studies for Ethiopia including a review of food-system policies, a meta-analysis and data mapping on healthy and sustainable diets, and a food consumption patterns study. The preliminary results from these studies have revealed the changing consumption patterns in both urban and rural areas of Ethiopia, such as an increasing amount of cereal consumption and declines in protein consumption. The quality and diversity of diets has also been identified as a major challenge in Ethiopia, particularly for certain social groups including pregnant women and children, larger households, the urban unemployed and households headed by the elderly and persons with disabilities.

The studies have also revealed that various policies and program interventions have had a relatively low impact on diet and nutrition, with a current scenario of only one in every four Ethiopians being able to afford a nutritious diet. The data mapping revealed where data can be accessed for evidence-based decision-making, but it has also revealed data gaps and areas where data quality and access could be improved. Overall, the studies have shown that further analysis will be needed about the driving factors behind changes in consumption and the high cost of a nutritious diet, along with greater coordination of food-systems actors. By the end of this project, the research team will produce recommendations on policies that can promote healthy and protective foods for low-income and vulnerable people in a gender-equitable manner. 

Meet the team:

Alebel Bayrau Weldesilassie

Alebel Bayrau Weldesilassie is a lead research fellow at the Policy Studies Institute (PSI) and coordinates the PSI Poverty and Social Welfare Policy Research Centre. Previously, he was a country economist at the International Growth Centre, based at the London School of Economics and Oxford University, and a visiting research fellow at the University of California at Berkeley. He has more than 15 years of experience in research and policy analysis that focuses on a range of development challenges related to agriculture, poverty, climate change, human capital development, labour markets and urbanization, with applications of micro-econometrics and impact evaluation techniques. Weldesilassie has published in various internationally peer-reviewed journals and is a member of the Ethiopian Economic Association and African Association of Agricultural Economics. He is the principal investigator on this project.

Masresha Tessema

Masresha Tessema is a public health nutritionist and researcher, currently the director of the Food Science and Nutrition Research Directorate at the Ethiopian Public Health Institute. He has over 10 years of experience in nutrition and food security. He received a MSc degree in applied human nutrition from Hawassa University and a PhD in public health nutrition from Wageningen University. His research activities include dietary diversity, micronutrient deficiency, protein-energy intake, linear growth failure management, biofortification impact measurement, aflatoxin exposure, diet-related non-communicable diseases, and linkages between nutrition health and climate change in developing countries. Tessema previously coordinated the national nutrition research and surveys in Ethiopia and has over 20 research publications in a peer-reviewed journal. He is the chair of the National COVID-19 Research and Technology Transfer Steering Committee.

Michael Ngadi

Michael Ngadi is a James McGill Professor at McGill University, where he has been teaching and directing multidisciplinary international projects related to food processing technologies, quality and safety optimization, and nutrition-sensitive value chains. He has held several positions including vice-president (regional) of the Canadian Society for BioEngineering, chair of the Northeast Agricultural and Biological Engineering Conference and he has served on the executive board of the 13th International Congress on Engineering and Food. Ngadi has led large-scale international projects that have impacted millions of people in Asia, the Caribbean, South America and Africa. He is a fellow of the Canadian Society for BioEngineering and of the Nigerian Institute of Agricultural Engineers.

Inge D. Brouwer

Inge D. Brouwer is a professor of nutrition at Wageningen University. Her research focuses on improving the quality of diets for (young) women and children in low- and middle-income countries. She uses agricultural or food-systems approaches, with a special emphasis on reducing the burden of undernutrition, micronutrient deficiencies and overnutrition. Brouwer has rich experience in food-system research and is currently leading the food system for healthy diet project in four countries.

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