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

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. 

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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.  

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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.  

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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.  

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