Understanding Consumer Beliefs and Choices Related to Food Safety: A Qualitative Study in Urban Ethiopia.

OBJECTIVE: Provide an in-depth examination of consumers' food safety beliefs and practices to draw implications for interventions to improve nutrition and food safety in Ethiopia. DESIGN: Adapted Focused Ethnographic Study approach using in-person semi-structured interviews and free-listing exercises, in two iterative phases. SETTING: A traditional food market in Hawassa, a mid-sized city. PARTICIPANTS: Forty-six market shoppers, selected randomly in line with quotas for age and gender. RESULTS: Consumers did not clearly differentiate between quality and safety, seeing them through connected concepts such as 'freshness'. While most respondents had some understanding of the causes of unsafe food, they did not generally worry about becoming ill themselves and felt food safety risks were easily mitigated through in-home behaviors. Thus, food safety practices were not a main motivator of market or vendor choice. There was no evidence that food safety concerns led consumers to prefer packaged, processed food or to avoid consuming fresh foods.Discussion: The study offers novel depth and detail on a topic of strong policy relevance. While building on an encouraging base of understanding of food safety, there remains considerable scope for increasing knowledge, particularly with regards to the need to procure safe food as opposed to expecting household-level practices to mitigate all safety risks. Motivating customers to give food safety factors more consideration when making food purchasing decisions, such as by leveraging emotion-based communication from trusted messengers to elevate the issue's salience in their minds, may contribute to improvements in food safety in low-income countries such as Ethiopia.

Health priority-setting for official development assistance in low-income and middle-income countries: a Best Fit Framework Synthesis study with primary data from Ethiopia, Nigeria and Tanzania.

BACKGROUND: Decision making process for Official Development Assistance (ODA) for healthcare sector in low-income and middle-income countries involves multiple agencies, each with their unique power, priorities and funding mechanisms. This process at country level has not been well studied. METHODS: This paper developed and applied a new framework to analyze decision-making process for priority setting in Ethiopia, Nigeria, and Tanzania, and collected primary data to validate and refine the model. The framework was developed following a scoping review of published literature. Interviews were then conducted using a pre-determined interview guide developed by the research team. Transcripts were reviewed and coded based on the framework to identify what principles, players, processes, and products were considered during priority setting. Those elements were further used to identify where the potential capacity of local decision-makers could be harnessed. RESULTS: A framework was developed based on 40 articles selected from 6860 distinct search records. Twenty-one interviews were conducted in three case countries from 12 institutions. Transcripts or meeting notes were analyzed to identify common practices and specific challenges faced by each country. We found that multiple stakeholders working around one national plan was the preferred approach used for priority setting in the countries studied. CONCLUSIONS: Priority setting process can be further strengthened through better use of analytical tools, such as the one described in our study, to enhance local ownership of priority setting for ODA and improve aid effectiveness.