Nutrition transition, double burden of malnutrition, and urbanization patterns in secondary cities of Bangladesh, Kenya and Rwanda.

BACKGROUND: By 2050, approximately 68% of the global population will live in cities, but nutrition data on urban populations of low- and middle-income countries are scarce. Fast growing secondary cities, combining characteristics and hurdles of urban and rural settings, are hotspots for the double burden of malnutrition. The Nutrition in City Ecosystems (NICE) project focuses on 6 secondary cities in Bangladesh, Kenya and Rwanda, to improve health and nutrition, and reduce poverty. To assess the baseline situation and guide future interventions, food insecurity, dietary diversity, nutrition status, and food production and purchasing patterns were explored. METHODS: In a cross-sectional study design, data were collected from urban and peri-urban households of Dinajpur and Rangpur in Bangladesh, Bungoma and Busia in Kenya, and Rubavu and Rusizi in Rwanda. Approximately 1200 households, in neighborhoods prone to malnutrition, were involved from April to June 2021. We assessed Household Food Insecurity Access Score (HFIAS), both current and before COVID-19, Household Dietary Diversity Score (HDDS), Minimum Dietary Diversity for Women (MDD-W), anthropometric measurements, household and socioeconomic information, and questions related to food production and consumer behavior. Further we collected secondary data on low birthweight and anemia during pregnancy. RESULTS: All cities experienced a substantial increase in food insecurity during the COVID-19 pandemic. Stunting rates in children under 5 years varied among the cities and ranged from 7.8% in Busia to 46.6% in Rubavu, while half of adult women were overweight (between 42.1% in Rusizi and 55.8% in Bungoma). Furthermore, many women did not consume an adequately diverse diet (MDD-W < 5 for 29.3% in Bangladesh, 47.5% in Kenya, and 67.0% in Rwanda), however many of the urban and peri-urban households were engaged in farming (58-78%). CONCLUSIONS: The double burden of malnutrition is high in secondary cities and the COVID-19 pandemic has exacerbated levels of food insecurity. Demand for, and access to, an affordable healthy diverse diet that comprises local, nutritious, and agroecologically produced foods present a pathway for overcoming the complex challenges of malnutrition.

Food Environments and Their Influence on Food Choices: A Case Study in Informal Settlements in Nairobi, Kenya.

The food environments that people have access to shape their food choices. The purpose of this study was to use mixed methods to characterize the external food environment in informal settlements in Nairobi, Kenya and to examine the individual factors that influence the way in which women interact with those environments to make food choices. We used a combination of food environment assessments (vendor mapping, collection of food prices, food quality assessments) and five focus group discussions with women (n = 26) in four villages within two informal settlements in Nairobi (Mukuru and Kibera) to better understand the drivers of food choice. We found a large number (n = 1163) of vendors selling a variety of food within the settlements. The highest number of vendors were selling fruits and/or vegetables; however, there was limited diversity of fruits available. Animal-source foods were considered relatively expensive as compared to plant-based foods, including prepared fried snacks. We found that the way women interacted with their food environments was influenced by individual factors such as income, time, convenience, and preferences. Our findings suggest that interventions targeting both the external food environment as well as individual factors such as income will be necessary to support healthy diets among low-income populations living in informal settlements in Kenya.

Drivers of food choice among women living in informal settlements in Nairobi, Kenya.

Suboptimal diets drive the multiple burdens of malnutrition among women living in informal settlements. Women's food choices have important implications for their health, as well as that of their families. The purpose of this study was to examine how food choice decisions might differ across different age groups of women living in informal settlements in Nairobi, Kenya. Using in-depth interviews which incorporated a free-listing task, we determined the factors influencing food choice decisions in women in two informal settlements, Kibera and Mukuru. Among women in all age groups, we found income and food price to be the most salient factors influencing food choice decisions. Differences across age groups regarding food choice considerations included individual preference and quality being more salient factors amongst younger women while household preferences were more salient among older women. Women also reported making trade-offs between food affordability and other factors including time and nutrition, which led to sub-optimal diets. Our findings suggest that interventions in these settings may need to be tailored to specific age groups. Additionally, interventions may need to target both individual factors and the external food environment to help women overcome the trade-offs they often find themselves making in food choice decisions.

Demand-side challenges to increase sales of new maize hybrids in Kenya.

In Eastern and Southern Africa, as the public sector has retreated from maize seed production and the private sector has emerged to fill the resulting void, a key issue for researchers, governments and private donors has been the capacity of privately owned, typically small scale, seed businesses to effectively produce and distribute hybrid seed. Roughly two decades on, research and development programming continues to focus on supply side issues in supporting the maize seed industry to bring new varieties to farmers. Motivated by thinking on agri-food value chains, this article explores the potential for achieving a stronger demand orientation in programming to support the maize seed industry, a requirement for varietal turnover. In 2019 data were collected in Kenya from i) 80 agro-dealers on their relations with seed businesses and their marketing of maize seed, ii) 466 farmers on their seed choice and engagement with agro-dealers and iii) 8 seed companies on their distribution and sales strategies. Results confirmed the overarching supply-push orientation of the industry, characterized by limited innovation and risk taking, weak collaboration between actors, low margins for retailers, and limited investments in seed marketing. Farmers showed weak appetite for acquiring new seed products, preferring instead to purchase seeds that they knew from experience. Better strategies for building seed value chains will require deeper insights on stakeholders needs and strategies, to include the capacity of seed businesses and retailers to innovate in business management and marketing.

Using Panel Community Surveys to Track the Impact of Crop Pests Over Time and Space - The Case of Maize Lethal Necrosis (MLN) Disease in Kenya from 2013 to 2018.

Maize lethal necrosis (MLN) disease appeared in Kenya in 2011, causing major damage. In a first survey of 121 communities in 2013, participants estimated the proportion of households affected and the yield loss in affected areas; from this survey, the overall loss was estimated at 22%, concentrated in western Kenya (94%). Efforts to combat the disease included planting resistant varieties, creating awareness of MLN management, and producing pathogen-free seed. In 2018, the same communities were revisited and asked the same questions, establishing a panel community survey. The results showed that incidents of MLN had greatly decreased, and the number of communities that had observed it had reduced from 76% in 2013 to 26% by the long rains of 2018; while still common in western Kenya (60%), MLN had greatly reduced elsewhere (to 10%). In 2013, 40% of farmers were affected, yield loss among affected farmers was estimated at 44%, and total yield loss was estimated at 22% (a production loss of 0.5 million metric tons/year), valued at US$187 million. By the long rains of 2018, 23% of farmers were affected, with a loss among affected farmers of 36%; overall annual loss was estimated at 8.5% or 0.37 million metric tons, valued at US$109 million, concentrated in western Kenya (79%). Of the recommended control measures, only the removal of diseased plants was commonly used (by 62% of affected communities), but not the use of agronomic practices (11%) or resistant varieties (9.5%). The reasons for the reduction in MLN are not well understood; external factors such as spraying insecticide against fall armyworm and unfavorable weather likely played a role, as did using disease-free seed, but not the use of resistant varieties or appropriate management practices. Still, as the pathogen remains in the fields, it is important to keep disseminating these control methods, particularly resistant varieties.[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY 4.0 International license.

Spread and impact of fall armyworm (Spodoptera frugiperda J.E. Smith) in maize production areas of Kenya.

Fall armyworm (FAW), one of the most important pests of maize in Latin America, suddenly appeared in Africa in 2016 and spread rapidly. Estimates of crop losses due to FAW are essential in order to compare the impact of these losses with the cost of controlling FAW and advise appropriate technology dissemination and policy. In this study, therefore, crop losses due to FAW in 2017 and 2018 were estimated in all the maize production areas of Kenya. Data were collected during June and July 2018 through 121 group discussions with 1439 farmers, separately with men (697) and women (742), in communities that were randomly selected to represent the major maize growing areas. The results showed that most participants (82%) could correctly identify the FAW from pictures. By 2016, FAW was observed by more than half of the communities (53%), with most of the other half first observing FAW in 2017. The proportion of farmers affected by FAW substantially increased, from the long rains of 2017 (63%) to the long rains of 2018 (83%), and in all zones except for the high tropics and moist mid-altitudes. However, the percentage of loss experienced by affected farmers decreased slightly, from 54% in 2017 to 42% in 2018. In 2017, the low- and medium-potential maize-production areas were the most affected, with losses of >50%, with high-potential areas facing losses of about 30%, resulting in a total loss of 37% for the whole country. In the main 2018 season, losses in the low- and medium-potential areas were less - about 20%, but the high-potential areas were now more affected, leading to a total estimate of 33%. We conclude that FAW has suddenly become a major pest in Kenya, causing losses of about a third of the annual maize production, estimated at about 1 million tonnes.

Do supermarkets contribute to the obesity pandemic in developing countries?

OBJECTIVE: Many developing countries are undergoing a nutrition transition with rising rates of overweight and obesity. This nutrition transition coincides with a rapid expansion of supermarkets. The objective of the present research is to study whether supermarkets directly contribute to overweight and other changes in nutritional status. DESIGN: This research builds on cross-sectional observational data. Household- and individual-level data were collected in Kenya using a quasi-experimental survey design. Instrumental variable regressions were employed to analyse the impact of supermarket purchase on nutritional status. Causal chain models were estimated to examine pathways through which supermarkets affect nutrition. SETTING: Small towns in Central Province of Kenya with and without supermarkets. SUBJECTS: A total of 615 adults and 216 children and adolescents. RESULTS: Controlling for other factors, buying in a supermarket is associated with a significantly higher BMI (P=0·018) and a higher probability of overweight (P=0·057) among adults. This effect is not observed for children and adolescents. Instead, buying in a supermarket seems to reduce child undernutrition measured by height-for-age Z-score (P=0·017). Impacts of supermarkets depend on many factors including people's initial nutritional status. For both adults and children, the nutrition effects occur through higher food energy consumption and changes in dietary composition. CONCLUSIONS: Supermarkets and their food sales strategies contribute to changing food consumption habits and nutritional outcomes. Yet the types of outcomes differ by age cohort and initial nutritional status. Simple conclusions on whether supermarkets are good or bad for nutrition and public health are not justified.

Consumer preferences for maize products in urban Kenya.

BACKGROUND: New maize varieties have been biofortified with provitamin A, mainly a-carotene, which renders the grain yellow or orange. Unfortunately, many African consumers prefer white maize. The maize consumption patterns in Africa are, however, not known. OBJECTIVE: To determine which maize products African consumers prefer to purchase and which maize preparations they prefer to eat. METHODS: A survey of 600 consumers was conducted in Nairobi, Kenya, at three types of maize outlets: posho mills (small hammer mills), kiosks, and supermarkets. RESULTS: Clients of posho mills had lower incomes and less education than those of kiosks and supermarkets. The preferred maize product of the posho-mill clients was artisanal maize meal; the preferred product of the others was industrial maize meal. Maize is the preferred staple for lunch and dinner, eaten as a stiff porridge (ugali), followed by boiled maize and beans (githeri), regardless of socioeconomic background. For breakfast, only half the consumers prefer maize, mostly as a soft porridge (uji). This proportion is higher in low-income groups. Consumers show a strong preference for white maize over yellow, mostly for its organoleptic characteristics, and show less interest in biofortified maize. CONCLUSIONS: Maize is the major food staple in Nairobi, mostly eaten in a few distinct preparations. For biofortified yellow maize to be accepted, a strong public awareness campaign to inform consumers is needed, based on a sensory evaluation and the mass media, in particular on radio in the local language.