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.

An examination of water, sanitation, and hygiene (WASH) accessibility and opportunity in urban informal settlements during the COVID-19 pandemic: Evidence from Nairobi, Kenya.

This research examines water, sanitation, and hygiene (WASH) accessibility and opportunity in Kibera and Mathare during the COVID-19 pandemic in 2021. Kibera and Mathare are two of the largest urban informal settlements in Nairobi (the capital city of Kenya) as well as Sub-Saharan Africa. Accessibility indicates how easily a person can reach WASH facilities from their home by walking. Opportunity represents how many WASH options a person has near their home. We utilize the data on water and toilet facilities collected by GroundTruth Initiative in partnership with Map Kibera Trust (local community partners) between February and April 2021 - amid the COVID-19 pandemic. By conducting quantitative geospatial analysis, we illustrate WASH accessibility and related issues that were not evident in previous studies: (1) 77.4% of people living in Kibera have limited WASH facility accessibility or opportunity; (2) 60.6% of people living in Mathare have limited WASH facility accessibility or opportunity; (3) there is a clear geographic pattern in WASH facility accessibility and opportunity; and (4) overall accessibility and opportunity is better in Mathare than in Kibera. This study is one of the first studies to examine WASH accessibility and opportunity in urban informal settlements during the COVID-19 pandemic by utilizing the current data and quantitative geospatial methods. Based on the results, we discuss important public health policy implications for people living in urban informal settlements to improve their WASH facility accessibility and opportunity during the COVID-19 pandemic.