The Perceived Food Environment Mediates the Effect of an Intervention Supporting the Private Sector to Improve Purchase of Pasteurized Milk in Kenya (P10-146-19)

Abstract

ObjectivesConsumers are often constrained from procuring and consuming nutritious and safe foods by a prohibitive food environment. The Marketplace for Nutritious Foods program in peri-urban Kenya sought to mitigate this challenge by providing supports to small and medium enterprises (SME) producing nutritious foods. In this study, we assessed the impact of support to an SME producing pasteurized milk available in affordable quantities via automated milk dispensers on milk purchasing behavior and the extent to which this relationship was mediated through measures of the food environment. MethodsWe conducted a cross sectional survey of 429 random consumers in four markets in Eldoret, Kenya. Two intervention markets, where the supported products were sold, were sampled and two comparison markets were matched based on size and distance to a major urban center. Surveys included questions pertaining to the food environment, notably measures of affordability, perceived availability, and desirability of milk products, as well as purchasing behavior. We used structural equation modeling (SEM) and multiple linear regression to assess the relationship between the intervention and frequency of pasteurized milk purchase and the mediating role of perceived availability, affordability, and desirability of pasteurized milk. Models controlled for income, household size, distance to market, and education. ResultsDemographic characteristics were balanced across groups. The intervention was associated with increased frequency of pasteurized milk purchase (β = 3.03, P = 0.03). This effect was largely mediated by desirability (β = 5.35, P < 0.001) and in part by affordability (β = 1.61, P = 0.05). Perceived availability was not associated with frequency of purchase (β = -0.02, P = 0.64) or intervention markets (β = 0.02, P = 0.85). Consumers in intervention markets reported greater desirability (β = 0.21, P = 0.03) and affordability (β = 0.33, P < 0.001) of pasteurized milk. In a composite SEM model predicting purchase, only desirability was significant. ConclusionsIn the era of sustainable development goals, market based solutions to promote better diets at scale are key. As we endeavor to increase the purchase of nutritious foods by low income consumers, the role of the food environment, and in particular making foods more desirable, should not be overlooked. Funding SourcesUSAID.