Urban physical food environments drive dietary behaviours in Ghana and Kenya: A photovoice study.

Rebecca Pradeilles,Richmond Aryeetey,Robert Akparibo,Amos Laar,Nicolas Bricas,Fiona Graham,Marco Bohr,Senam Klomegah,Paula Griffiths,Michelle Holdsworth,Akua Tandoh,Ana Irache,Hibbah Araba Osei-Kwasi,Francis Zotor,Mark A Green,Nathaniel Coleman,Kobby Mensah,Emily K Rousham,Gershim Asiki,Milka Wanjohi ,Elizabeth Kimani‐Murage ,Stella Muthuri

doi:10.1016/j.healthplace.2021.102647

Abstract

We identified factors in the physical food environment that influence dietary behaviours among low-income dwellers in three African cities (Nairobi, Accra, Ho). We used Photovoice with 142 males/females (≥13 years). In the neighbourhood environment, poor hygiene, environmental sanitation, food contamination and adulteration were key concerns. Economic access was perceived as a major barrier to accessing nutritionally safe and healthy foods. Home gardening supplemented household nutritional needs, particularly in Nairobi. Policies to enhance food safety in neighbourhood environments are required. Home gardening, food pricing policies and social protection schemes could reduce financial barriers to safe and healthy diets.

Highlights

Low-and middle-income countries (LMICs), including countries in Sub-Saharan Africa (SSA), are experiencing dietary transitions as a result of food system transformations following socio-economic devel opment (Imamura et al, 2015; Popkin et al, 2020)
Changes in diet towards the consumption of energy-dense nutrient-poor (EDNP) foods, rich in saturated fat and added sugars, combined with low levels of physical activity have significantly contributed to a rise in over weight/obesity and nutrition-related non-communicable diseases (NR-NCDs), such as type 2 diabetes and cardiovascular diseases (Abra hams et al, 2011; Popkin et al, 2012; Branca et al, 2019)
There has been a significant rise in overweight and obesity among both men and women in SSA countries (Global Nutrition Report, 2020) and its prevalence is twice as high among urban dwelling women compared to men (Amugsi et al, 2017)

Summary

Introduction

Low-and middle-income countries (LMICs), including countries in Sub-Saharan Africa (SSA), are experiencing dietary transitions as a result of food system transformations following socio-economic devel opment (Imamura et al, 2015; Popkin et al, 2020). There has been a significant rise in overweight and obesity among both men and women in SSA countries (Global Nutrition Report, 2020) and its prevalence is twice as high among urban dwelling women compared to men (Amugsi et al, 2017). The overall prevalence of overweight and obesity in Ghana increased from 29.3% (women) and 14.4% (men) in 2000 to 41.0% (women) and 22.1% (men) in 2016. In Kenya, overweight/obesity increased from 22.5% (women) and 11.6% (men) in 2000 to 32.6% (women) and 16.3% (men) in 2016 (Global Nutrition Report Country Profiles, 2019a; 2019b). In children and adolescents (5–19 years old), the prevalence of overweight and obesity has steadily risen from 5.5% (Ghana) and 4.9% (Kenya) in 2000 to 10.7% (Ghana) and 11.2% (Kenya) in 2016 (Global Nutrition Report Country Profiles, 2019a; 2019b). Non-communicable diseases have become an important public health issue in both countries accounting for 43% (Ghana), and 27% (Kenya) of total deaths (World Health Organization, 2018a, 2018b)

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