The African urban food environment framework for creating healthy nutrition policy and interventions in urban Africa

Hibbah Araba Osei-Kwasi, Amos Laar, Francis Zotor, Rebecca Pradeilles, Richmond Aryeetey, Mark Green, Paula Griffiths, Robert Akparibo, Milkah Njeri Wanjohi, Emily Rousham, Amy Barnes, Andrew Booth, Kobby Mensah, Gershim Asiki, Elizabeth Kimani-Murage, Nicolas Bricas, Michelle Holdsworth

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)

Abstract

This study developed, validated, and evaluated a framework of factors influencing dietary behaviours in urban African food environments, to inform research prioritisation and intervention development in Africa. A multi-component methodology, drawing on concept mapping, was employed to construct a framework of factors influencing dietary behaviours in urban Africa. The framework adapted a widely used socio-ecological model (developed in a high-income country context) and was developed using a mixed-methods research approach that comprised: i. Evidence synthesis consisting of a systematic review of 39 papers covering 14 African countries; ii. Qualitative interview data collected for adolescents and adults (n = 144) using photovoice in urban Ghana and Kenya; and iii. Consultation with interdisciplinary African experts (n = 71) from 27 countries, who contributed to at least one step of the framework (creation, validation/evaluation, finalisation). The final framework included 103 factors influencing dietary behaviours. Experts identified the factors influencing dietary behaviours across all the four levels of the food environment i.e. the individual, social, physical and macro levels. Nearly half (n = 48) were individual-level factors and just under a quarter (n = 26) were at the macro environmental level. Fewer factors associated with social (n = 15) and physical (14) environments were identified. At the macro level, the factors ranked as most important were food prices, cultural beliefs and seasonality. Factors ranked as important at the social level were household composition, family food habits and dietary practices. The type of food available in the neighbourhood and convenience were seen as important at the physical level, while individual food habits, food preferences and socioeconomic status were ranked highly at the individual level. About half of the factors (n = 54) overlap with those reported in an existing socio-ecological food environment funded by a Global Challenges Research Fund Foundation Award (project code: MR/P025153/1) led by the MRC, and supported by AHRC, BBSRC, ESRC and NERC, with the aim of improving the health and prosperity of low and middle-income countries. Awards received by MH (PI). The funders had no role in study design, data collection and analysis, the decision to the public, or preparation of the manuscript.

Original languageEnglish
Article numbere0249621
JournalPLoS ONE
Volume16
Issue number4 April 2021
DOIs
Publication statusPublished - Apr 2021

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