Analysing Diet Composition and Food Insecurity by Socio-Economic Status in Secondary African Cities

Abstract

This chapter takes as its starting point theorizing around nutrition and food system transitions thought to be increasingly occurring in urban Africa, and how this may be linked to a growing non-communicable disease burden. We focus specifically on the secondary city context by analysing household survey data gathered from six cities across Ghana, Kenya and Uganda during 2013–2015. We asked how diet composition and diversity, food sources and food security varied by socio-economic status, using expenditure and demographic data to create a proxy for household well-being. In this way, we investigate one of the claimed keystones affecting urban food systems and dietary health in sub-Saharan Africa—that of obesogenic urban food environments. Our findings indicate that the socio-economic status of a household was the most important factor influencing household dietary diversity and food security status, i.e. better-off households were more likely to feel food secure and eat from a greater variety of food groups. In addition, the number of income sources was additionally associated with higher dietary diversity. We also found that a household’s involvement in agriculture had only a small positive effect on food security in one city and was associated with a reduction in dietary diversity scores. Our findings emphasize the importance of supporting aggregated national and international statistics on agricultural production and trade with detailed local analyses that focus on actual household food access and consumption. We also see reasons to be cautious about making causal claims regarding consumption change and obesogenic urban environments as the major contributor to a rising obesity and non-communicable disease burden in Africa.

Similar, yet different! Comparing Ugandan secondary cities’ food system and nutritional transformations to findings from African primary cities

“…Mbarara contexts, while slightly improving food security and reducing food outlays, did not translate into better dietary diversity than non-farm households (Mackay et al 2023). We speculate this may be due to the focus on the same food crops (maize, beans, matooke, potatoes) commonly consumed.…”

“…A review of 11 southern African secondary and primary cities by Frayne and colleagues found mean HDDS of 6 across all cities, but when split by food security experience, food secure households had a median HDDS of 8 while insecure households had median HDDS of 5 food groups (Frayne et al 2014). In comparison to four other secondary cities in Ghana and Kenya, Ugandan cities do seem to have lower mean HDDS (Mackay et al 2023). The importance of maize/rice/beans for food security, and a lower diet diversity for the region, is reported by others (Ngaruiya et al 2017;Raschke and Cheema 2008;Pottier 2015).…”

“…There was little evidence of highly organised entrepreneurial market gardening for city markets. Of note was that the agricultural practice of urban inhabitants in the Mbale/Mbarara contexts, while slightly improving food security and reducing food outlays, did not translate into better dietary diversity than non-farm households (Mackay et al 2023 ). We speculate this may be due to the focus on the same food crops (maize, beans, matooke, potatoes) commonly consumed.…”

“…This was also found by Mackay ( 2018 ) in secondary Ghanaian cities. Having a maize/carb-rich staple that provides calorific satiation is similar across many African contexts (Frayne et al 2014 ; Mackay et al 2023 ).…”