Community perceptions on the factors in the social food environment that influence dietary behaviour in cities of Kenya and Ghana: a Photovoice study

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

doi:10.1017/s1368980022002270

Cited by 4 publications

(2 citation statements)

References 40 publications

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“…This is because individual level factors, such as the cost of food, interact with the bigger social and physical food environment. 48,49 In Nairobi, convenience was identified as a key factor influencing food choice, confirming previous observations by Downs et al 26 We did not collect additional information on the issues around convenience, such as perceived cost savings, ease of access to street vendors versus open-air markets and use of fuel. Nevertheless, for Nairobi, improving the quality of food from vendors and retailers or kiosks would be a key strategy so that convenient food is also healthful and available within short walking distances.…”

Section: Discussionsupporting

confidence: 73%

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Determinants of dietary diversity and drivers of food choice among low‐income consumers in urban Kenya, Malawi and Zimbabwe

Gichohi‐Wainaina,

Kee‐Tui,

Zoethout

et al. 2023

J Human Nutrition Diet

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IntroductionRapid urbanisation affects lifestyle and eating habits, predominantly causing a dietary shift that adds challenges to meet dietary recommendations within a complex food system. This research investigated dietary diversity and food choice drivers among low‐income consumers in three urban settlements (Nairobi, Kenya; Bulawayo, Zimbabwe and Lilongwe, Malawi, representing rapid, moderate and slow urban growth patterns, respectively) as a first step towards improving diets across cultures and geographies.MethodsMixed methods data collection was employed for this study. Qualitative methods such as rapid foodscape appraisal workshops and food stories in selected low‐income settlements in Nairobi, Bulawayo and Lilongwe were utilised to collect information on the food environments (food balances, infrastructure, safety, policies and institutions). Quantitative data such as socio‐demographic characteristics and dietary diversity were collected via structured questionnaires using Cognitive Edge's SenseMaker® (n = 890, 450 and 440 for Nairobi, Bulawayo and Lilongwe, respectively). The dietary intake of respondents was assessed using a 24‐h recall, which was then converted to the food group diversity score (FGDS).ResultsDifferent levels of compounded stress affected dietary diversity and quality, including high food prices, concerns about sanitation and hygiene and the role of food standards regulation bodies. The mean FGDS across all locations was lower than the recommended cut‐off of 5 (4.5, 2.8 and 2.6 across Nairobi, Zimbabwe and Lilongwe, respectively). Additionally, in Nairobi, there were gender differences in diet diversity, with men having a higher dietary diversity score than women (4.6% vs. 4.3%; p = 0.004). The majority of respondents in Lilongwe (65%) reported price as the most important driver of food choice, compared to 38% in Nairobi and 42% in Bulawayo.Discussion/ConclusionsOur observation of poor‐quality diets provides further evidence of the need for food policies that are cognisant of the nutrition and health of the growing population of the urban poor. Such policies would focus on lowering the costs of nutritious foods as well as ensuring food safety within the complex food system observed in the urban low‐income environment.

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Section: Discussionsupporting

confidence: 73%

“…These policies, need to consider multiple levels and broader drivers of food choice and consumption. This is because individual level factors, such as the cost of food, interact with the bigger social and physical food environment 48,49 …”

Section: Discussionmentioning

confidence: 99%

Determinants of dietary diversity and drivers of food choice among low‐income consumers in urban Kenya, Malawi and Zimbabwe

Gichohi‐Wainaina,

Kee‐Tui,

Zoethout

et al. 2023

J Human Nutrition Diet

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Individual‐level drivers of dietary behaviour in adolescents and women through the reproductive life course in urban Ghana: A Photovoice study

Liguori

Pradeilles

Laar

et al. 2022

Maternal & Child Nutrition

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Evidence on the individual‐level drivers of dietary behaviours in deprived urban contexts in Africa is limited. Understanding how to best inform the development and delivery of interventions to promote healthy dietary behaviours is needed. As noncommunicable diseases account for over 40% of deaths in Ghana, the country has reached an advanced stage of nutrition transition. The aim of this study was to identify individual‐level factors (biological, demographic, cognitive, practices) influencing dietary behaviours among adolescent girls and women at different stages of the reproductive life course in urban Ghana with the goal of building evidence to improve targeted interventions. Qualitative Photovoice interviews (n = 64) were conducted in two urban neighbourhoods in Accra and Ho with adolescent girls (13–14 years) and women of reproductive age (15–49 years). Data analysis was both theory‐ and data‐driven to allow for emerging themes. Thirty‐seven factors, across four domains within the individual‐level, were identified as having an influence on dietary behaviours: biological (n = 5), demographic (n = 8), cognitions (n = 13) and practices (n = 11). Several factors emerged as facilitators or barriers to healthy eating, with income/wealth (demographic); nutrition knowledge/preferences/risk perception (cognitions); and cooking skills/eating at home/time constraints (practices) emerging most frequently. Pregnancy/lactating status (biological) influenced dietary behaviours mainly through medical advice, awareness and willingness to eat foods to support foetal/infant growth and development. Many of these factors were intertwined with the wider food environment, especially concerns about the cost of food and food safety, suggesting that interventions need to account for individual‐level as well as wider environmental drivers of dietary behaviours.

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Socio-Ecological Factors in Building a Healthy Community: A Comparative Study of Healthy Community Assessment Standards

Zhao,

Chen,

Zhang

2024

Buildings

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Healthy community assessment standards significantly influence community design and planning and are an important measure of a community’s ability to support health and well-being. Previous studies have mostly focused on built-environment indicators. However, building a healthy community is a complex issue involving multiple dimensions and factors. The consideration of the full range of health promotion factors is the key to determining their potential impact on individuals’ health. It is necessary to consider multiple perspectives to deepen the understanding of community health influences and enhance the effectiveness of the implementation of the assessment standards. The socio-ecological model (SEM) provides a critical framework for understanding the multiple influences on individual health. In this study, a two-dimensional interdisciplinary analytical framework of “socio-ecological factors–development goals” is developed by integrating development goals that summarize building considerations in assessment standards. Contextual analysis is used to examine the provisions of the following assessment standards: Assessment Standard for Healthy Community (ASHC), Assessment Standard for Healthy Retrofitting of Existing Residential Area (ASHRERA), WELL Community Standard (WELL), and Fitwel Certification System of Community (Fitwel). The results show that community and organization factors are used more than interpersonal and policy factors among the four standards. Humanistic constructions lack attention in the ASHC and ASHRERA standards compared with the other standards. The differences between the four standards indicate that there is a need to focus on regional features and develop locally adapted interventions. This study offers a novel exploration of the potential effectiveness of healthy community assessment standards from a multidisciplinary perspective. The results of this study support standard-setters and planners in the development of interventions to improve building healthy communities using intersectionality frameworks.

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Community perceptions on the factors in the social food environment that influence dietary behaviour in cities of Kenya and Ghana: a Photovoice study

Cited by 4 publications

References 40 publications

Determinants of dietary diversity and drivers of food choice among low‐income consumers in urban Kenya, Malawi and Zimbabwe

Determinants of dietary diversity and drivers of food choice among low‐income consumers in urban Kenya, Malawi and Zimbabwe

Individual‐level drivers of dietary behaviour in adolescents and women through the reproductive life course in urban Ghana: A Photovoice study

Socio-Ecological Factors in Building a Healthy Community: A Comparative Study of Healthy Community Assessment Standards

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