Food Environments and Their Influence on Food Choices: A Case Study in Informal Settlements in Nairobi, Kenya

Abstract

The food environments that people have access to shape their food choices. The purpose of this study was to use mixed methods to characterize the external food environment in informal settlements in Nairobi, Kenya and to examine the individual factors that influence the way in which women interact with those environments to make food choices. We used a combination of food environment assessments (vendor mapping, collection of food prices, food quality assessments) and five focus group discussions with women (n = 26) in four villages within two informal settlements in Nairobi (Mukuru and Kibera) to better understand the drivers of food choice. We found a large number (n = 1163) of vendors selling a variety of food within the settlements. The highest number of vendors were selling fruits and/or vegetables; however, there was limited diversity of fruits available. Animal-source foods were considered relatively expensive as compared to plant-based foods, including prepared fried snacks. We found that the way women interacted with their food environments was influenced by individual factors such as income, time, convenience, and preferences. Our findings suggest that interventions targeting both the external food environment as well as individual factors such as income will be necessary to support healthy diets among low-income populations living in informal settlements in Kenya.

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

“…In all the locations we investigated, there were poor average dietary diversity scores, indicating diets that are likely low in micronutrients. Similar to our study, several studies have observed that the poorest communities are at the highest risk of insufficient micronutrient intake due to low consumption of vegetables and fruits, as well as animal‐sourced foods and other sources of protein 26–30 . Sub‐optimal diets predispose low‐income urban populations to undernutrition, poor micronutrient status and, when combined with shifts towards urban lifestyles, NCDs.…”

“…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.…”

“…Our findings of reliance on informal markets, and thus limited investment in and control of food quality and safety, were observed in studies in several African cities 32,33 . Further, there were differentials in the type of goods obtained from different vendors, a finding that has previously been reported 26,34,35 . For this reason, the impacts of rapidly changing food environments within evolving food systems and their effects on food choices, nutrition and health in the context of LMICs need to be further investigated.…”

“…Similar to our study, several studies have observed that the poorest communities are at the highest risk of insufficient micronutrient intake due to low consumption of vegetables and fruits, as well as animal-sourced foods and other sources of protein. [26][27][28][29][30] Sub-optimal diets predispose low-income urban populations to undernutrition, poor micronutrient status and, when combined with shifts towards urban lifestyles, NCDs. Our observation of poor-quality diets provide further evidence of the need for food policies and programmes that are cognisant of the nutrition and health of the growing population of the urban poor.…”

“…32,33 Further, there were differentials in the type of goods obtained from different vendors, a finding that has previously been reported. 26,34,35 For this reason, the impacts of rapidly changing food environments within evolving food systems and their effects on food choices, nutrition and health in the context of LMICs need to be further investigated. Such efforts should take into account forecasts for urban cities, particularly in LMICs, such as population growth, increases in (consumers') income and urbanisation.…”