Food systems and structural and rural transformation: a quantitative synthesis for low and middle-income countries

Our review explores the changing food production, distribution and consumption environment in low and middle-income countries and emerging economies as a basis for framing how to study food systems in order to address public health issues of food safety and nutrition. It presents the state of knowledge on existing food systems science and its use in terms of sustainable actions for food safety and public health. The review identifies a knowledge gap in food system mapping and governance, with value chain mapping of key commodities often missing. Despite a number of initiatives, the application of food systems methods is highly variable in scope and quality. Most analyses concentrate on specific commodities, rarely taking into account the need for a whole diet approach when looking at nutrition or the assessment of a range of infectious agents and their interactions when looking at food safety. Of the studies included in the review there is a growing observation of “informal” food systems, a term used inconsistently and one that requires revision. “Informal” food systems link to the formal sector to provide food security, yet with trade-offs between economic efficiencies and food safety. Efforts to improve food safety are hampered by inadequate food safety capacities and a lack of policy coherence leading to: inadequate investment; fragmented food quality control systems; weak or non-existent traceability mechanisms; weak foodborne disease surveillance; obsolete food regulation; and weak regulatory enforcement. In-depth food systems assessments can complement risk analysis to identify risky behaviors and understand institutional settings in order to improve codes of practice and enforcement. Methods for looking at food safety from a food systems perspective are emerging, yet existing nutrition and food systems science are not advancing sufficiently in response to nutritional public health problems. There is an urgency for improved understanding of the structure and drivers of the food systems, for better planning of changes that leads to nutrients access and healthy levels of eating. It is proposed that countries and international institutions provide an atlas of food system maps for the key commodities based on an agreed common methodology and developed by multidisciplinary teams.

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Effective food systems innovations: An inventory of evidence from Bangladesh, Ethiopia, Nigeria, Viet Nam, and other low-and middle-income countries

10.2499/p15738coll2.134401 ◽

2021 ◽

Author(s):

Els Lecoutere ◽

Marrit Van den berg ◽

Alan de Brauw

Keyword(s):

Food Systems ◽

Viet Nam ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

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The effects of food systems interventions on food security and nutrition outcomes in low- and middle- income countries

10.23846/b/egm/202101 ◽

2021 ◽

Author(s):

Keyword(s):

Food Security ◽

Food Systems ◽

Middle Income ◽

Middle Income Countries ◽

Food Security And Nutrition ◽

Low And Middle Income

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Metrics to analyze and improve diets through food Systems in low and Middle Income Countries

Food Security ◽

10.1007/s12571-020-01091-2 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1085-1105

Author(s):

Mequanint B. Melesse ◽

Marrit van den Berg ◽

Christophe Béné ◽

Alan de Brauw ◽

Inge D. Brouwer

Keyword(s):

Food Systems ◽

Food System ◽

Systems Approach ◽

Analytical Framework ◽

Data Availability ◽

Middle Income ◽

The Sustainable Development ◽

Middle Income Countries ◽

Public Data ◽

Low And Middle Income

Abstract Taking a food systems approach is a promising strategy for improving diets. Implementing such an approach would require the use of a comprehensive set of metrics to characterize food systems, set meaningful goals, track food system performance, and evaluate the impacts of food system interventions. Food system metrics are also useful to structure debates and communicate to policy makers and the general public. This paper provides an updated analytical framework of food systems and uses this to identify systematically relevant metrics and indicators based on data availability in low and middle income countries. We conclude that public data are relatively well available for food system drivers and outcomes, but not for all of the food system activities. With only minor additional investments, existing surveys could be extended to cover a large part of the required additional data. For some indicators, however, targeted data collection efforts are needed. As the list of indicators partly overlaps with the indicators for the Sustainable Development Goals (SGDs), part of the collected data could serve not only to describe and monitor food systems, but also to track progress towards attaining the SDGs.

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An Emergent Framework of the Market Food Environment in Low- and Middle-Income Countries

Current Developments in Nutrition ◽

10.1093/cdn/nzab023 ◽

2021 ◽

Author(s):

Djeinam Toure ◽

Anna Herforth ◽

Gretel H Pelto ◽

Lynnette M Neufeld ◽

Mduduzi N N Mbuya

Keyword(s):

Food Environment ◽

Food Systems ◽

Personal Characteristics ◽

Future Research ◽

Product Characteristics ◽

Middle Income ◽

Middle Income Countries ◽

Research Priority ◽

Measurement Framework ◽

Low And Middle Income

Abstract Background Food systems are increasingly recognized as critical for advancing nutrition, and the food environment is viewed as the nexus between those systems and dietary consumption. Developing a measurement framework of the market food environment is a research priority, particularly for low- and middle-income countries (LMICs), which face rapid shifts in markets, dietary patterns, and nutrition outcomes. Objective In this study, we sought to assess current conceptions and measures of the market food environment that could be adapted for use in LMICs. Methods We conducted a narrative review of the literature to identify measures of the market food environment in recent use. First, we identified and reviewed frameworks of the food environment for LMICs with a specific focus on the market food environment. Second, we compiled 141 unique measures of the market food environment from 20 papers into a list that was pile-sorted by five nutrition experts into domains. We then categorized the measures based on percentage agreement across all sorts. Finally, we compared measured and conceptual domains of the market food environment to identify measurement gaps and needed adaptations. Results Conceptual frameworks provide differing definitions of the market food environment but conform in their definitions of food availability, price, marketing, and product characteristics. Greater clarity is needed in defining relevant vendor and product characteristics. Eight measured domains of the market food environment emerged from the literature review, with significant overlap among conceptual domains. Measurement gaps exist for food quality, safety, packaging, desirability and convenience. Personal characteristics also emerged as measured domains, although these are not of the food environment, per se. Conclusions These results are a step towards elucidating how, why and where we measure the market food environment in LMICs. Future research should focus on prioritizing the most meaningful methods and metrics, and developing new measures where gaps exist.

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An Emergent Measurement Framework of the Market Food Environment in Low- and Middle-Income Countries (OR21-08-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.or21-08-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Djeinam Toure ◽

Mduduzi Mbuya ◽

Anna Herforth ◽

Gretel Pelto ◽

Lynnette Neufeld

Keyword(s):

Value Chain ◽

Food Environment ◽

Food Choice ◽

Food Systems ◽

Food Prices ◽

Middle Income ◽

Food Stores ◽

Middle Income Countries ◽

Measurement Framework ◽

Low And Middle Income

Abstract Objectives Food systems are increasingly recognized as critical to advancing better nutrition, with the food environment as the nexus between food systems and dietary consumption. Developing a robust measurement framework of the market food environment is a research priority particularly for low and middle income countries (LMIC), where market food environments are rapidly shifting, accompanied by shifts in diet patterns and nutrition outcomes. The objective of this work was to identify existing metrics of the food environment and develop a measurement framework that can be used to assess the outcomes of nutrition-sensitive, market-focused interventions in LMIC. Methods We conducted a narrative review of the food environment literature using targeted searches of peer-reviewed articles, agency websites, and bibliographies to identify measures of the food environment in current or recent use. First, we extracted 182 unique measures from and compiled them into a list. Second, a pile-sorting exercise was conducted online by 5 nutrition experts, selected for their expertise in food environment, ethnographic, food choice, and/or nutritious value chain research. Participants were asked to sort the measures into piles that belonged together and create a label for each pile. An in-depth debriefing was conducted with each sorter to obtain the reasoning for their sorts. We then categorized the results into emergent groups based on the percentage agreement of the assignment of individual items into the piles. Results Eight broad categories with at least 75% measure agreement emerged pertaining to both perceived and objective measures of the built/physical food environment. Etic measures included the availability of food stores, the availability and quality of foods within a store, food prices, and marketing. Emic (perception) measures included perceptions of access to food stores, perceptions of food availability and quality in stores, and affordability. Personal characteristics and values determining food choice also emerged; these are not measures of the food environment per se. Conclusions These results begin to outline a measurement framework for assessing the market food environment that can be adapted to LMIC. The next step will be to test the framework and evaluate its utility as a tool to further understanding around consumer food choices. Funding Sources GAIN.

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The effects of food systems interventions on food security and nutrition outcomes in low- and middle-income countries

10.23846/egm016 ◽

2021 ◽

Author(s):

Nick Moore ◽

◽

Charlotte Lane ◽

Ingunn Storhaug ◽

Amber Franich ◽

...

Keyword(s):

Food Security ◽

Food Systems ◽

Middle Income ◽

Middle Income Countries ◽

Food Security And Nutrition ◽

Low And Middle Income

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Reverse thinking: taking a healthy diet perspective towards food systems transformations

Food Security ◽

10.1007/s12571-021-01204-5 ◽

2021 ◽

Author(s):

I. D. Brouwer ◽

M. J. van Liere ◽

A. de Brauw ◽

P. Dominguez-Salas ◽

A. Herforth ◽

...

Keyword(s):

Food Environment ◽

Food Systems ◽

Food System ◽

Unintended Consequences ◽

Healthy Diet ◽

Middle Income ◽

Middle Income Countries ◽

Conflicting Objectives ◽

Healthy Diets ◽

Low And Middle Income

AbstractFood systems that deliver healthy diets without exceeding the planet’s resources are essential to achieve the worlds’ ambitious development goals. Healthy diets need to be safe, accessible, and affordable for all, including for disadvantaged and nutritionally vulnerable groups such as of smallholder producers, traders, and consumers in low- and middle-income countries. Globally, food systems are experiencing rapid and drastic changes and are failing to fulfil these multiple duties simultaneously. The international community therefore calls for rigorous food systems transformations and policy solutions to support the achievement of healthy diets for all. Most strategies, however, are essentially supply- and market-oriented. Incorporation of a healthy diet perspective in food system transformation is essential to enable food systems to deliver not only on supplying nutritious foods but also on ensuring that consumers have access can afford and desire healthy, sustainable, and culturally acceptable diets. This paper argues that this should be guided by information on diets, dietary trends, consumer motives, and food environment characteristics. Transformational approaches and policies should also take into account the stage of food system development requiring different strategies to ensure healthier diets for consumers. We review current knowledge on drivers of consumer choices at the individual and food environment level with special emphasis on low- and middle income countries, discuss the converging and conflicting objectives that exist among multiple food-system actors, and argue that failure to strengthen synergies and resolve trade-offs may lead to missed opportunities and benefits, or negative unintended consequences in food system outcomes. The paper proposes a menu of promising consumer- and food-environment- oriented policy options to include in the food systems transformation agenda in order to shift LMIC consumer demand towards healthier diets in low- and middle income countries.

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Vegetables for Healthy Diets in Low- and Middle-Income Countries: A Scoping Review of the Food Systems Literature

Food and Nutrition Bulletin ◽

10.1177/03795721211068652 ◽

2022 ◽

pp. 037957212110686

Author(s):

Jody Harris ◽

Winson Tan ◽

Jessica E. Raneri ◽

Pepijn Schreinemachers ◽

Anna Herforth

Keyword(s):

Scoping Review ◽

Low Income ◽

Food Systems ◽

Food System ◽

Food Group ◽

Middle Income ◽

Middle Income Countries ◽

Scoping Reviews ◽

Healthy Diets ◽

Low And Middle Income

Background: Vegetables are an essential element in healthy diets, but intakes are low around the world and there is a lack of systematic knowledge on how to improve diets through food system approaches. Methods: This scoping review assessed how studies of food systems for healthy diets have addressed the role of vegetables in low- and middle-income countries. We apply the PRISMA guidelines for scoping reviews to narratively map the literature to an accepted food systems framework and identify research gaps. Results: We found 1383 relevant articles, with increasing numbers over 20 years. Only 6% of articles looked at low-income countries, and 93% looked at single-country contexts. Over half of articles assessed vegetables as a food group, without looking at diversity within the food group. 15% looked at traditional vegetables. Issues of physical access to food were among the least studied food system topics in our review (7% of articles). Only 15% of articles used a comprehensive food system lens across multiple dimensions. There is also a research gap on the impacts of different policy and practice interventions (13% of articles) to enable greater vegetable consumption. Conclusions: Food system studies necessarily drew on multiple disciplines, methods and metrics to describe, analyze, and diagnose parts of the system. More work is needed across disciplines, across contexts, and across the food system, including understanding interventions and trade-offs, and impacts and change for diets particularly of marginalized population groups. Filling these gaps in knowledge is necessary in order to work toward healthy vegetable-rich diets for everyone everywhere.

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