scholarly journals An Emergent Measurement Framework of the Market Food Environment in Low- and Middle-Income Countries (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.

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

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.

scholarly journals Using a global food environment framework to understand relationships with food choice in diverse low- and middle-income countries

2021 ◽  
Vol 29 ◽  
pp. 100511
Author(s):  
Shilpa V. Constantinides ◽  
Christopher Turner ◽  
Edward A. Frongillo ◽  
Shiva Bhandari ◽  
Ligia I. Reyes ◽  
...  
Keyword(s):  
Food Environment ◽  
Food Choice ◽  
Middle Income ◽  
Middle Income Countries ◽  
Global Food ◽  
Low And Middle Income

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

Food Security ◽  
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.

scholarly journals Elaborating the science of food choice for rapidly changing food systems in low-and middle-income countries

2021 ◽  
Vol 28 ◽  
pp. 100503
Author(s):  
Christine E. Blake ◽  
Edward A. Frongillo ◽  
Andrea M. Warren ◽  
Shilpa V. Constantinides ◽  
Krystal K. Rampalli ◽  
...  
Keyword(s):  
Food Choice ◽  
Food Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals The how tough is WASH framework for assessing the climate resilience of water and sanitation

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Guy Howard ◽  
Anisha Nijhawan ◽  
Adrian Flint ◽  
Manish Baidya ◽  
Maria Pregnolato ◽  
...  
Keyword(s):  
Climate Change ◽  
Rural Communities ◽  
Universal Access ◽  
Small Towns ◽  
Water And Sanitation ◽  
Middle Income ◽  
Sanitation Services ◽  
Middle Income Countries ◽  
Measurement Framework ◽  
Low And Middle Income

AbstractClimate change presents a major threat to water and sanitation services. There is an urgent need to understand and improve resilience, particularly in rural communities and small towns in low- and middle-income countries that already struggle to provide universal access to services and face increasing threats from climate change. To date, there is a lack of a simple framework to assess the resilience of water and sanitation services which hinders the development of strategies to improve services. An interdisciplinary team of engineers and environmental and social scientists were brought together to investigate the development of a resilience measurement framework for use in low- and middle-income countries. Six domains of interest were identified based on a literature review, expert opinion, and limited field assessments in two countries. A scoring system using a Likert scale is proposed to assess the resilience of services and allow analysis at local and national levels to support improvements in individual supplies, identifying systematic faults, and support prioritisation for action. This is a simple, multi-dimensional framework for assessing the resilience of rural and small-town water and sanitation services in LMICs. The framework is being further tested in Nepal and Ethiopia and future results will be reported on its application.

scholarly journals Effect of Food Environment Interventions on Anthropometric Outcomes in School-Aged Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Bianca Carducci ◽  
Christina Oh ◽  
Emily C Keats ◽  
Daniel E Roth ◽  
Zulfiqar A Bhutta
Keyword(s):  
Health Outcomes ◽  
Food Environment ◽  
Cochrane Library ◽  
Free Text ◽  
Environmental Interventions ◽  
Middle Income ◽  
Middle Income Countries ◽  
School Aged Children ◽  
The Impact ◽  
Low And Middle Income

ABSTRACT Food environments may promote access to unhealthy foods, contributing to noncommunicable diseases in low- and middle- income countries (LMICs). This review assessed published evidence on the effects of food environment interventions on anthropometric (BMI and weight status) outcomes in school-aged children (5–9 y) and adolescents (10–19 y) (SACA) in LMICs. We summarized randomized controlled trials (RCTs) and quasi-experimental studies (QES) published since 2000 to August 2019 in the peer-reviewed and gray literature that assessed the effects of food-related behavioral and environmental interventions on diet-related health outcomes in SACA in LMICs. Electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Library) were searched using appropriate keywords, Medical Subject Headings, and free text terms. Eleven RCTs and 6 QES met the inclusion criteria, testing multicomponent behavioral and environmental interventions in schools. Analysis of 6 RCTs (n  = 17,054) suggested an overall effect on change in BMI [mean difference (MD): −0.11, 95% CI: −0.19 , −0.03], whereas there was no observed effect in 5 studies using endline BMI (n  = 17,371) (MD: 0.05, 95% CI: −0.32, 0.21). There was no significant pooled effect among the 3 QES (n  = 5,023) that reported differences in change in BMI or endline (MD: −0.37, 95% CI: −0.95, 0.22). There is limited evidence to support the modification of diet-related health outcomes through school-based food environment interventions in SACA in LMICs. Further studies are needed to understand the impact of school and community-based food environment interventions on nutritional status in this population.

scholarly journals The Importance of a Food Systems Approach to Low and Middle Income Countries and Emerging Economies: A Review of Theories and Its Relevance for Disease Control and Malnutrition

2021 ◽  
Vol 5 ◽  
Author(s):  
Pablo Alarcon ◽  
Paula Dominguez-Salas ◽  
Eric M. Fèvre ◽  
Jonathan Rushton
Keyword(s):  
Public Health ◽  
Food Safety ◽  
Emerging Economies ◽  
Food Systems ◽  
Food System ◽  
Systems Science ◽  
Multidisciplinary Teams ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

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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