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The African urban food environment framework for creating healthy nutrition policy and interventions in urban Africa

Osei-Kwasi H.A., Laar A., Zotor F., Pradeilles R., Aryeetey R.N.O., Green M.A., Griffiths P., Akparibo R., Wanjohi M.N., Rousham E., Barnes A., Booth A., Mensah K., Asiki G., Kimani-Murage E.W., Bricas N., Holdsworth M.. 2021. PloS One, 16 (4) : 17 p..

DOI: 10.1371/journal.pone.0249621

This study developed, validated, and evaluated a framework of factors influencing dietary behaviours in urban African food environments, to inform research prioritisation and intervention development in Africa. A multi-component methodology, drawing on concept mapping, was employed to construct a framework of factors influencing dietary behaviours in urban Africa. The framework adapted a widely used socio-ecological model (developed in a high-income country context) and was developed using a mixed-methods research approach that comprised: i. Evidence synthesis consisting of a systematic review of 39 papers covering 14 African countries; ii. Qualitative interview data collected for adolescents and adults (n = 144) using photovoice in urban Ghana and Kenya; and iii. Consultation with interdisciplinary African experts (n = 71) from 27 countries, who contributed to at least one step of the framework (creation, validation/evaluation, finalisation). The final framework included 103 factors influencing dietary behaviours. Experts identified the factors influencing dietary behaviours across all the four levels of the food environment i.e. the individual, social, physical and macro levels. Nearly half (n = 48) were individual-level factors and just under a quarter (n = 26) were at the macro environmental level. Fewer factors associated with social (n = 15) and physical (14) environments were identified. At the macro level, the factors ranked as most important were food prices, cultural beliefs and seasonality. Factors ranked as important at the social level were household composition, family food habits and dietary practices. The type of food available in the neighbourhood and convenience were seen as important at the physical level, while individual food habits, food preferences and socioeconomic status were ranked highly at the individual level. About half of the factors (n = 54) overlap with those reported in an existing socio-ecological food environment framework develop

Mots-clés : alimentation humaine; comportement alimentaire; zone urbaine; politique nutritionnelle; politique alimentaire; nutrition humaine; alimentation saine; afrique; ghana; kenya; alimentation urbaine

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