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Food system transformation using diet quality as an entry point:
lessons for work on food environments
3 November 2020
Namukolo Covic (PhD)Senior research Coordinator
IFPRI/A4NH Addis Ababa, Ethiopia
Twitter handle: @NamukoloC
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Introduction: key messages
1. Share Ethiopia experience on developing FBDGs using diet
quality to identify entry points for food system transformation
2. Lessons for changes needed on food environments to support
better diet quality
3. Diet quality needs should be both and input and outcome of
food system transformation
Diet Quality
Food Supply
Food Environment
Nutrition outcomes
Health outcomes
Sustainability considerations
Consumer Environment
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58
51
44
38 37
0
10
20
30
40
50
60
70
2000 2005 2011 2016 2019
Stunting prevalence, children under 5 (%)
Stunting prevalence, children under 5 (%)
Adapted from EDHS, 2016 & 2019
There are multiple burdens of malnutrition in Ethiopia that the
food system must address
Micronutrient deficiencies highly prevalentVit A, zinc, folate,
B12, iodine
EPHI. 2016. National Micronutrient Survey Report
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In 2020, the cost of a nutritious diet continues to limit
accessibility for many. Not much fluctuation in relation to the
COVID-19 Progression but this may change.
The only National Food consumption survey available (2011)
reflects poor diet quality. Small studies since paint a similar
picture
EPHI & WFP, 2020
Diet quality is poor
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Diet quality is poor reflected by low proportion of children
6-23 months meeting MDD and MAD based on DHS reports
12
26
36
23 23
28
23
17
7
13
22
8 11
18
12 11
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5
10
15
20
25
30
35
40
45
50
Ethiopia Ghana Kenya Malawi Nigeria Rwanda Zambia Zimbabwe
Pro
po
rtio
n o
f ch
ildre
n m
eeti
ng
MD
D
MA
D, %
Arrows show the previous reported proportion and direction of
changeInconsistent progress is reflected, how can we do better?
MDD MAD20142018
20102016
20132015
20162018
20132015
20132018
20152019
United Nations Children’s Fund, Division of Data, Analysis,
Planning and Monitoring (2020). Global UNICEF Global Databases:
Infant and Young Child Feeding: Minimum diet diversity (MDD),
Minimum acceptable diet (MAD), Minimum meal frequency, New
York, July 2020.
314
24 34
2418
22
14
15 1710
8
47
4
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Anchoring and scaling
• Understand trends in diet transition and quality across
settings and population groups
• Need to develop Food-based dietary guidelines for diverse
settings
• Enhancing understanding of consumer behavior
• Understand the interactions between diet and food system
changes
• Predict changes and implications
• Assess and support on-going interventions & innovations
using a food systems and whole diet approach –Role of private and
public sector
• Tradeoffs and synergies • Design and test implementation
models that foster food system innovations that sustainably
enhance diet quality
• Develop capacity for food systems approaches
• Identify entry points for transitions to scale
• Engage multi-stakeholder platforms
Lessons on informing food system transformation: Ethiopia
1
2
3
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Factors in the urban food environments influences choices by
adolescents from two schools in Ethiopia
Main objective: to identify influencing factors of adolescents’
dietary choices in urban Ethiopia
A first study using Photovoice has been published here. A
research brief has been developed and is being translated in
Amharic for wider dissemination.
Main findings of the study:
• Participants had good knowledge on food safety and hygiene,
which did not translate into healthy food purchasing habits.
• Unhealthy and unsafe foods appeared to be more available
and/or cheap in their neighborhoods.
• Healthy foods were considered more expensive and associated
with closed shops as opposed to open markets.
Key lessons from food systems perspective: Concerns for food
safety and hygiene and perceptions of affordability seem to be the
dominating factor for adolescents’ food choices.
https://www.cambridge.org/core/services/aop-cambridge-core/content/view/174A74173A8B45FBB1644452CB6A42E9/S1368980020002487a.pdf/assessing_factors_influencing_adolescents_dietary_behaviours_in_urban_ethiopia_using_participatory_photography.pdf
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Challenges on drivers of food system change
Food supply systemsLimited production of nutrient dense
foods
Limited value chains for nutrient dense
foods & distribution challenges
Food processing limited primarily to
staples
Food retail & provisioning with limited diversity
Limited food environment
Consumer choices need to be better
understood
Poor diet
quality
We should work backwards from diet quality challenges to
identify entry points for the needed food system
transformations
Including for the food environment
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Anchoring and scaling
• Trends in diet transition and quality across settings and
population groups
• Food-based dietary guidelines for general population almost
complete
• Enhancing understanding of consumer behavior
• Better understanding of interactions between diet and food
system changes
• Predict changes and implications
• Assess and support on-going interventions & innovations
using a food systems and whole diet approach –Role of private and
public sector
• Tradeoffs and synergies • Design and test implementation
models that foster food system innovations that sustainably
enhance diet quality
• Enhanced capacity for food systems approaches and research
• Identified entry points for transitions to scale
• Engaging multi-stakeholder platforms
The themes highlighted in green are those that have or are being
addressed
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Key messages
1. We are using diet quality through the process of developing
FBDGs to identify entry points for food system transformation
2. It has been possible to identify challenges in the food
environments e.g. study with adolescents to support better diet
quality
3. Diet quality needs should be both and input and outcome of
food system transformation this could help address trade offs.
Diet Quality
Food Supply
Food Environment
Nutrition outcomes
Health outcomes
Sustainability considerations
Food Environment
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