Februray 13, 2025

This blogpost is a reproduction of the abstract of a paper based on FoSTA-Health research being conducted by Peter Yiga, Pui Yee Tan, Stephen Whitfield, Yun Yun Gong (University of Leeds); Christian Chomba (ACF Zambia), Andrea Menefee, Patrick Kalenga, Caitlin Shannon (Care International Zambia and USA), Tabita Mfune (University of Zambia) 

The food environment in Zambia is increasingly becoming obesogenic. This is mainly a result of  lack of cross-sectoral policies, and a lack of explicit regulations to manage transitions in the food systems. The current policy landscape and perception among policy makers is to focus on bottom-up approaches, to force the industry into fundamental changes. This needs to be combined with top-down approaches, involving dialogue on key issues with the food industry.

Background

Zambia is experiencing a nutrition transition potentially due to the ongoing changes in food environments. The study aimed to explore policy makers’ perception of the food environment in Zambia,  understand the policy context associated with the ongoing transformations and identify potential opportunities to optimise the food environment.

Method

18 key informant interviews were conducted with policy makers in Zambia during February-March 2024. An interview guide was developed on the basis of the food environment framework(1) comprising four dimensions including availability, accessibility, marketing, and social cultural influences. For each dimension, transitions, and existing/potential policies were explored. Interviews were transcribed verbatim and analysed thematically.

Results

Across urban and rural contexts in Zambia, policy makers perceived two different trends that are happening in parallel; rural communities were understood to be eating an increasingly monotonous, maize-based diet, whilst aspiring to transition to unhealthy western dietary trends. In urban contexts, there was a perceived transition towards diets characterised by fast foods and a limited variety of vegetables  and fruits being consumed among the middle class, whilst monotonous maize-based diets and unhealthy street fast foods are being consumed by the urban poor. Across both settings, a switch from unrefined to refined maize meal, and a dependence on soya pieces was highlighted.

These transitions were attributed to an increasingly obesogenic food environment. An increased availability of unhealthy fast foods due to mushrooming fast food chains, coupled with persistently limited diversity and affordability of healthy foods, particularly, fruits was observed. In terms of food accessibility, there is an emerging prominence of supermarkets with unhealthy offers and limited fresh foods. Aggressive unhealthier food marketing (through billboards in key locations, supermarket placements, social media, enticing packaging, TV prime time and celebrities) targeting mostly  children has increased.

Wet markets are still the main source for fresh foods but suffer infrastructural deficits and related food safety challenges. 

Agricultural policies prioritising maize and recently soybeans plus supportive investment economic policies towards the food industry without explicit regulations also contribute to the obesogenic food environment. Other problematic policies include the vitamin A fortification of sugar (indirectly promoting sugar consumption) and the prioritisation of production of exotic foods for export (decreased attention to indigenous foods). Generally, well-coordinated policy strategies aimed at promoting healthier dietary transitions is missing. One noticeable positive contribution is being made through nutrition education using food based dietary guidelines(2, 3), though this has limited effectiveness without other food environment interventions.

Opportunities which could be explored to support a healthier food environment include public-private partnerships to incentivise healthier foods production across the entire food chain, zoning policies limiting establishing and advertising unhealthy foods around schools, and integrating food based dietary guidelines in school curricula.

Participants also proposed strategies such as adopting easy to understand food labels (traffic system), nudging guidelines encouraging supermarkets to include seasonal indigenous and healthier options in prominent locations, and government led procurement preconditions to promote healthier indigenous foods in school canteens and public events, as well as investing in  infrastructure improvements and re-organisation of wet markets.

Current political attention to a potential NCD epidemic and existing public-private platforms like Nutrition Business Network(4) and the Lusaka Food Policy Platform(5) led by WFP and Consumer Unit Trust respectively are noted as key facilitators for improving food environments in Zambia.  The private sector is viewed as having an important role, hence positive and timely dialogue between government and industry must be established. Likewise, multisectoral platforms to visualise cross-sectoral policy externalities is needed.

Conclusion

The food environment in Zambia is increasingly becoming obesogenic, attributable to negative externalities resulting from the lack of cross-sectoral policies coupled with limited explicit regulations to manage the transitions. The current policy landscape and perception among policy makers is to focus on bottom-up approaches, to force the industry into fundamental changes. However, a combination of bottom-up and top-down approaches encompassing key dialogues with the food industry are needed.

References

• Turner C, Aggarwal A, Walls H et al. (2018) Concepts and critical perspectives for food environment research: a global framework with implications for action in low-and middleincome countries.  Global food security 18, 93-101.
• National Food and Nutrition Commission WFP (2023) Report for the review of the healthy diets  campaign in Zambia.
• Ministry of Agriculture Zambia FaAO (2021) Zambia Food-Based Dietary Guidelines Technical Recommendations.
• https://sunbusinessnetwork.org/national_pages/zambia/.
• https://cuts-lusaka.org/pdf/policy-brief-the-lusaka-food-security-initiative.pdf