Influence of poverty concerns on demand for healthier processed foods: A field experiment in Mexico City

Living in poverty can present cognitive biases that exacerbate constraints to achieving healthier diets. Better diets could imply food choice upgrades within certain food categories, such as electing processed foods with an improved nutritional profile. This study evaluated the influence of monetary and health concerns on the willingness to pay (WTP) for healthier processed foods in a low-income section of Mexico City. We employed priming techniques from the scarcity literature, which are applied for the first time to healthier food purchasing behaviours in low-income settings. Our predictions are based on a dual system framework, with choices resulting from the interaction of deliberative and affective aspects. The WTP was elicited through a BDM mechanism with 423 participants. Results showed that induced poverty concerns reduced the valuations of one of the study's healthier food varieties by 0.17 standard deviations. The latter effect did not differ by income level. The WTP for a healthier bread product but one with relatively high sugar and fat content was reduced by induced poverty concerns only among certain consumers without bread purchasing restrictions (78% of the sample). Potential mechanisms were assessed through regression analysis and structural equation modelling. The relationship between poverty concerns and WTP was mediated by increased levels of stress. While we could not rule out impact on cognitive load, it was not deemed a mediator in this study. Our findings signal that improvements in economic and psychological well-being among low-income consumers may aid to increase their demand for healthier processed foods.

Changes in women's empowerment in the household, women's diet diversity, and their relationship against the background of COVID-19 in southern Bangladesh

The COVID-19 pandemic in Bangladesh, associated public health measures, and people's reactions were projected to have caused job losses among women, a decline in women's empowerment and reduced women's diet diversity. Using a November 2020 telephone survey to re-interview adult female respondents of a November 2019 in-person survey, contrary to expectations we find that more women found than lost jobs, and women's diet diversity increased over the year partly marked by the COVID-19 pandemic. We did not find evidence of a decline in women's involvement in food purchase decisions, nor women's autonomy over use of household income. The change in women's outside employment is neither statistically related to changes in women's involvement in food purchase decisions, changes women's autonomy over use of household income, nor changes in women's diet diversity. Change in women's involvement in food purchase decisions is positively related with change in women's diet diversity and change in women's autonomy over income use is negatively related with change in women's diet diversity.

Sweet or not: Using information and cognitive dissonance to nudge children toward healthier food choices

In the interest of public health, it is important to nudge children toward healthier food choices (e.g., beverages with less added sugar). We conducted a field experiment in a peri-urban region in Vietnam to evaluate the effects of information and cognitive dissonance on the food choices of children. Our sample consisted of more than 1200 primary school children, randomly assigned into three groups: control, health information, and health information plus hypocrisy inducement. The third group was intended to raise cognitive dissonance by illustrating the gap between what people know they should do (socially desired behaviors) and what they actually do (transgressions). The results indicate that health information increased the likelihood of selecting milk with less sugar by around 30 %, as compared to the control group. Hypocrisy inducement did not make any additional contribution to healthier food choices. The treatment effects declined when there was a delay between the treatment and the behavioral choice. We discuss the practical implications of our findings for short-term intervention field studies.

Identifying effective message-framing techniques in behaviour change communication for healthy diets: An experimental study of promoting biofortified maize adoption in Ethiopia

There is an increasing interest in using insights from behavioural economics and psychology to influence people's decisions. However, little is known as to how to leverage these insights to inform educational campaigns in the context of nutrition-sensitive agriculture. We help to fill this void by investigating the effect of framed messages (gain vs loss) in stimulating demand for nutritionally enhanced crops. We conducted a field experiment with 648 farmers and found the following key results. First, nutrition education stimulates demand for nutritionally enhanced crops among smallholder farmers. Without nutrition education, farmers are less likely to switch from producing conventional maize to nutritionally enhanced maize. Second, gain-framed messages are slightly more effective: they result in a higher willingness to pay for nutritionally enhanced maize than loss-framed messages. Third, motivational orientations and risk perceptions of individuals moderate the effect of the framed messages.

Improving Food Systems: A Participatory Consultation Exercise to Determine Priority Research and Action Areas in Viet Nam

With increased burden of malnutrition on global health, there is a need to set clear and transparent priorities for action in food systems at a global and local level. While priority settings methods are available for several adjacent domains, such as nutrition and health policies, setting priorities for food system research has not been documented and streamlined. The challenges involve food systems' multisector, multi-stakeholder and multi-outcome nature. Where data exists, it is not easy to aggregate data from across food system dimensions and stakeholders to make an informed analysis of the overall picture of the food system, as well as current and potential food system trade-offs to inform research and policy. Once research priorities are set, they risk staying on paper and never make their ways to concrete outputs and outcomes. In this paper, we documented and assessed the inclusive process of setting research priorities for a local food system, taking Vietnamese food systems as a case study. From this exercise, we examined how priority setting for food systems research could learn from and improve upon earlier priority setting research practices in other domains. We discussed the lessons for research and policies in local food systems, such as the need for a concrete follow-up plan accompanying the priority setting process.

Consumer Nutrition Knowledge and Dietary Behavior in Urban Ethiopia: A Comprehensive Study

This paper studies the association between nutrition knowledge and consumer dietary behavior using large survey data from 996 respondents in Addis Ababa, Ethiopia. We find that health was the most important factor in individuals' food choice. However, most consumers were found to have imperfect understanding of the link between food and health. Especially, the causes and consequences of obesity were poorly understood. A considerable proportion of respondents also endorsed harmful food taboos. We found that nutrition knowledge was positively associated with more diversified diets and healthy eating attitudes and practices. Individuals with higher levels of nutrition knowledge were also more likely to reject harmful food taboos.

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

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.

A qualitative exploration of the experiences of community health animation on malaria control in rural Malawi

BACKGROUND

While great strides have been achieved in fighting malaria through the Roll Back Malaria (RBM) strategy, the recent world malaria report shows an increase in malaria-related deaths compared to previous years. Malaria control tools are efficacious and effective in preventing the disease; however, the human behaviour aspect of the intervention strategies is weak due to heavy reliance on positive human health behaviour. The challenge lies in adoption of control interventions by the target population which, to an extent, may include access to prevention and treatment tools. We present a qualitative assessment of the use of the Health Animator (HA) model for Information, Education and Communication (IEC) to improve adoption and use of malaria control by promoting positive health behaviours.

RESULTS

We conducted 3 Focus Group Discussions (FGDs) and 23 individual in-depth interviews (IDIs) with HAs. Each FGD consisted of 8 participants. Data was analysed using QSR International NVivo 10 software. There are four main themes emerging regarding HA experiences. The perceptions include; collaborative work experience, personal motivation and growth, community participation with health animation and challenges with implementation. Results suggest that HAs were pleased with the training as they gained new information regarding malaria, which affected their use of malaria control interventions within their families. Knowledge was well assimilated from the trainings and influenced personal growth in becoming a community leader. Support from the leadership within the village and the health system was important in legitimising the main messages. The community responded positively to the workshops valued the information imparted. The voluntary nature of the work in a poverty-stricken community affected sustainability.

CONCLUSIONS

There is need to empower communities with strategies within their reach. Functioning traditional social support structures are a crucial element in sustainability. Voluntarism is also key for sustainability, especially for rural and remote communities with limited sources of income.