Perspectives About Food Safety in Diverse Low- And Middle-Income Countries

Concerns about unsafe food influence food choice, and consumption of unsafe foods increases morbidity and mortality, particularly in low- and middle-income countries. Actions to ensure safety of food are dominated by mitigation of biological and chemical hazards through supply-side risk management, disregarding individuals’ experiences and perspectives of food safety. We aimed to identify and categorize perspectives about food safety in five countries. Five Drivers of Food Choice projects provided transcripts from 17 focus groups discussions and 303 interviews in Kenya, Ghana, India, Guinea, and Vietnam. We analyzed transcripts using a priori and emergent codes. Individuals constructed meaning about food safety through personal experience and social influences. Community and family members contributed knowledge about food safety. Concerns about food safety were influenced by reputations of and relationships with vendors. Concerns were amplified by mistrust of vendors’ purposeful adulteration or unsafe selling practices and new methods used to produce food. Individuals were reassured of food safety by positive relationships with vendors; homecooked meals; implementation of policies and regulations being followed; vendor adherence to environmental sanitation and food hygiene practices; cleanliness of vendors’ appearance; vendors’ or producers’ agency to use risk mitigation strategies; and transparency in production, processing, and distribution of food. Individuals’ perspectives about food safety influence food choices. The success of food-safety policies hinges on consideration of these perspectives in design and implementation

Development of a methods repository for food choice behaviors and drivers at the household and individual levels

This brief identifies important constructs for assessing drivers of food choice behaviors and describes progress on the development of a repository of instruments and measures for assessing these constructs. OBJECTIVES 1. List constructs that can be assessed to understand drivers of household and individual food choice behaviors. 2. Identify instruments and measures to assess each food choice construct and organize these into a searchable repository. 3. Illustrate the use of the Food Choice Repository

Integrated Child Nutrition, Parenting, and Health Intervention in Rural Liberia: A Mixed-Methods Feasibility Study

In Liberia, children are exposed to multiple forms of adversity which can negatively impact their health and development. Research is needed to examine the feasibility and benefits of integrated interventions that can be incorporated into existing health delivery programs to simultaneously address low responsive stimulation, undernutrition, and infection. This study assessed the feasibility of an integrated intervention promoting psychosocial stimulation and improved child feeding by the provision of eggs and fish. The integrated intervention was incorporated into an existing government health program. Thirty female caregiver-child dyads were randomly selected from two rural communities in Liberia. Participants received fortnightly group parenting sessions and weekly eggs and fish designated for child consumption, for four weeks. Trained community health workers delivered the intervention. Assessments were conducted before and after the intervention using quantitative surveys and qualitative interviews. At baseline, we examined the home environment, caregiver-child interactions, diet, and infection control practices. At endline, we assessed the feasibility of the intervention. Descriptive analyses were conducted with quantitative data. Qualitative data were analyzed using conventional content analysis. Baseline findings indicated uncommon responsive parenting, inadequate early learning opportunities, high food insecurity, and high child morbidity. Mixed methods indicators of feasibility, including acceptability, adoption, and fidelity were high. Qualitative data from this feasibility study informed several future modifications to the program, including engaging fathers, supplementing group sessions with home visits, and broadening facilitator eligibility. This integrated intervention is feasible and can be incorporated into existing health programs to support early child development

Determinants of egg consumption by infants and young children in Ethiopia

AbstractObjective:To identify determinants of egg consumption in infants and young children aged 6–23·9 months in Ethiopia.Design and setting:Data used were from the cross-sectional baseline survey of an egg campaign in Ethiopia implemented by the Global Alliance for Improved Nutrition.Participants:Children aged 6–23·9 months (n 453) were sampled. Data on socio-demographic characteristics, economic resources, caregiver’s behaviour, child health and feeding practices, and egg consumption in the last 7 d were collected using interviewer-administered questionnaires. Multivariable ordinal logistic regression was used to examine the association between explanatory variables and egg consumption in the last 7 d.Results:About half of children (53·4 %) did not consume eggs in the last 7 d. The odds of children consuming eggs were 4·33 (P &lt; 0·002) times higher when their caregivers had some college education compared with no education. Wealth was positively (OR, 1·13, P = 0·029) and household food insecurity was negatively (OR, 0·96, P = 0·117) associated with child egg consumption. Purchasing eggs (OR, 9·73, P &lt; 0·001) and caregiver’s positive behavioural determinants (OR, 1·37, P = 0·005) were associated with child egg consumption. The associations of socio-demographic characteristics and economic resources with egg consumption provide evidence of partial mediation through caregiver behaviour and child health.Conclusions:About half of children aged 6–23·9 months consumed eggs. Availability of eggs in households, mainly through purchase, was strongly associated with egg consumption. Education of caregivers and household heads and economic resources were associated with egg consumption and may operate through caregiver behaviour.</jats:sec