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Nutritious food procurement in cities in low and middle income countries

  • Published on March 9, 2022

This paper presents two case studies from cities in LMIC settings to explore enabling factors for and barriers to nutritious food procurement: the city-run Students Feeding Agency in Addis Ababa, Ethiopia and Sassoon General Hospital Meal Programme in Pune, India. The Addis Ababa City Administration Students Feeding Agency aims to address undernutrition and improve educational outcomes by feeding all 351,000 public school students from preschool to eighth grade. The Agency also provides uniforms, books, and menstrual pads. The Sassoon General Hospital programme, run by a state-run hospital with 1,400 inpatient beds, provides medically tailored meals for all admitted patients. The programme helps support patient recovery and reduces pressure on families to bring outside food to hospitalised family members. Both programmes are important examples for their respective urban areas and beyond, as both Addis Ababa and Pune are increasingly facing challenges relating to rapid urbanisation and the double burden of malnutrition.

Malnutrition in all its forms is a major public health challenge and remains unacceptably common, especially in low- and middle-income countries (LMICs). Most LMICs are experiencing the double burden of malnutrition: the coexistence of undernutrition along with overweight and obesity. Public food procurement may be one option for addressing these issues. Governments can use procurement to support and stabilise agricultural markets. For example, the governments of Bangladesh and India purchase rice and wheat at guaranteed prices, and provide these staples to poor households. Nutritious food procurement can also address hospital malnutrition. Hospital care can cause or exacerbate malnutrition due to illness-related malnutrition (e.g., infection-related metabolic changes), loss of appetite and changes in taste, swallowing disorders, gastrointestinal symptoms like nausea, social isolation and mental illness, poor dental health, financial barriers, and timing issues with medical procedures or food getting cold by the time it reaches the patient. Hospital malnutrition increases hospital stay length, readmission likelihood, healthcare costs, and likelihood of death after hospitalisation. Policymakers are increasingly recognising nutritious food procurement as an opportunity to address malnutrition. This working paper helps contribute to share experiences and best practices by presenting two qualitative case studies of programmes in Addis Ababa, Ethiopia and Pune, India and discussing both some of their challenges and factors that helped enable them to succeed.

Supporting document(s)

13.NUTRITIOUS food procurement in cities in low and middle income countries.pdf
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