Household food safety, dietary diversity and malnutrition in an urban context: Evidence from urban Ghana

Abstract

Food safety, dietary diversity and malnutrition are significant issues confronting urban households. A nutrition and epidemiological transition is occurring in developing countries, leading to a double burden of malnutrition (DBM) and disease. Due to time constraints urban dwellers face, convenience motives drive households’ decisions when allocating time for domestic activities, including food consumption and cooking. Their food consumption decisions manifest in behaviours like where they purchase their food, dietary diversity and time spent cooking. Thus, relying on primary and secondary data from Ghana, this study addresses three critical questions in three analytical chapters. <br /> The first analytical chapter applied Structural Equation Models (SEM) to address the effect of food safety and nutrition knowledge on urban households’ food purchasing and cooking behaviour. The results show that although households have some food safety knowledge, it did not translate into appropriate food safety cooking practices. Furthermore, convenience was the primary consideration for urban households in choosing food markets, not food safety. Additionally, most urban households purchased from traditional open-air markets, and supermarket patronage was very low, especially for raw and fresh foodstuffs. We conclude that food safety is a public good, and market failure inhibits its efficient delivery; therefore, public policy and government regulations are required to ensure households are guaranteed safe foods. <br /> In the second analytical chapter, we used two rounds of equal panel household data, fixed effects Poisson and Correlated Random Effects (CRE) Probit models to estimate the effect of weather seasonality on urban households’ food safety (incidence of diarrhoea/vomiting), dietary diversity and food expenditure. The results show that food safety is a challenge, and the higher food price of staples positively correlates with the incidence of diarrhoea/vomiting. Some raw foodstuffs tested positive for foodborne pathogens like E. coli, Staphylococcus aureus and aflatoxins. However, we did not find the effect of seasonality on household dietary diversity score (HDDS) and food expenditure per capita to be significant among sampled urban households. <br /> The final analytical chapter shows the results of the effect of cooking time on household DBM in urban Ghana. We used the three rounds of the Ghana Socioeconomic Panel Survey (GSPS) data and estimated the results using the Cragg hurdle and CRE Probit models. The results show the existence of household DBM in urban Ghana. The most common form of household DBM is an “overweight/obese woman and a stunted child”. Households’ cooking time has plateaued, although men are increasing their cooking time. Women are the primary food handlers, but women who are employees spend less time cooking than those who are not. Unlike cooking time, household size and wealth status positively affected DBM. Household DBM is complex and the result of multiple factors. Our analysis suggests that factors like cooking time should be assessed in an encompassing context of household structure and consumption patterns. <br /> The study concludes that urban households face systemic food safety issues from the food markets they patronise. However, convenience considerations supersede concerns about food safety; therefore, although households have sufficient knowledge and attitude towards food safety, they only sometimes translate it into appropriate purchasing and cooking practices/behaviour. Households also suffer from DBM, and cooking time has plateaued, but cooking time does not affect many forms of household DBM. Therefore, cooking time only does not guarantee healthy eating outcomes. Therefore, we recommend that the government strengthen policies and regulations on producing and retailing foods to promote compliance by food retailers and households. Also, promote household consumption of nutrient-dense meals so all members can meet their dietary requirements.