Julia de Bruyn

Pumpkin holds significant potential to improve food security, nutrition, and economic development in sub-Saharan Africa, yet is one of many neglected and underutilized crop species which has received limited attention from researchers and policymakers. This scoping review synthesizes findings from 44 peer-reviewed and grey literature sources across multiple disciplines to appraise the state of research on pumpkin within sub-Saharan African food systems. It explores value chain dynamics, dimensions of the food environment, consumer behaviour, and policy factors, alongside outcomes for nutrition, health, economic development, environmental sustainability, and social equity. The evidence base is geographically concentrated – with 41 studies (93%) having a single-country focus and the majority conducted in Ethiopia, Kenya, and South Africa—and shows limited methodological diversity, with 33 (75%) employing cross-sectional observational designs. Fifteen documents examined value chain activities, 18 focused on consumer behaviour, and 37 provided insights into external and personal dimensions of the food environment – although none explicitly applied a food environment framework. Most studies centred on consumers and the use of pumpkin leaves and fruit. Production was the most frequently analysed value chain component, with other areas significantly underexplored. Insights on vendors, processors, and policymakers were largely absent, as were urban and peri-urban contexts. Of food environment dimensions, findings on availability, product properties, and desirability were most common. Evidence on outcomes of pumpkin production, value chain participation, and consumption remains limited: with a primary focus on social equity and food and nutrition security. Our review identifies the need for an interdisciplinary, systems-oriented approach in future research, covering the entire value chain and incorporating gender, market, and policy dimensions. Collated evidence supports the need for targeted interventions to improve processing, enhance food safety, shift cultural perceptions, and strengthen governance mechanisms, for pumpkin to contribute more substantially to resilient, equitable African food systems.

The safety of fresh food is a serious concern across sub-Saharan Africa. Stronger incentives are needed to stimulate market retailers to adopt more hygienic practices and to drive improvements in fresh produce market infrastructure. A price premium for safe produce could incentivize retailers to do this, but it is unknown if shoppers would accept a higher price. The objective of this study was to evaluate the demand for safer vegetables among urban consumers in Africa. The Becker–DeGroot–Marschak (BDM) method was used to conduct a non-hypothetical experimental auction with 417 randomly selected shoppers in five fresh produce markets in Kisumu, Kenya. Shoppers chose between two bundles of mixed African leafy vegetables: (1) whole, unpackaged, and (2) minimally processed vegetables – washed, plucked, and packaged; and two food safety conditions: (3) conventional handling practices in a traditional stall, and (4) hygienic handling in an improved stall based on government guidelines. The results show that shoppers are willing to pay about 24% more for whole vegetables from clean stalls and about 26% more for minimally processed vegetables. Plucked vegetables pose a higher food safety risk than whole vegetables, but wealthier, time-constrained shoppers opt for them for convenience. These findings indicate that urban shoppers in Kenya attach value to the safety of fresh produce. Retailers can command higher prices by enhancing stall hygiene, but external support will be needed to upgrade retail market infrastructure.

Background: Progress on maternal health in low- and middle-income countries (LMICs) has stagnated, underscoring calls for holistic approaches to improve women’s nutrition. Diets link human health and environmental sustainability, necessitating equitable food system transformations to address climate change and malnutrition in all its forms. Food environments are a key entry point within food systems for improving nutrition; however, existing frameworks are not gender-sensitive and few consider vulnerable groups in low-resource settings. Methods: We conducted a systematic scoping review of peer-reviewed literature published in English, Spanish, Portuguese, and French from Web of Science, EBSCO, and PubMed to identify determinants of food acquisition practices and dietary intakes of women of reproductive age in LMICs. We synthesised 518 studies from 125 countries. By systematically identifying 143 eco-social, structural and individual-level determinants, we identified key determinants to develop an empirically grounded food environment conceptual framework for women. Findings: We identified women’s agency, characterised by decision-making and financial autonomy, bargaining power, control over time, and freedom of movement, as a prominent mediator of women’s food acquisition and dietary intakes, including across regions and the rural-urban continuum. Findings indicate that women’s agency, alongside supportive legislative, structural, and social enabling environments will be critical leverage points for improving women’s access to and consumption of nutritious foods, especially where resources are constrained. Conclusion: For countries to sustainably address malnutrition, this empirically grounded framework identifies pathways for addressing the macro, social and individual determinants of food acquisition and dietary intakes that are often overlooked yet critical for resilient food environments and sustainable development. Key messages: This is the first study to provide an empirically grounded food environment conceptual framework specific to women in LMICs. By systematically mapping key determinants of women’s food acquisition and dietary intakes, we identified novel food environment dimensions to develop an empirically grounded framework for women with applicability across regions and the rural-urban continuum in low- and middle-income countries. This novel conceptual framework, emphasising the importance of women’s agency in relation to external and personal food environments, may be used to guide research needs, analyses, and entry points for interventions to sustainably improve women’s nutrition in LMICs, especially in resource-constrained settings. Research in context: Evidence before this study: Women in low- and middle-income countries (LMICs) are disproportionally affected by malnutrition in all its forms. Food environments are a key food system entry point to improve nutrition. However, current food environment frameworks are not gender-sensitive, limiting the effectiveness of nutrition interventions. We systematically searched Web of Science Core Collection, EBSCO, and PubMed for peer-reviewed studies published between 1 ^st January 2010 and 30 ^th April 2023 in English, Spanish, Portuguese, and French reporting on determinants of women’s food acquisition practices and dietary intakes in LMICs. We used a broad search criterion based on emerging food environment concepts and the expanded food security definition. Data were extracted for women aged 15-49 years and by physiological status (pregnant, lactating, and non-pregnant/non-lactating). Added value of this study: This is the first study to provide an empirically grounded food environment conceptual framework specific to women in LMICs. By mapping patterns of 143 determinants inductively derived from the literature against existing conceptual frameworks, we identified novel determinants of women’s food acquisition and dietary intakes. Our results are representative across multiple geographical regions and the rural-urban continuum in LMICs. We add a novel socio-ecological layer: women’s agency as a key mediator for the ability of an individual to exert control over resources contributing to one’s own dietary outcomes. Implications of all the available evidence: Women’s food environments are complex, necessitating holistic systems approaches to sustainably improve women’s nutrition in LMICs. It is critical that policies and programmes address underlying legislative, structural and socio-cultural determinants mediating women’s agency, alongside other key external and personal food environment determinants influencing procurement and consumption of nutritious diets. This novel empirically grounded conceptual framework can guide future research priorities, analytical approaches, and key intervention points to optimise women’s nutrition.

Recent years have seen growing concern about the ‘hollowing out’ of the middle class, due to processes of polarisation. In this paper, we examine different conceptualisations of polarisation, and introduce the concept of expenditure-adjusted polarisation that considers not only income, but also various key categories of expenditure at a household level: housing, groceries and meals, transport and energy. Analysing longitudinal data from the Household, Income and Labour Dynamics in Australia Survey, we show that the Australian society is significantly more polarised, with fewer middle-income households, when the relative size of income groups in a given year is based on expenditure-adjusted income rather than pre-expenditure income. Such polarisation is particularly prominent when housing expenditure is considered and has distinctive spatial patterns. In contrast, our analysis finds no evidence of a temporal pattern of polarisation in Australia between 2005 and 2019, with no substantial change in the size of income groups over time, regardless of which income measures are used. We argue that a more nuanced conceptualisation of polarisation, and its relation to processes of ‘hollowing out’ and rising inequality, is needed to inform urban scholarship and policy.

Effective actions for the fishery and aquaculture sectors to contribute toward improving nutrition rely on an understanding of the factors influencing fish intake, particularly amongst vulnerable populations. This scoping review synthesises evidence from 33 studies in the African Great Lakes Region to examine the influence of food environments on fish acquisition and consumption. We identified only two studies that explicitly applied a food environment framework and none that linked policy conditions with the contribution of fish to diets. Economic access to fish was represented in the largest number of included studies (21 studies), followed by preferences, acceptability and desirability of fish (17 studies) and availability and physical access (14 studies). Positive perceptions of taste and low cost, relative to other animal-source foods, were drivers of fish purchases in many settings; however, limited physical and economic access were frequently identified as preventing optimal intake. In lakeside communities, fish were increasingly directed toward external markets which reduced the availability and affordability of fish for local households. Few studies considered intra-household variations in fish access according to age, gender or physiological status, which represents an important knowledge gap. There is also scope for future research on seasonal influences on fish access and the design and rigorous evaluation of programmes and policies that address one or more constraints of availability, cost, convenience and preferences.

Innovative methods to collect dietary data at multiple times across the year are needed to better understand seasonal or temporal changes in household diets and measure the impact of nutrition-sensitive agricultural programmes in low-income countries. The present study aims to validate a picture-based research tool for participants to self-record their household’s dietary diversity each month in villages of Manyoni District, Tanzania. Pictorial record charts were developed to reflect local food resources. In 113 randomly selected households, the person responsible for food preparation was trained to mark all items consumed by any household member within the home, or prepared for consumption outside the home, for a single recording day. The next day, an interview-based household 24-h food recall (H24HR) was collected for the same period. Separate analyses tested agreement (a) between picture charts and H24HR and (b) between H24HR following chart completion and on an alternative day. Concordance between methods differed between food groups and items but was high to very high for all cereals, vegetables, pulses, legumes and nuts and almost all fruits. Recording of ten items (including non-cultivated fruits and ingredients of mixed dishes) differed significantly between H24HR assessments, all of which were reported by more households in interviews following chart completion. Results suggest potential for visual prompts and the contemporaneous nature of data collection to improve the accuracy of interview-based recall. With adequate investment in developing and implementing context-adapted tools, pictorial charts may also offer an effective standalone method for use at multiple time-points in agricultural programmes.

There is substantial current interest in linkages between livestock-keeping and human nutrition in resource-poor settings. These may include benefits of improved diet quality, through animal-source food consumption and nutritious food purchases using livestock-derived income, and hazards of infectious disease or environmental enteric dysfunction associated with exposure to livestock feces. Particular concerns center on free-roaming chickens, given their proximity to children in rural settings, but findings to date have been inconclusive. This longitudinal study of 503 households with a child under 24 months at enrolment was conducted in villages of Manyoni District, Tanzania between May 2014, and May 2016. Questionnaires encompassed demographic characteristics, assets, livestock ownership, chicken housing practices, maternal education, water and sanitation, and dietary diversity. Twice-monthly household visits provided information on chicken numbers, breastfeeding and child diarrhea, and anthropometry was collected six-monthly. Multivariable mixed model analyses evaluated associations between demographic, socioeconomic and livestock-associated variables and (a) maternal and child diets, (b) children’s height-for-age and (c) children’s diarrhea frequency. Alongside modest contributions of chicken-keeping to some improved dietary outcomes, this study importantly (and of substantial practical significance if confirmed) found no indication of a heightened risk of stunting or greater frequency of diarrhea being associated with chicken-keeping or the practice of keeping chickens within human dwellings overnight.

Newcastle disease (ND) is a viral disease of poultry with global importance, responsible for the loss of a potential source of household nutrition and economic livelihood in many low-income food-deficit countries. Periodic outbreaks of this endemic disease result in high mortality amongst free-ranging chicken flocks and may serve as a disincentive for rural households to invest time or resources in poultry-keeping. Sustainable ND control can be achieved through vaccination using a thermotolerant vaccine administered via eyedrop by trained “community vaccinators”. This article evaluates the uptake and outcomes of fee-for-service ND vaccination programs in eight rural villages in the semi-arid central zone of Tanzania. It represents part of an interdisciplinary program seeking to address chronic undernutrition in children through improvements to existing poultry and crop systems. Newcastle disease vaccination uptake was found to vary substantially across communities and seasons, with a significantly higher level of vaccination amongst households participating in a longitudinal study of children’s growth compared with non-participating households (p = 0.009). Two multivariable model analyses were used to explore associations between vaccination and chicken numbers, allowing for clustered data and socioeconomic and cultural variation amongst the population. Results demonstrated that both (a) households that undertook ND vaccination had a significantly larger chicken flock size in the period between that vaccination campaign and the next compared with those that did not vaccinate (p = 0.018); and (b) households with larger chicken flocks at the time of vaccination were significantly more likely to participate in vaccination programs (p < 0.001). Additionally, households vaccinating in all three vaccination campaigns held over 12 months were identified to have significantly larger chicken flocks at the end of this period (p < 0.001). Opportunities to understand causality and complexity through quantitative analyses are limited, and there is a role for qualitative approaches to explore decisions made by poultry-keeping households and the motivations, challenges and priorities of community vaccinators. Evidence of a bi-directional relationship, however, whereby vaccination leads to greater chicken numbers, and larger flocks are more likely to be vaccinated, offers useful insights into the efficacy of fee-for-service animal health programs. This article concludes that attention should be focused on ways of supporting the participation of vulnerable households in ND vaccination campaigns, and encouraging regular vaccination throughout the year, as a pathway to strengthen food security, promote resilience and contribute to improved human nutrition.

Suboptimal breastfeeding practices, early initiation of complementary feeding, and monotonous cereal‐based diets have been implicated as contributors to continuing high rates of child undernutrition in sub‐Saharan Africa. Nutrition‐sensitive interventions, including agricultural programs that increase access to nutrient‐rich vegetables, legumes, and animal‐source foods, have the potential to achieve sustainable improvements in children's diets. In the quest to evaluate the efficacy of such programs in improving growth and development in the first 2 years of life, there is a role for mixed methods research to better understand existing infant and young child feeding practices. This analysis forms part of a longitudinal study assessing the impact of improvements to poultry health and crop production on diets and growth of 503 randomly selected children from eight rural communities in Manyoni District in central Tanzania. Using an explanatory sequential design, the quantitative phase of data collection was conducted between May 2014 and May 2016, comprising six monthly structured questionnaires, four monthly household‐level documentation of chicken and egg consumption, and fortnightly records of children's breastfeeding status. The subsequent qualitative phase involved in‐depth interviews with a subset of 39 mothers in October 2016. Breastfeeding was almost universal (96.8%) and of long duration (mean = 21.7 months,SD = 3.6), but early initiation of complementary feeding was also common (74.4%; mean = 4.0 months,SD = 1.8), overwhelmingly driven by maternal perceptions of insufficient milk supply (95.0%). Chicken and eggs were infrequently eaten, but close associations between maternal and child consumption patterns (p < .001) suggest the potential for strategies that increase household‐level consumption to bring nutritional benefits to young children.

Animal-source foods (ASF) have the potential to enhance the nutritional adequacy of cereal-based diets in low- and middle-income countries, through the provision of high-quality protein and bioavailable micronutrients. The development of guidelines for including ASF in local diets requires an understanding of the nutrient content of available resources. This article reviews food composition tables (FCT) used in sub-Saharan Africa, examining the spectrum of ASF reported and exploring data sources for each reference. Compositional data are shown to be derived from a small number of existing data sets from analyses conducted largely in high-income nations, often many decades previously. There are limitations in using such values, which represent the products of intensively raised animals of commercial breeds, as a reference in resource-poor settings where indigenous breed livestock are commonly reared in low-input production systems, on mineral-deficient soils and not receiving nutritionally balanced feed. The FCT examined also revealed a lack of data on the full spectrum of ASF, including offal and wild foods, which correspond to local food preferences and represent valuable dietary resources in food-deficient settings. Using poultry products as an example, comparisons are made between compositional data from three high-income nations, and potential implications of differences in the published values for micronutrients of public health significance, including Fe, folate and vitamin A, are discussed. It is important that those working on nutritional interventions and on developing dietary recommendations for resource-poor settings understand the limitations of current food composition data and that opportunities to improve existing resources are more actively explored and supported.