Ebenezer Kwabena Yamoa

Objectives: Low- and middle-income countries are challenged by high rates of food and nutrition insecurity. Suboptimal production, distribution, availability, and affordability of nutritious foods, especially at the local level, disproportionately affect nutritionally vulnerable groups. We identified nutrient deficiencies among women, young children, and adolescents as part of the NutriShed project implemented in Ghana. Design: Using a survey design, dietary behavior was assessed by administering an interactive multi-pass 24-hour recall tool. Setting: This study was conducted in Asesewa and Takoradi, in GhanaParticipants: Survey participants were adult women (18 years and older), young children (2–5 years) and adolescents (12–18 years) living in the two communities. Main outcome measures: Data from 581 participants, comprising 187 women, 197 children, and 197 adolescents were analyzed. Estimated Average Requirements (EAR) were determined for each nutrient using data on the type and quantity of food consumed during the 24-hour period preceding the recall. The median EAR was compared to reference EAR for each nutrient. Limiting nutrients were identified based on age-sex specific cut-off reference EAR values.Results: Calcium, folic acid, and riboflavin were identified as key limiting micronutrients in the diets of women, children, and adolescents in both Asesewa and Takoradi. However, inadequacy for the three limiting nutrients was more prevalent in Asesewa than in Takoradi.Conclusions: The findings highlight the need for targeted strategies that address suboptimal diets in urban communities in Ghana. Particularly, strategies are needed to address nutrient inadequacy among women and adolescents, in Asesewa, who may be at greater risk.

As urbanization accelerates, towns and cities worldwide face the challenge of planning nutrition security for their growing populations, in the context of their local food systems. Urban food systems in low- and middle-income countries are often complex, with large geospatial spread in the flow of foods. This complexity is compounded by the frequently informal nature of the markets and value chains governing flows, and the changing climate. Urban planners could benefit from tools to plan their nutrition security in such settings, but there is little research on such methods and tools.Our study proposes a novel approach, NutriShed, to map the origins and flows of key micronutrients, and illustrates its application in two Ghanaian cities: Takoradi and Assesewa. Nutrished involves objectively identifying vulnerabilities within nutrient supply chains and food systems infrastructure as a means to unravel the flow of food into and through cities. The NutriShed approach is guided by a framework designed to track the spatial flows of essential nutrients into and out of the study communities, focusing on nutrient gaps, regional production deficits, and food system vulnerabilities. The NutriShed approach is structured in several stages: Stage I identifies nutrient gaps using dietary surveys of vulnerable population sub-groups. In stage II, quantifies nutrient flows by surveying food markets, traders, and food transport systems. Stage III utilizes geospatial tools to map nutrient flows and assess food system infrastructure and climate vulnerabilities. Stage IV examines nutrient flow vulnerabilities in relation to road density, climate risks, and infrastructure usage. Stage V identifies nutrition-sensitive interventions using GIS techniques to propose strategies for enhancing nutrient supply and bolstering food system resilience. Throughout the process, it is important to engage with relevant stakeholders to ensure participation and uptake of findings for planning and implementation.