PARTNERSHIPS FOR HEALTHY DIETS AND NUTRITION IN URBAN AFRICAN FOOD SYSTEMS – EVIDENCE AND STRATEGIES Technical Report on Qualitative Data Collection (Focus Group Discussions) Pictures of the participants discussing: Picture by Fongar A/Alliance of Bioversity International and CIAT December 2020 by Andrea Fongar1, Beatrice Ekesa1, Youri Dijkxhoorn2, and Vincent Linderhof2 1The Alliance of Bioversity International and CIAT 2Wageningen Economic Research Kampala, 09 December 2020 Technical Report on qualitative data collection – December 2020, Kampala Uganda Executive Summary Poverty and malnutrition hotspots are moving from rural to urban communities, as Africa is urbanizing. The population in cities and countries are faced with the coexistence of overweight, obesity, micronutrient deficiency and undernourishment, the so-called ‘triple’ burden of malnutrition. The question is Who is and Why are they affected remains unclear. The project ‘NOURICITY’ seeks to answer these questions by engaging in a chain of multi- stakeholder participatory events and fieldwork meant to deliver a blueprint for partnerships seeking to improve urban nutrition in Africa. The urban population in Uganda increased from 7.4 million in 2014 to 9.4 million in 2017 attributed to the establishment of new urban areas, rural-urban migration and population growth. Still, countrywide 26% of the population are food insecure and malnutrition in all its form is persistent. The project aims at improving urban nutrition in Uganda by bridging knowledge gaps about the systemic and individual drivers of the urban food systems and by developing partnerships to improve nutrition in urban areas. Therefore, a qualitative data collection exercise to gather information about dietary knowledge, food environment, food sources, food choices and key information sources was carried out in Kanyanya parish, Kawempe division. Kanyanya parish has around 26,800 inhabitants and is sub-divided into five zones as its demographic characteristics are similar to those of Kawempe division and Kampala city. The data collection through focus group discussion (FGD) guides the survey and associated questionnaires for measuring the effectiveness of interventions for healthier diets. With the support of a facilitator and a note- taker, FGDs took place at three purposively selected meeting venues in three zones in February 2020. Working closely with the zone leader, for each discussion, the total participants were 30 community members (10 women, 10 men and 10 youth). In total, 85 participants (34 women, 24, men and 27 youth) from the five zones of the parish participated at the 3-day activity. Considering the sub-groups of women, men and youths’ data was collected from 9 FGDs (3 women, 3 men and 3 youth). Agreeing on operational definitions such as healthy food and food safety by the participants was a challenge as the opinions were quite diverse. As healthy food participants mentioned the following statements: balanced diets, bodybuilding food, and foods with nutrients like vitamins. Key food safety concerns were storage and preparation of food, but also the preservation of food was mentioned. Concerning the food environment, the majority of the community has access to tap water (70%), which is used as drinking water. Over 80% use pit latrines as sanitation facility, although the conditions vary substantially. Improper disposal of human refuse and garbage was reported in all zones. Nearly all groups mentioned the absence of a designated garbage collection space, but collection services from private companies and governmental (KCCA) are available at a cost. Findings showed that decisions about food choice are positively influenced by price, availability, taste and preferences. In return, price, lack of cash and the availability of healthy food items are limiting factors. As the four most important factors which determine food availability price, availability of roads and traders and demand was indicated. Most of the Page 2 of 38 Technical Report on qualitative data collection – December 2020, Kampala Uganda parish members use food stalls as the main food outlet and the traditional markets are used by almost everyone. The biggest, but also most distant market (timewise) is Kalerwe to each of the zone, on average 48 minutes by foot. About nine other markets were mentioned by the participants. As the main source of information and news, 100% of the groups/participants named the community radio or radio, as well as television. Community meetings and leaders as a source of information were named by 44%, 33% indicated a smartphone and 22% social medial, newspapers or rumours. The main identified challenges within the food system in the parish Kanyanya include elements of the food supply chain, such as post-harvest losses and poor infrastructure and transport of food towards the community/parish. Challenges within the food environment of the community include issues around food safety, the availability and affordability of the preferred and healthy food items. Additionally, the missing knowledge and awareness of healthy food and waste management influence the component consumer behaviour and the external drivers of the food system. The area suffers from flooding and poor waste and sanitation practices. The named challenges will be further investigated and used to establish and design possible interventions for the next project steps. Page 3 of 38 Technical Report on qualitative data collection – December 2020, Kampala Uganda Table of Content Executive Summary ................................................................................................................... 2 Table of Content ........................................................................................................................ 4 Table of Tables ........................................................................................................................... 5 Table of Appendix ...................................................................................................................... 5 List of Abbreviations .................................................................................................................. 6 Acknowledgement ..................................................................................................................... 6 1. Introduction ........................................................................................................................ 7 1.1. Objectives .................................................................................................................... 8 2. Methods .............................................................................................................................. 8 2.1. Selection and description of the study area .............................................................. 8 2.2. Participants and data collection ............................................................................... 10 2.3. Recruitment of enumerators and training ............................................................... 11 2.4. Data cleaning, reporting and coding ........................................................................ 11 3. Results ............................................................................................................................... 11 3.1. General issues ........................................................................................................... 12 3.2. Dietary knowledge and home food environment ................................................... 13 3.3. Food choice ............................................................................................................... 17 3.4. Food source ............................................................................................................... 19 3.5. Information source, perception ............................................................................... 20 4. Conclusion......................................................................................................................... 20 5. References ........................................................................................................................ 22 Appendix .................................................................................................................................. 23 Page 4 of 38 Technical Report on qualitative data collection – December 2020, Kampala Uganda Table of Tables Table 1 Characteristics of Kanyanya parish, Kawempe division and Kampala city .................... 9 Table 2 Timetable, zone and venue of the FGD ....................................................................... 10 Table 3 Disaggregated numbers of participants of the nine FGD ............................................ 12 Table 4 Healthy food definitions by the different groups and zones ...................................... 13 Table 5 Food safety definitions by the different groups and zones ........................................ 15 Table 6 Main source of drinking water per zone and sub-group ............................................. 16 Table 7 Perception of sanitation facilities in the community .................................................. 16 Table 8 Common food items named according to food group classification .......................... 19 Table 9 Main food outlets of the communities and estimated proportion of usage .............. 19 Table 10 Source of information regarding food safety, health and